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MB-4145 - USA (Texas) - Third Party Administrative Services - Deadline June 5,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4145

Government Authority located in Texas; USA based organization looking for expert vendor for third party administrative services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide third party administrative services.
- The selected carrier shall be responsible for all claims incurred on/or after November 1, 2020. It is imperative that any exclusion, limitations or any other deviation be clearly outlined and discussed.
- Maintain a fully automated claims adjudication system in compliance with electronic transmission standards and security requirements and all other regulations as required by HIPAA, provide WEB access to plan participants that allows for claim status and offers various customer service functions.
- Maintain records and managements reports, including claims and accounting information as required by the contract.
- Provide timely response to inquiries from plan participants and providers regarding eligibility and status of claim, correspondence, payment and any other information requested by such parties in a manner that will limit the City’s involvement in day-to-day inquiries.
- Prepare and review with the Human Resources staff the summary plan documents and
enrollment materials. In addition, print summary plan documents and enrollment materials, claim forms, and any other communication material as required by the contract.
- If respondent uses ID cards, the City prefers respondent mail identification cards to the
employee’s home address.
- Deliver utilization reports. The City and its consultants need to be able to access standard reports online, preferably in excel format.
- Provide online access to additional standard or ad hoc reports as needed by the City. If a specific report cannot be generated online, prepare and provide such to the City electronically.
- Meet with representatives of the city’s department as often as deemed
necessary by the City.
- Attend annual Open Enrollment meetings. The Respondent may be required to give employee’s
additional information on plan types and give oral presentations about types of plans offered to
City employees.
(2) All the questions must be submitted no later than May 22, 2020  

[C] Eligibility:

Onshore (US organization Only)

[D] Work Performance:

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

Expiry Date : Friday, 5 June, 2020

Question Answer Deadline : Friday, 22 May, 2020

Category : Medical Billing and Coding

Country : USA

State : Texas

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