MB-6528 - USA (Texas) - Compliance and Cost Containment Strategy and Management Service - Deadline July 21,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-6528

Government Authority located in Texas; USA based organization looking for expert vendor for compliance and cost containment strategy and management service.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide compliance and cost containment strategy and management service of healthcare costs categories.
- Outline the experience of your compliance analysis and medical claims review for Public Agencies in the US.
- Provide the savings based on 20,000 participants of self-insured plans.
- Ability to conduct compliance analysis and claims review on J code claims.
- Please outline if your company provides real time access for Members to be able to login to a (secure and compliant) portal to view and upload related forms for claims.
- Please provide examples of the compliance with contract terms, plan provisions, and federal billing guidelines as well as timeliness of claim submissions and payments.
- Please provide examples if your data allows for customizable reporting.
- Company’s methodology for imaging and indexing of medical claims, if applicable.
- Company’s length of time for process medical claims for compliance analysis.
- Company will apply compliance analysis and principles to UB-04 forms, revenue code itemized healthcare statements, medical records, repricing statements, explanation of benefits
statements, and other documentation provided for each claim under review.
(2) All the questions must be submitted no later than July 14, 2022
(3) The contract period will be for three years.

[C] Eligibility:

- Onshore (USA ONLY);

[D] Work Performance:

Performance of the work will be Offsite.

Expiry Date : Thursday, 21 July, 2022

Question Answer Deadline : Thursday, 14 July, 2022

Category : Medical Billing and Coding

Country : USA

State : Texas

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