MB-4021 - USA (Ohio) - Third Party Claims Management Services - Deadline April 8,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-4021

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

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide a third-party administrator with on-staff attorney to assist in the proactive and aggressive management of its self-insured and state-funded claims. The third-party administrator shall provide all claims management services including, but not limited to:
1. Complete file retention on every claim.
2. Provide assistance, when necessary, in determining validity and compensability of claims.
3. Filing of claims and associated documents with the bureau of workers’ compensation.
4. Monitor all claims for cost-effective handling.
5. Coordinate all independent medical examinations, referral to case management, rehabilitation and/or work-hardening programs.
7. Provide RTA with online access to workers’ compensation data maintained by the third-party administrator.
8. Monitor action by bureau of workers’ compensation, claimant and his/her representative and, with the approval of RTA, initiate corrective action.
9. Provide actuarial services for self-insured program:
a. Determine reserve amount for all new claims;
b. Maintenance of check stock;
c. Calculation of temporary total disability compensation;
d. Review all bills submitted for payment to ensure rates are usual, customary and reasonable;
e. Issue checks for medical and compensation payments; and
f. Provide assistance in completion of S1-40, ICD-9, yearly renewal application, and all other required self-insured paperwork.
(2) A pre-proposal conference will be held on March 26, 2020.
(3) Contract period will be for three years.

[C] Eligibility:

- Onshore (US Organization Only);

[D] Work Performance:

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

Expiry Date : Wednesday, 8 April, 2020

Pre-proposal Conference Date : Thursday, 26 March, 2020

Category : Medical Billing and Coding

Country : USA

State : Ohio

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