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MB-4159 - USA (Texas) - Workers Compensation Third Party Administration Service - Deadline June 10,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4159

Government Authority located in Texas; USA based organization looking for expert vendor for workers compensation third party administration service.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide workers compensation third party administration service.
- The TPA is expected to provide comprehensive documentation for all files; including documentation of recorded statements (or lack of).
- A contribution comment should be placed in all files, regardless of whether it applies or not to ensure that the reviewer understands the issue has been addressed.
- Reserving - comments in the file should include claim facts such as age, pre-existing conditions, previous injuries, and any other problems and conditions that would prolong the claim longer than expected.
- Peer reviews should be obtained prior to accepting new conditions and surgeries that were not in an initial diagnosis.
- Adjusters are to document file activity to bring files to closure and communicate with the insured for any questionable claims to ensure proper handling.
- Subrogation is to be properly documented along with ISO claim search.
- All benefits are to be issued timely within the state allowed deadline to avoid penalties from the state.
- Compensability of claims are to be properly documented in all files.
- Files are to be consistently managed by adjuster and claims best practices are to be adequately applied.
(2) All questions must be submitted no later than May 19, 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 : Wednesday, 10 June, 2020

Question Answer Deadline : Tuesday, 19 May, 2020

Category : Medical Billing and Coding

Country : USA

State : Texas

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