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MB-5953 - USA (Washington) - Transfer Diagnosis-Related Group and Medicare Advantage Indirect Medical Education Services - Deadline February 4,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5953

Government Authority located in Washington; USA based organization looking for expert vendor for transfer diagnosis-related group and Medicare advantage indirect medical education services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide transfer diagnosis-related group and Medicare advantage indirect medical education services
- Medicine Patient Financial Services Department will select one Contractor to evaluate inpatient claims for Transfer DRG Payments and Medicare Advantage IME Billing
- Transfer DRG Payments (TDRG): when patients are transferred from an acute care setting to another level of care, paid on a PPS basis, the acute care DRG is reduced for the hospital’s length of stay as compared to the average length of stay for that DRG. Hospitals often code claims
based on recommended discharge planning; however, the patients do not always enter the next level of care (HH/SNF). This results in unnecessarily reduced hospital payments
- Medicare Advantage IME Billing (IME): Fee-for-service Medicare reimburses the Indirect Medical Education (IME) amounts for beneficiaries in managed care plans. Hospitals are required to bill the claim to the managed care plan for payment of the claim minus IME and Medicare FFS for the IME payment. Managed care plan naming conventions do not always clearly identify that the
plan is a Medicare Advantage plan and shadow billing opportunities are missed.
(2) All the questions must be submitted no later than January 14, 2022.

[C] Eligibility:

Onshore (USA organization Only)

[D] Work Performance:

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

Expiry Date : Friday, 4 February, 2022

Question Answer Deadline : Friday, 14 January, 2022

Category : Medical Billing and Coding

Country : USA

State : Washington

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