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MB-4255 - USA (Ohio) - Worker Compensation Third Party Administrator Services - Deadline June 22,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4255

Government Authority located in Ohio; USA based organization looking for expert vendor for worker compensation third party administrator services.

[A] Budget: Looking for proposal

[B] Scope of Service:

Vendor needs to provide worker compensation third party administrator services
• Providing professional consulting services to the District.
• Maintaining an electronic/computer record of all claims filed with the District.
o Including the transfer of all past records that need to be maintained.
• Filing all required documents with the Ohio Bureau of Workers’ Compensation as directed by the District’s Workers’ Compensation Administrator.
• Issuing appropriate medical payments in claims as directed by the District weekly.
• Issuing Explanation of Benefits in connection with payments to medical providers.
• Calculating and issuing indemnity payments to injured workers as directed by the District.
• Providing monthly, quarterly, and annual reports including, but not limited to, current payments, historical totals, reserves, detail loss runs, SI-40 and other required expenditures.
• Arranging Independent Medical Examinations (IME) with occupational specialists in the area related to the allowed condition(s) in claims.
• Arranging medical records reviews as appropriate.
• Providing on-line access to the District’s claims, data and records
• Providing metrics with comparisons with other comparable wastewater treatment facilities both locally and national. Including but not limited to:
o Days off work by nature of injury, body part or diagnosis code
o Occupation category, i.e. maintenance, plant operation, administrative
o Average medical cost per employee o Average indemnity cost per employee.
• Providing Medicare Reporting Services o Process and submit appropriate MMSEA Section [1] Medicare Secondary Payer Mandatory Reports through the COBSW as the District Account Designee. • Providing attorney representation at all C92 and Treatment/Testing1 related hearings. All other hearings, including allowance requests, additional allowance requests, and temporary total disability benefit hearings will be handled by legal counsel designated by the District, at the District’s expense. The District reserves the right to forward any hearing to legal counsel designated by the District, including C92 and Treatment/Testing related hearings, and, if the District choses to do so, such representation will occur at the District’s expense. However, at all times, the Successful Proposer must coordinate with the District’s Legal Department and legal counsel designated by the District. This coordination includes timely responding to questions, requests for information, and other duties necessary to represent the District, as determined by the District.

[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 : Monday, 22 June, 2020

Category : Medical Billing and Coding

Country : USA

State : Ohio

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