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MB-5209 - USA (Florida) - Management Services for Self-Funded Group Health Insurance and Prescription Benefit Program - Deadline May 20,2021

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5209

Government Authority located in Florida; USA based organization looking for management services for self-funded group health insurance and prescription benefit program.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide management services for self-funded group health insurance and prescription benefit program.
- Provide banking arrangements for claims funding that are in accordance with the District’s standards,
- Cooperate with the managed care organizations and the UR firms in resolving discrepancies for proper payment of benefits when compliance dictates the use of one or both programs,
- Conduct semi-annual internal audits for claim accuracy and occurrence of mis payments. Results must be reported to the District within 10 business days from the end of the reporting period,
- Provide COBRA and HIPAA administration and pay COBRA beneficiary claims,
- Administer the plan on a detailed billing remittance basis by division, separated by active employees, retirees, and COBRA beneficiaries,
- Retain medical claims history online for a minimum of 24 months,
- Provide claims fiduciary services. Establish claim denial and grievance procedures that are clearly communicated to members. Grievance procedures must be consistent with all applicable federal and state law, rule, and regulations, including Healthcare reform,
(2) All questions must be submitted no later than May 6,2021.

[C] Eligibility:

Onshore (US Organizations Only)

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

[E] Proposal Submission:

Response can be submitted digitally via Email or Online.

Expiry Date : Thursday, 20 May, 2021

Question Answer Deadline : Thursday, 6 May, 2021

Category : Medical Billing and Coding

Country : USA

State : Florida

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