Posted Date : September 20,2018
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-2564
Government Authority located in Georgia; USA based organization looking for expert vendor for workers compensation claims management services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide workers compensation claims management services including
medical management and claims administration services, to reach settlement of claims in appropriate circumstances, to assist in selection of defence counsel, providing loss control, assistance in excess coverage access, and assistance with required State reporting.
- Provide all of the following services.
1. Administrative services.
2. Claims services.
3. First Notice of Injury services.
4. Loss statistic services.
5. Managed Care Organization (MCO) services to include:
a. Network access and development services
b. Triage
c. Telephonic case management and (when appropriate and agreed upon, site case management)
d. Pharmaceutical benefit management services
e. Communicable disease management program services
f. Utilization review, including:
i. Medical bill review and audit services
ii. Pre-certification
iii. Concurrent and retrospective review
g. Peer-to-peer review
6. Workers’ Compensation excess placement assistance.
7. Loss control services.
(2) Contract period will be for three years.
[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: October 19,2018
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-2564
Government Authority located in Georgia; USA based organization looking for expert vendor for workers compensation claims management services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide workers compensation claims management services including
medical management and claims administration services, to reach settlement of claims in appropriate circumstances, to assist in selection of defence counsel, providing loss control, assistance in excess coverage access, and assistance with required State reporting.
- Provide all of the following services.
1. Administrative services.
2. Claims services.
3. First Notice of Injury services.
4. Loss statistic services.
5. Managed Care Organization (MCO) services to include:
a. Network access and development services
b. Triage
c. Telephonic case management and (when appropriate and agreed upon, site case management)
d. Pharmaceutical benefit management services
e. Communicable disease management program services
f. Utilization review, including:
i. Medical bill review and audit services
ii. Pre-certification
iii. Concurrent and retrospective review
g. Peer-to-peer review
6. Workers’ Compensation excess placement assistance.
7. Loss control services.
(2) Contract period will be for three years.
[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: October 19,2018
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$