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MB-6551 - USA (Georgia) - Workers Compensation Third Part Claims Administration Services - Deadline July 8,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-6551

Government authority located in Georgia; USA based organization looking for expert vendor for workers compensation third part claims administration services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third-party claims administration services in regard to workers’ compensation insurance claims.
• Claims Administration / Adjudication
• Twenty-four (24) hour contact with employees upon receipt of claim
• Medical bill review and audit
• Investigating Claims
• Payment of indemnity benefits, medical bills, mileage payments, etc.
• Processing of Lost Time and Medical Only claims
• Adjusting Claims
• Managing a Risk Management Systems and Reporting
•  Administrator shall determine eligibility for and recommend payment of medical benefits and authorize examinations to determine the nature and extent of disability when appropriate.
•  Administrator shall obtain and evaluate the medical expert opinion as to the nature, extent, and duration of temporary disability and the amount of any residual permanent disability to be anticipated.
•  Administrator shall investigate or arrange for investigation of, as is necessary and appropriate, questionable cases and the status of disabled employees in order to adjust all cases and to assist in the trial or settlement of litigated cases.
•  Administrator shall actively report and participate in the uncovering of fraudulent claims and fraud investigations.
•  Third-Party Administrator is required to have in place a claim administration system that has the ability to enter and display claim adjuster notes.
•  Administrator shall maintain close liaison with treating physicians to assure that employees receive proper care and to identify and prevent over-treatment situations.
•  Administrator shall authorize hospitalization, surgery, and other types of approved treatments.
(2) All question must be submitted no later than July 1, 2022.

[C] Eligibility:

- Onshore (US Organization Only);

[D] Work Performance:

Performance of the work will be Offsite.

Expiry Date : Friday, 8 July, 2022

Question Answer Deadline : Friday, 1 July, 2022

Category : Medical Billing and Coding

Country : USA

State : Georgia

Cost to Download This RFP Document : $ 5

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