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MB-5876 - USA (Jackson, Mississippi) - Third Party Administration Services - Deadline January 12,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5876

Government Authority located in Jackson, Mississippi; USA based organization looking for expert vendor for third party administration services.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide third party administration (TPA) services to the government authority located in Jackson, MS.
1. Dedicated account service
- Writing to the board with the resolution of the issue or an explanation of when the issue can be resolved, with a defined timetable, within an average (as measured on an annual basis) of two business days.
2. Provider network manager
- Network manager who will consistently evaluate and manage the provider network, including recruiting, negotiating, and contracting with providers on behalf of the Plan and keep OI informed. The provider network manager shall analyze claims and network and non-network performance and shall meet with OI staff at least quarterly to review network activities.
3. Client service representative
- Representative must maintain records of all inquiries or complaints and the disposition, including but not limited to, date of inquiry or complaint received; party making inquiry of complaint; description of inquiry or complaint; disposition and date of disposition.
4. Welcome packets and identification (ID) card
- Responsible for producing welcome packets and ID cards and for mailing these items to the participant’s home address.  The TPA will be responsible for mailing, within five days of receipt of eligibility, the welcome packets and ID cards.
5. Vendor system interface
- Responsible for the electronic exchange of claims, provider and eligibility files and related information to and from the Board vendors.
6. Online access for board staff
- Online access must allow for viewable inquiry only including historical eligibility and claims information.
7. Claims administration
- Responsible for maintaining a system for timely and accurate processing, adjudicating, and recording of claims for benefits in accordance with the current plan document, any applicable requirements established by the board and any modifications or changes as communicated by the Board or as required by federal or state law.
(2) All question must be submitted no later than December 9, 2021.
(3) Contract term will be two years.

[C] Eligibility:

Onshore (USA organization Only)

[D] Work Performance:

Performance of the work will be offsite.

Expiry Date : Wednesday, 12 January, 2022

Question Answer Deadline : Thursday, 9 December, 2021

Category : Medical Billing and Coding

Country : USA

State : Mississippi

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