Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-7228

Government Authority located in Florida; USA based organization looking for expert vendor for third party administrator service.

[*] Budget: Looking for Proposals

[*] Scope of Service:

(1) Vendor needs to provide third party administrator service for workers compensation, employer liability, property and liability.
- Claims reported with a date of accident on or after October 1, 2023, to provide a transition with no disruption or delay in the processing of claims. Provide a detailed work plan for the implementation and transition of claims incurred and reported prior to the effective date of the Contract to assure that the transition occurs with no delays in delivery of medical benefits or delays in payments to any claimants or clinicians or in the general handling of all claims.
- Administer workers’ compensation benefits in accordance with established practice parameters and protocols of treatment as provided for in Chapter 440, statutes.
- Make initial contact with the employee and establish a claims file within twenty-four hours of receipt of the employers’ first report of injury or illness for the county.
- Provide on-going training to county employees as needed or requested to explain division of workers’ compensation (DWC) benefit notices and other required letters, forms, and procedures.
- Acknowledge county human resources staff inquiries within same workday and provide an update on forecasted issue resolution timeframe.
- All penalties incurred because of failure of the TPA to comply with statutory laws or administrative regulations will be the sole responsibility of the TPA.
- Maintain accurate and timely loss runs in a format system acceptable to the County and required by law.
- County will select defense and subrogation counsel.
- TPA is responsible for proceeding against responsible persons, agencies, or agents in subrogation actions to recover losses suffered by the county due to employee injuries.
- All claims’ files remain the property of the county and will not be disposed of without the county’s prior authorization.
- Close files that meet closing criteria in a timely manner.
- Attend workers’ compensation appeals board hearings, status conferences and trials along with depositions, conferences with legal defense counsel, and meetings with county staff as required.
- Provide analysis and strategies for medical service and facility cost savings resulting from your preferred provider network or other services.
- Employ strategies for cost savings due to TPA operation or contracted bill review activities.
- Be available on a twenty-four (24) hour basis and provide immediate response to claims investigation requests through use of email or cellular telephones.
- Prepare and follow service instructions that have been approved by the county in the handling of the county claims.
- Receive and examine on behalf of the county all reports of third-party liability claims including claims by an employee of an insured against another insured.
(2) All the questions must be submitted no later than April 6, 2023

[*] Eligibility:

- Onshore (USA Organization Only);

[*] Work Performance:

- Performance of the work will be Offsite.

Expiry Date : Thursday, 13 April, 2023

Question Answer Deadline : Thursday, 6 April, 2023

Category : Medical Billing and Coding

Country : USA

State : Florida

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