Posted Date : July 12,2019
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-3301
Government authority located in Arizona, USA; based organization looking for expert vendor for employee benefits medical services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
Vendor needs to provide employee benefits medical services for access medical administration, medical networks, and medical management services, employees, retirees, COBRA members, and their eligible dependents.
- contract separately for the administration of the Health Savings Account
- Enhance current medical management for catastrophic review, out-of-network, and specialty case negotiated costs
- Improve reporting on clinical reviews and documented return on investments
- Maintain control and access to claims and utilization data in order to make appropriate program decisions
- Claims Processing
- Health Call Center
- day-to-day contact with the primary responsibility of responding to all issues related to billing, enrollment, termination, and eligibility
- medical and pharmacy claims history, utilization management, disease management, and case management data
- Claim file extract and exchanges
- Medicare reclamation process
- Claims payment process including, but not limited to, auto-adjudicated and manually processed claims.
[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: August 09,2019
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-3301
Government authority located in Arizona, USA; based organization looking for expert vendor for employee benefits medical services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
Vendor needs to provide employee benefits medical services for access medical administration, medical networks, and medical management services, employees, retirees, COBRA members, and their eligible dependents.
- contract separately for the administration of the Health Savings Account
- Enhance current medical management for catastrophic review, out-of-network, and specialty case negotiated costs
- Improve reporting on clinical reviews and documented return on investments
- Maintain control and access to claims and utilization data in order to make appropriate program decisions
- Claims Processing
- Health Call Center
- day-to-day contact with the primary responsibility of responding to all issues related to billing, enrollment, termination, and eligibility
- medical and pharmacy claims history, utilization management, disease management, and case management data
- Claim file extract and exchanges
- Medicare reclamation process
- Claims payment process including, but not limited to, auto-adjudicated and manually processed claims.
[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: August 09,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$