Posted Date : July 22,2020
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-4390
Government Authority located in Nevada; USA based organization looking for expert vendor for medicaid third party liability, recovery audit contracting and medicaid estate recovery services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide third party liability services, managed care secondary recovery services, recovery audit contracting services, medicaid estate recovery services, subrogation and casualty reduction services, cost avoidance services, health insurance premium payment services and managed care TPL data exchange and evaluation services.
- Vendor Accounting: payments related to the contract shall not be made payable to the vendor, vendor shall not accept as payment any tender other than check, cashier’s check, treasurer’s check, wire, ach, or money order, vendor shall be responsible for depositing and ensuring the deposit of all funds in relation to the contract, deposit funds only into state approved accounts, restrictively endorse all payments upon receipt as appropriate.
- HIPAA: shall ensure that the operation of all its systems is performed in accordance with Federal and State regulations and guidelines related to security and confidentiality and meet all privacy and security requirements of HIPAA regulations, ensure all staff are trained regarding their regulatory obligations under HIPAA, HIPAA compliant medical release or HIPAA Qualified Protective Order will be required prior to releasing PHI for the casualty.
- Medicaid Third Party Liability to identify and pursue recovery from any individual, entity, or public or private program that is or may be liable to pay all or part of the medical assistance provided on behalf of a recipient, investigate claims paid by the Medicaid program on behalf of Medicaid recipients that may have had concurrent coverage from an OHC identified during the course of Vendor’s data matching processes, identify payments of claims made by Medicaid where another liable third party has been identified through data exchange and eligibility matches, identify inappropriate payment of claims, including managed care and capitation payments. Examples of inappropriate payments include, but are not limited to, payments made after date-of-death or periods of ineligibility, identify claims where the provider has inappropriately unbundled inpatient and outpatient claims that were paid in error by Medicaid.
(2) All question must be submitted no later than July 27, 2020.
[C] Eligibility:
- Onshore (USA Organization 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 19,2020
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-4390
Government Authority located in Nevada; USA based organization looking for expert vendor for medicaid third party liability, recovery audit contracting and medicaid estate recovery services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide third party liability services, managed care secondary recovery services, recovery audit contracting services, medicaid estate recovery services, subrogation and casualty reduction services, cost avoidance services, health insurance premium payment services and managed care TPL data exchange and evaluation services.
- Vendor Accounting: payments related to the contract shall not be made payable to the vendor, vendor shall not accept as payment any tender other than check, cashier’s check, treasurer’s check, wire, ach, or money order, vendor shall be responsible for depositing and ensuring the deposit of all funds in relation to the contract, deposit funds only into state approved accounts, restrictively endorse all payments upon receipt as appropriate.
- HIPAA: shall ensure that the operation of all its systems is performed in accordance with Federal and State regulations and guidelines related to security and confidentiality and meet all privacy and security requirements of HIPAA regulations, ensure all staff are trained regarding their regulatory obligations under HIPAA, HIPAA compliant medical release or HIPAA Qualified Protective Order will be required prior to releasing PHI for the casualty.
- Medicaid Third Party Liability to identify and pursue recovery from any individual, entity, or public or private program that is or may be liable to pay all or part of the medical assistance provided on behalf of a recipient, investigate claims paid by the Medicaid program on behalf of Medicaid recipients that may have had concurrent coverage from an OHC identified during the course of Vendor’s data matching processes, identify payments of claims made by Medicaid where another liable third party has been identified through data exchange and eligibility matches, identify inappropriate payment of claims, including managed care and capitation payments. Examples of inappropriate payments include, but are not limited to, payments made after date-of-death or periods of ineligibility, identify claims where the provider has inappropriately unbundled inpatient and outpatient claims that were paid in error by Medicaid.
(2) All question must be submitted no later than July 27, 2020.
[C] Eligibility:
- Onshore (USA Organization 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 19,2020
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$