MB-4197 - USA (California) - Third Party Administrative Services and Utilization Review Program - Deadline June 25,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4197

Government Authority located in California; USA based organization looking for expert vendor for third party administrative services and utilization review program.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third party administrative services and utilization review program.
- Third-Party Administrative Services provide Plan Documents Preparation, Enrollment Services; paper and online, Member Services, for plan members, Client Services, for plan administrators, Plan Implementation and Set-up, Internal audits; implementation and ongoing, Coordination of Benefits, Subrogation, identify any external vendors utilized, Savings negotiation with non-network providers, identify any external vendors utilized, Management Reports – Claims History – Customized Reporting, Member online portal, HIPAA – Security, Mobile app, Client online portal, Separate fee structures for non-standard services and Claim integration with current medical network provider and Rx provider, including any fees.
- Utilization Management Program including but not limited to triggers used to review and authorize services/treatment, ongoing review of services/treatment, cost savings, integration with other ur programs, networks utilized, external vendors, prior notification, prior authorization, continuing stay review and discharge planning, large case management, maternity management programs, weight management programs, depression management programs, predictive modelling, chronic disease management; dialysis, cancer, cardiac, peer to peer review and wellness programs.
(2) All question must be submitted no later than June 15, 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.

[E] Proposal Submission:

Response should be submitted physically (courier or post).

Expiry Date : Thursday, 25 June, 2020

Question Answer Deadline : Monday, 15 June, 2020

Category : Medical Billing and Coding

Country : USA

State : Illinois

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