MB-5974 - USA (Indiana) - All Payer Claims Database Administrator Services - Deadline April 4,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-5974

Government Authority located in Indiana; USA based organization looking for expert vendor for all payer claims database administrator services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide all payer claims database administrator services
- A large-scale database that collects and aggregates significant amounts of data, including but not limited to, eligibility data, medical claims, pharmacy prescription drug claims, non-fee-for-service information, and provider data
- To facilitate the following:
- Identifying health care needs and informing health care policy.
- Comparing costs between various treatment settings and approaches.
- Providing information to consumers and purchasers of health care.
- Improving the quality and affordability of patient health care and health care coverage
- Administrator Duties and Responsibilities:
- Prioritizing security and protection of personal identifiable information and protected health information data, considering the volume and the sensitivity of the data hosted within the data warehouse,
- Performing data analytics and providing analytical tools and access to the end users;
- Providing datasets and reports;
- Furnishing data access for State-approved users;
- Providing a consumer facing health care cost and quality decision support website and mobile application that are free to use and allow the public to view the average negotiated charges by each health carrier for specific health care services provided by an individual health care provider, as well as the quality metrics for facilities and health care providers for specific services
- Design, Development, and Implementation:
- In order to design, develop, and implement the System, the Administrator should utilize a State-approved methodology
- Data Security and Privacy:
- Are robust, extensible, and forward looking in design;
- Use modern technologies that can migrate to the technologies and data submission methods of tomorrow;
- Have flexibility to handle future person and health care provider related linkage and shared services with other health data systems;
- Are efficient and effective;
- Provide quality, consistency, and accessibility of information;
- Are protective of patient privacy
- Data Collection Services:
- Interact on a continuing basis with Submitters, insurers, health maintenance organizations, third party administrators, pharmacy benefit managers, and other entities managing claims to detect and solve problems related to regulations and the claims submission process; this interaction may include email or phone communications, written materials, website development, FAQs, and annual meetings
- Data Consolidation Services:
- Consolidate and enhance data for analytic use. Requests for data will most likely be filtered by the State, but the Administrator may be asked to provide input on a request.
- Produce a Data Dictionary containing detailed specifications and documentation for the consolidated data sets, including description of files, tables, data elements, codes, and completeness of elements
- Data Production and Consumer Websites:
- Create and maintain a consumer website where consumers can find price and quality information
- Maintain public-facing records of all releasable data requests on website
- Produce, maintain, and publish on website complete documentation of the data sets including logic used to transform data and create derived data elements
- Be responsible for notifying all data recipients of any extract, created for either public use or research purposes that was later identified to have issues, either due to Administrator or Submitter error, that significantly affects its usefulness and/or completeness, regardless of the cause of the issues
- Maintenance & Support:
- System Maintenance. The Administrator must plan and execute tasks required to ensure that all solution components stay relevant and useable. This support includes resolution of technical issues, application of patches, preventative maintenance, planning/execution of upgrades, and regular performance monitoring and performance reporting.
(2) All the questions must be submitted no later than February 1, 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 : Monday, 4 April, 2022

Question Answer Deadline : Tuesday, 1 February, 2022

Category : Medical Billing and Coding, Web Design and Development

Country : USA

State : Indiana

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