MB-5222 - USA (South Carolina) - Workers Compensation Third Party Administration Service - Deadline May 19,2021

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5222

Government Authority located in South Carolina; USA based organization looking for expert vendor for workers compensation third party administration service.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide the management of workers compensation claims in a K-12, public entity, self-insured program.
- Provide all aspects of workers compensation claim administration from first report of injury until closure of claim, including for reopened claims until closure. This includes but is not limited to the following.
a) Receiving online, fax or telephonic report of injury and three-point contact with employee, employer (reporting supervisor or designated SDGC contact, and medical provider).
b) Prompt review of claims for compensability or denial, and closure of compensable claims as soon as possible.
c) Claim investigations if necessary.
d) Required reporting or filings with authorities having jurisdiction, such as Section 111 reporting, filing of state forms, etc.
e) Assignment of defense counsel, nurse case management, surveillance, or other services when appropriate and with necessary consultation with and approval of SDGC.
f) Establish claim reserves and notify insured of reserve changes greater than $50,000
- In consultation with SDGC create and maintain a written Claim Administration Manual specifically for SDGC outlining the claim administration guidelines and performance standards. Provide a copy to SDGC.
- Respond to SDGC calls and requests within 24 hours or as agreed to as part of claim administration guidelines.
- Ensure all communications and documents are accurate and professional.
- Annual claim review meeting to review all lost time claims greater than $10,000 or claims agreed upon by SDGC and TPA.
- Annual Stewardship Meeting.
(2) All the questions must be submitted no later than May 5, 2021

[C] Eligibility:

- Onshore (US Organization Only);

[D] Work Performance:

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

Expiry Date : Wednesday, 19 May, 2021

Question Answer Deadline : Wednesday, 5 May, 2021

Category : Medical Billing and Coding

Country : USA

State : South Carolina

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