Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-7236

Government Authority located in Connecticut; USA based organization looking for expert vendor for billing and collections service.

[*] Budget: Looking for Proposal

[*] Scope of Service:

(1) Vendor needs to provide billing and collections service for to help supplement all current billing and collection for a fixed monthly fee effective July 1, 2023, for dates of service from June 2023 forward.
- Private Pay, Medicaid, Medicare, and Managed Medicare account for 95% of collections. Private insurance, worker's compensation, and other carriers account for the remaining 5% of collections.
1. Private Pay:
- Sending out monthly billing in advance (i.e. billing for July 2023 is sent out on June 15th). Payments will be received by agency and posted to either Matrix or the new software.
- Reviewing admission agreements at the time of admission to help ensure valid insurance information, as well as a responsible party, is in place.
- Follow-up protocols for private pay that include collection on Medicaid applied income.
2. Medicaid:
- Monthly billing via agency portal.
- Prompt follow-up on all billing rejections.
- Ensuring that the billed amount and paid amount are equal, and any credit or debit balances are promptly resolved.
3. Medicaid Pending:
- Keep track of all medicaid pending claims (regardless of dates of service)
- Produce a monthly status report
- The vendor should describe how they will follow-up with the responsible party or the patient to complete the medicaid application
- Escalation if patient or family cooperation is not forthcoming
- Medicare and managed medicare
- Participate in weekly Minimum Data Set (MDS) meetings to make sure all medicare billing information is in place
- Monthly medicare billing
- Correction of any medicare rejections
- Prompt Resolution of any medicare credit balances
- Quarterly filing of medicare credit balances
5. Third-Party Insurance
- Understanding of the terms of agency’s contracts with each insurance company
- Billing and follow-up of all insurance claims
(2) The contract period will be for one year.

[*] Eligibility:

- Onshore (USA Organization Only);

[*] Work Performance:

Performance of the work will be Offsite/Onsite.

Expiry Date : Wednesday, 5 April, 2023

Category : Medical Billing and Coding

Country : USA

State : Connecticut

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