MB-6620 - USA (Ohio) - Behavioral Health Third Party Administrator Services - Deadline August 15,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-6620

Government Authority located in Ohio; USA based organization looking for expert vendor for behavioral health third party administrator services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide behavioral health third party administrator services
1. Account Management;
2. Implementation Management;
3. Communication;
4. Program Administration;
5. Claims Administration;
6. Member Services;
7. Eligibility Data;
8. Web Portal;
9. Data Integration;
10. Behavioral Health Appeals Administration;
11. Network Structure;
12. Provider Network Characteristics;
13. Utilization Management;
14. Care Advocacy;
15. The Ohio Disability Management Program;
16. Reporting;
17. Performance Guarantees;
18. Quality Improvement Plan;
19. Transition Management;
20. Audits;
21. Statement on Standards for Attestation Engagements
22. Catastrophic and Pandemic Incident(s); and
23. Financial and Recordkeeping.
A. Account Management, Including:
1. Account Executive responsible for the overall management of the account.
2. Account Manager responsible for day-to-day needs of the account and will be available during regular business hours.
3. The Contractor agrees that up to four (4) site visits per year will be made to the State offices, at no additional cost to the State. These meetings may include a quarterly financial review and/or a review of other program operations. Additional meetings may occur as needed by the State
B. Claims Administration.
1. The Contractor shall process and pay claims for covered services rendered by participating and non-participating providers and issue all explanations of benefits and similar notices to claimants.
2. The Contractor will pay approved claims to behavioral health providers on no less than a weekly basis.
3. The Contractor shall provide an explanation of benefits either electronically or by paper, to plan participants when a claim is incurred.
(2) All question must be submitted no later than August 5, 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 location.

Expiry Date : Monday, 15 August, 2022

Question Answer Deadline : Friday, 5 August, 2022

Category : Medical Billing and Coding

Country : USA

State : Ohio

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