MB-3767 - USA (Ohio) - Third Party Administrator Services - Deadline February 7,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3767

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

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third party administrator services for the city’s self-insured workers’ compensation program and nurse case management for the city’s return to work program.
- Workers’ Compensation Administration Must be experienced with administering self-insured workers’ compensation policy in the State
- Must be able to receive, process, analyze and examine claim filed against the City’s risk.
- Agrees to execute action on any motions, appeals, or other documents.
- Agrees to establish a file with respect to each claim and issue all checks or drafts in payment of all claims.
- Agrees to investigate all claims and recommend the amount of loss reserve to be established with respect to each claim.
- Agrees to furnish all claim forms necessary for proper claims administration and reporting.
- Agrees to supervise all litigation or other proceedings involving any claim, including the attendance of any judicial or administrative hearings involving any claim when appropriate.
- Agrees to retain and then destroy files for each claim in accordance with approved standards.
- Agrees to monitor all treatment programs recommended to a claimant by any care provider
-. Agrees to provide access codes and training to allow employer to view certain program and claim data via a secure internet connection.
- Agrees to provide periodic report summarizing those claims processed during the period.
Individual claims showing loss payments, expenses, and assigned reserves to indicate expected future costs.
- Review medical bills submitted in connection with a claim for appropriateness and re-price bills against a usual, customary and reasonable database or state mandated fee schedule.
- Provide telephonic nurse case management on selected claims; providing communication with the injured worker and relevant medical provider.
- Agrees to provide annual Service Organization Controls.
(2) All question must be submitted no later than January 17, 2020.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

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

Expiry Date : Friday, 7 February, 2020

Question Answer Deadline : Friday, 17 January, 2020

Category : Medical Billing and Coding

Country : USA

State : Ohio

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