MB-4264 - USA (Massachusetts) - Third Party Administrator Consultant Services - Deadline June 18,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4264

Government Authority located in Massachusetts; USA based organization looking for expert vendor for third party administrator consultant services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide workers’ compensation expertise and guidance for a term of five years in the areas of claims administration, account management, claims, medical case management and statistical reporting.
- Assist agency with fulfilling its obligations under the commonwealth’s workers’ compensation act as deemed necessary and appropriate.
- The Proposer shall provide one dedicated account manager to ensure that all matters related to customer service, claims case management, medical case management, loss control, utilization review, finance and technology are well maintained to agency satisfaction.
- Keep up-to-date on trends and changes with the workers’ compensation law that may directly affect the WC program.
- Ensure compliance with 452 CMR 6.00-Utlization Review and Quality Assessment. The Proposer shall indicate how they propose to meet this requirement. If this service will be subcontracted to a vendor, the vendor and their proposed fee schedule must be identified.
- The Proposer shall be responsible for putting the WC excess carrier on notice, as policy requires.
- The Proposer shall complete a 3-point contact on all claims within 24 hours of receipt of the Notice of Injury to ensure that the claim is triaged to the proper claims team member for further handling.
- All active claims should be tracked on a 30-day diary. Notes in the database that can be viewed, should accurately reflect the current status of the claim and detail proactive steps that will be taken by the claims case manager and medical case manager to bring the file to resolution.
- The claims case manager and medical case manager should be available for monthly claim reviews the first 6 months of the transition phase and quarterly thereafter; if deemed necessary.
(2) All the questions must be submitted no later than June 16, 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 : Thursday, 18 June, 2020

Question Answer Deadline : Tuesday, 16 June, 2020

Category : Medical Billing and Coding

Country : USA

State : Massachusetts

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