Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-6656

Government Authority located in New Mexico; USA based organization looking for expert vendor for workers compensation third party administration claims service.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide workers compensation third party administration claims service.
a. Workers compensation third party claim administration services
b. Workers compensation managed care services
c. Return-to-work coordination services
d. Workers compensation medical bill review services
e. Workers compensation pharmacy network
f. OSHA reporting
- This includes first aid claims for the district which allows them to be paid by the TPA and tracked as a first aid claim in the TPA claims system.
- Investigate all claims for compensability and monitor all claims for potential fraud. Evaluate each claim for potential subrogation and contact the district’s director of risk management if any questions regarding liability arise before pursuing subrogation.
- Installing any necessary automated claims administration systems and all hardware upgrades necessary to access the system.
- Installing and converting historical data, including claim, payment and reserve information and transferring paper files and electronic files from the district.
- Transferring records and systems to the succeeding TPA at the transition of the contract (if a different TPA is selected) with no additional cost or fee required.
- Administrative fees should cover the cost of administrator’s staff; all office space; storage space for closed files; supplies; forms; posters and pamphlets and brochures for injured employees as required by the state labor code and the administrative director; standard management reports; telephone expenses; postage; laser check stock; computer hardware and software; transcription services (if utilized for claims examiner’s correspondence); and other equipment and supplies necessary for claims handling.
(2) All the questions must be submitted no later than August 10, 2022

[C] Eligibility:

- Onshore (USA ONLY);

[D] Work Performance:

Performance of the work will be Offsite.

Expiry Date : Tuesday, 23 August, 2022

Question Answer Deadline : Wednesday, 10 August, 2022

Category : Medical Billing and Coding

Country : USA

State : New Mexico

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