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MB-4059 - USA (South Dakota) - Third Party Claims Data Matching Services - Deadline May 5,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4059

Government Authority located in South Dakota; USA based organization looking for expert vendor for third party claims data matching services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third party claims data matching services to identify third parties who are responsible for payment of the health, medical care, and other benefits available under the department’s programs to the government authority located in San Antonio, TX.
- The vendor will demonstrate their ability to conduct a national match between insurer information and the departments file using a format agreeable to the insurer and the vendor.
- Successful data matching is limited to circumstances where insurance coverage is located for a client during the period of time they were a Medicaid-eligible recipient
- Vendor is responsible for all costs associate with claims submissions.
-  Vendor will be responsible for notifying the department of any HIPPA-required information that is missing prior to submitting the claims to insurers.
- Vendor will verify appropriate insurer coverage exists prior to claims submission. Verification may be telephonic, web-based, electronic mail, or any other method agreed upon between the vendor and the department.    
- Vendor will demonstrate the ability to report: data validation within one week, the number of claims received, the number of claims submitted to appropriate insurers, and other information to be submitted to department and provide suggested format and intervals.
- Vendor will provide verification that claims were submitted to insurers.
(2) All questions must be submitted no later than April 21, 2020.
(3) A letter of intent to respond will be due on April 14, 2020.
(4) Contract term will be three years.

[C] Eligibility:

- Onshore (USA Organization Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Tuesday, 5 May, 2020

Question Answer Deadline : Tuesday, 21 April, 2020

Category : Medical Billing and Coding

Country : USA

State : South Dakota

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