MB-4133 - USA (Iowa) - Pharmacy Claims Processing Service - Deadline May 14,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4133

Government Authority located in Iowa; USA based organization looking for expert vendor for pharmacy claims processing service.

[A] Budget: Looking For Proposal

[B] Scope of Service:

(1) Vendor needs to provide pharmacy claims processing service
- To reimburse pharmacies for 100% of the cost of naloxone plus a dispensing fee for the dispensation of naloxone,
- Provide BIN/PCN information for pharmacies to utilize in order to bill for naloxone dispensings.
- Provide network access to all in-state, Iowa-licensed general or limited-use pharmacies that dispense prescription drugs to outpatients. 
- Auto-enroll patients and auto-generate a member ID upon submission of claims by the pharmacy.
Receive and process claims (and claim reversals) submitted by pharmacies,
- Provide immediate response to pharmacies submitting claims with denial information (including, reason for denial and steps for override, if applicable), or claim reimbursement information,
- Within 7 (seven) days of receiving claim information, reimburse pharmacies for the cost of product dispensed at the current State Medicaid rate for naloxone products plus a $20 dispensing fee,
- The claims processor will assist the state with ensuring pharmacies, pharmacists, and pharmacy technicians are aware of the program and have the necessary information to submit claims for naloxone dispensation,
- The Claim processor will keep track of available funds for the program based on claims processed,
- The claims processor may not assess any fees, penalties on participating pharmacies.
- The claims processor may not promote any specific pharmacy to the general public.
(2) All questions must be submitted no later than May 7, 2020.

[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 : Thursday, 14 May, 2020

Question Answer Deadline : Thursday, 7 May, 2020

Category : Medical Billing and Coding, Pharmaceutical, Pharmacy & Related Services

Country : USA

State : Iowa

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