Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-7835

Government Authority located in Alaska; USA based organization looking for expert vendor for fiscal intermediary claims processing services.

[*] Budget: Looking for Proposals

[*] Scope of Service:

(1) Vendor needs to provide fiscal intermediary claims processing services.
- The Contractor will provide the functionalities to support the following high-level administrative workflow and receive electronic claims and clinical documentation to validate and process payment to external providers.
- Provider submits claim to a health plan through the agency office.
- Supplemental medical information such as certificate of medical necessity, discharge summaries, lab results, operative reports to support a claim payment.
- Crossover claims that requests payment be sent to a secondary health plan by a primary plan.
- Inquiry of claim to help providers follow claims through the adjudication process.
- Last step in the administrative workflow. Payment occurs by check or electronic funds transfer.
- Explanation of payment made to the provider by the health plan. Includes information on patient, service, provider, and claims adjustments.
(2) Contract period will be for one year.

[*] Eligibility:

Onshore (USA Organization Only)

[*] Work Performance:

Performance of the work will be Onsite/offsite

[*] Proposal Submission:

Response can be submitted digitally via Email or Online.

Expiry Date : Friday, 17 November, 2023

Category : Medical Billing and Coding

Country : USA

State : Alaska

RFP Expired

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