Posted Date : May 01,2019
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-3071
Government Authority Located in Arizona; USA based organization looking for expert vendor for worker compensation bill review services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide worker compensation bill review services to timely and properly provide all services necessary to perform bill review under the Workers' Compensation program,
- Review individual bills and identify and appropriately re-price charges outside of Physician Fee Schedule,
- Review individual bills and identify medically unnecessary procedures per Evidence Based Medicine Guidelines,
- Review individual bills and identify medical providers who provide excessive utilization of procedures per Evidence Based Medicine Guidelines,
- Review individual bills and identify and appropriately recode improperly coded medical procedures,
- TPA shall provide the Contractor with the original bill for review and evaluation for the pick-up and return of said bill and related documentation in a manner and frequency,
- must be able to interface with the TPA system software to include the following data interface (at minimum):
- Claim file, payment file and history data to be provided by the incumbent Bill Review,
- regarding a PPO network, including a prescription drug network, physical therapy network, durable medical equipment network, etc.
(2) A pre-proposal meeting will be held on May 7, 2019.
(3) All questions must be submitted no later than May 8, 2019.
[C] Eligibility:
Onshore (USA Only)
[D] Work Performance:
Performance of the work will be Offsite. Vendor needs to carry work in their office location.
Budget :
Deadline to Submit Proposals: May 21,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
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Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-3071
Government Authority Located in Arizona; USA based organization looking for expert vendor for worker compensation bill review services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide worker compensation bill review services to timely and properly provide all services necessary to perform bill review under the Workers' Compensation program,
- Review individual bills and identify and appropriately re-price charges outside of Physician Fee Schedule,
- Review individual bills and identify medically unnecessary procedures per Evidence Based Medicine Guidelines,
- Review individual bills and identify medical providers who provide excessive utilization of procedures per Evidence Based Medicine Guidelines,
- Review individual bills and identify and appropriately recode improperly coded medical procedures,
- TPA shall provide the Contractor with the original bill for review and evaluation for the pick-up and return of said bill and related documentation in a manner and frequency,
- must be able to interface with the TPA system software to include the following data interface (at minimum):
- Claim file, payment file and history data to be provided by the incumbent Bill Review,
- regarding a PPO network, including a prescription drug network, physical therapy network, durable medical equipment network, etc.
(2) A pre-proposal meeting will be held on May 7, 2019.
(3) All questions must be submitted no later than May 8, 2019.
[C] Eligibility:
Onshore (USA Only)
[D] Work Performance:
Performance of the work will be Offsite. Vendor needs to carry work in their office location.
Budget :
Deadline to Submit Proposals: May 21,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$