Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-7849

Government Authority located in Nebraska; USA based organization looking for expert vendor for third party administrator for workers' compensation service.

[*] Budget: Looking for Proposals

[*] Scope of Service:

(1) Vendor needs to provide third party administrator for workers' compensation service.
- Accept injury reports via a 1-800 number staffed 24 hours a day with trained professionals.
- Evaluate any open claim and make recommendations to the city as to their proper disposition in accordance to the workers’ compensation act or where applicable.
- Maintain complete records (hard copy and computerized) on all reported claims.
- Submit a monthly billing of expenditures to the city.
- Prepare and deliver appropriate benefit payments (medical) utilizing a payment method agreed upon with the city.
- Calculate indemnity payments on a bi-weekly basis required by the workers’ compensation act and provisions in the bargaining unit contracts. submit these indemnity calculations to the finance department for payment.
- Stay in contact with physicians and other involved medical personnel as required to maintain a current perspective on the claimants’ progress toward his and her return to work.
- Keep current on the claimant’s treatment plan and on any barriers to the expected return to work date.
- Prepare reports as required by the city for presentation at monthly workers’ compensation meetings.
- Attend case management discussion along with case managers to review cases of a complex nature and cases which require team decisions and thought. (duration of meetings are to be held either in person or remote.
- Evaluate cases with the potential for litigation providing the city with direction on the most cost-effective manner for resolution. Recommendation should include expected legal outcome, settlement potential and cost savings.
- Provide access to computer-based claim system to workers’ compensation program manager and other staff as designated by the hr department.
- Review all medical bills, in conjunction with the case managers, for appropriateness to employee injury and diagnosis.
- Provide assistance, as requested, to the city in preparation of annual self-insurance renewal filings.
(2) All questions must be submitted no later than November 9, 2023.  
(3) The contract term will be three years. 

[*] Eligibility:

- Onshore (USA Organization Only);

[*] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Wednesday, 15 November, 2023

Question Answer Deadline : Thursday, 9 November, 2023

Category : Medical Billing and Coding

Country : USA

State : Nebraska

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