MB-5930 - USA (New Hampshire) - Workers Compensation Third Party Claims Administration and Related Services - Deadline January 21,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5930

Government authority located in New Hampshire, USA; based organization looking for expert vendor for workers compensation third party claims administration and related services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide workers compensation third party claims administration and related claims management services for claims management, litigation management, disability management, loss control, Medicare Secondary Payer mandatory reporting, managed care, risk management information services and other related services.
- administrative fee is a flat fee for claims management, loss control, managed care, legal defense, Medicare Secondary Payer mandatory reporting, information systems and other related service
- to investigate, analyze and track losses as well as proactively identify potential opportunities for improvement and provide recommendations to prevent losses
- Ensure a seamless transition in indemnity payments and medical treatment/managed care
- Immediate prioritization of claims in active litigation
- Claims Administration includes but is not limited to: claims adjusting services including compensability investigation, reserving practices, claim reviews, medical care and cost control, disability management, litigation management and payment control
- All claims, including medical only and lost time claims, shall be investigated to determine compensability and include contact with the applicable agency personnel to verify accident details and resolve compensability issues
- Review and adjustment of medical bills for compliance with fee schedules, usual and customary limitations, treatment plans and clinical logic, as well as jurisdictional rules and requirements regarding medical necessity, casualty, and precertification; includes adjustments negotiated with providers regarding particular charges and elimination of duplicate bills, bills for non-covered services and bills disallowed through peer review
- Customized claim detail with ability to add valuation date
- IT system with the ability to create and run reports
- ability to log on to the vendor’s computer portal system to report claims and run more basic, agency specific standard claim reports.
(2) All questions must be submitted no later than December 30, 2021.

[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 : Friday, 21 January, 2022

Question Answer Deadline : Thursday, 30 December, 2021

Category : Medical Billing and Coding

Country : USA

State : New Hampshire

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