Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-6696

Government Authority located in California; USA based organization looking for expert vendor for bill review service.

[A] Budget: Looking for Proposals

[B] Scope of Service:

Vendor needs to provide bill review service (BRS) which is a generalized name for a commercial service which processes the medical, mental health and dental bills submitted for claims filed with
victim compensation program.
- The BRS Interface is a data exchange with the bill review service that agency contracts with to provide pricing and adjudication information on medical, dental and mental health bills and
Non-Standard Bills. The following files are exchanged:
• eligibility data;
• provider data;
• bill images;
• bill and adjudication data;
• reject file
- General Interface File Requirements
• All Send interface files (Provider, Eligibility, Bill Log and Bill Images) should be zipped
• The zipped Send file should be pushed to the BRS contractor FTP server
• The Receive Bill Data file should be pulled from the BRS contractor FTP server.
• All files will not have a header record or trailer record
• The export files are tab delimited and the import file is an XML file.
• BRS Bill Schema: This schema has three levels corresponding to the Bill, Bill Line Item and
Bill Line Item Payer data, shown as follows
- For each bill manually keyed, BRS performs a series of validations and then determination (often called adjudication) of the allowed amount for each service by applying agency rate billing guidelines for medical, dental, and mental health services.
- Each bill image is formatted and saved as an individual multi-page PDF.

[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 : Wednesday, 31 August, 2022

Category : Medical Billing and Coding

Country : USA

State : California

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