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MB-4506 - USA (Florida) - Workers Compensation Third-Party Administrator Services - Deadline September 30,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4506

Government Authority located in Florida; USA based organization looking for expert vendor for workers compensation third-party administrator services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide workers compensation third-party administrator services to service the city’s self-insured workers’ compensation claims in accordance with F.S. 440, applicable state administrative code, applicable city code, city administrative regulation (s), resolutions and collective bargaining agreements and services provided by the successful proposer will also include administration of indemnity, medical care and treatment rendered by external medical providers and other services usual and customary to workers’ compensation claims administration.
- Assume the complete handling of all prior claims as well as new claims originating from the effective date of this contract.
- It is required that claims data and any and all other documentation associated with all current and prior claims be transferred into claims administrator’s computer information system to ensure future city loss runs will contain a complete history of all claim years.
- Claims administrator shall review all notices of injury received from the city, investigate, take recorded statements, accept or deny claim and medically manage claim in accordance with state statute 440.
- Claims administrator shall conduct essential investigation, including scene investigations and claimant contact on all reported claims.
- Coordinate medical treatment for all claims by promptly setting appointments and authorizing necessary physician referrals and treatments.
- Employ the services of outside professionals to assist in investigations, claims adjustments and defense of claims. Such services may include, but shall not be limited to surveillance, rehabilitation, claims specific nurse case manager and subject matter experts.
- Pay all claims and expenses in a timely fashion from the city’s loss fund account, which shall be maintained by the claims administrator.
- Fees, interest and civil penalties required due to late payments or adjuster mishandling shall be absorbed by the claims administrator, unless the error is solely caused by late reporting or misreporting of information by the city.
- Pursue all possibilities for subrogation, liens, recovery from the state and excess carriers.
- The city must approve any sum negotiated for recovery of third party liens.
- Administrator shall submit all state and federal filings; including form 1099 and all reporting required by the Medicare secondary payer provisions; prepare, maintain and file statistical information required by rating bureaus and appropriate state agencies.
- Keep city’s risk management staff informed of regulatory or industry changes affecting the workers’ compensation program.
- Prepare and maintain electronic files as necessary for legal defense, subrogation action or other proceedings.
- Develop and follow appropriate written policies to address employee’s request for a second opinion, questions on medical evaluation and grievance.
(2) All questions must be submitted no later than September 11, 2020.
(3) The term of contract will be three years.

[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, 30 September, 2020

Question Answer Deadline : Friday, 11 September, 2020

Category : Medical Billing and Coding

Country : USA

State : Florida

Cost to Download This RFP Document : $ 5

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