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MB-5194 - USA (Illinois) - Worker Compensation Administration Service - Deadline May 4,2021

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5194

Government Authority located in Illinois; USA based organization looking for expert vendor for worker compensation administration service.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide worker compensation administration service.
1. Claims Handling Service
- The contractor shall provide the district with necessary services in the handling and resolution of worker’s compensation claims. The contractor shall pay medical bills and loss wage payments, as required by the state workers compensation commission, and submit an invoice weekly to the district for expense disbursement and reimbursement of those payments.
- Review and process all industrial cases in accordance with the requirements of the state workers compensation commission. Determine compensability of injuries and illness in accordance with the state workers compensation commission act.
- Determine eligibility for and authorize payment of temporary total disability compensation in coordination with medical advice and rehabilitation efforts.
- Maintain on each case reserves for all anticipated benefits and expenses.
- Work with legal counsel to defend contested cases.
- Interface with the excess workers compensation carrier.
2. Risk Management Services - If able to provide risk management services, please provide a description of your program and associated costs.
3. Medical Control Services
- Arrange for discounts beyond the state workers compensation fee schedule as allowed by law to help reduce medical costs. Monitor closely any changes in the fee schedule to maximize cost savings. All such contracts or preferred provider organizations shall be reviewed by the district.
- Maintain and monitor a duly licensed Utilization Review firm to assist in cost reduction and cost savings.
- Assist in establishing standards for the evaluation of physical capacity of injured employees to return to work and provide guidance in the application of standards to individual cases.
- Review all software prior to final agreement.
4. Claims Database Services
- Provide electronic access to the claims database on active and inactive claims.
- Provide weekly summaries of all checks issued for medical and indemnity claims including expenses in electronic format.
- Provide monthly loss runs with claims data in electronic format.
- Provide 1099-Forms for each medical provider as required by IRS regulations.
- Provide a reporting system that the District can access to generate specific data reports into Excel and Word format.
- Provide standard reports that can be automatically generated.
5. Loss Prevention
- Flexibility and availability are key in working with our multiple locations.
- Suggestions and help in implementation of loss prevention policy and procedure.
6. Electronic
- File claims electronically.
- Access to claims information.
- Report generating capabilities.
(2) Contract term 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 : Tuesday, 4 May, 2021

Category : Medical Billing and Coding

Country : USA

State : Illinois

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