Posted Date : May 29,2019
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : ACCT-7175
Government Authority located in Tucson, Arizona; USA based organization looking for expert vendor for medical and pharmacy claims audit services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide medical and pharmacy claims audit services will include all claims paid as well as zero paid claims to the government authority located in Tucson, AZ.
- Audit firm will be required to audit of medical claims and pharmaceutical/prescription drug claims.
- Audit Firm will review all pertinent plan design documents, audit firm will electronically audit 100% of the medical claims paid by administrator to determine if co-payments coinsurance and deductibles were correctly applied, audit firm will then select a “validation sample” of medical claims that will provide the necessary information to support issues within each error category of the electronic audit, audit firm will then perform an on-site audit of those selected claims at UHCs claims
payment locations.
(2) All question must be submitted no later than June 12, 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: June 18,2019
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 : ACCT-7175
Government Authority located in Tucson, Arizona; USA based organization looking for expert vendor for medical and pharmacy claims audit services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide medical and pharmacy claims audit services will include all claims paid as well as zero paid claims to the government authority located in Tucson, AZ.
- Audit firm will be required to audit of medical claims and pharmaceutical/prescription drug claims.
- Audit Firm will review all pertinent plan design documents, audit firm will electronically audit 100% of the medical claims paid by administrator to determine if co-payments coinsurance and deductibles were correctly applied, audit firm will then select a “validation sample” of medical claims that will provide the necessary information to support issues within each error category of the electronic audit, audit firm will then perform an on-site audit of those selected claims at UHCs claims
payment locations.
(2) All question must be submitted no later than June 12, 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: June 18,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$