Posted Date : August 24,2021
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-5618
Government Authority located in Nevada; USA based organization looking for expert vendor for self-insured insolvencies services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide self-insured insolvencies services that include administration of workers’ compensation claims for existing, future, and unknown future insolvent self-insured employers and self-insured associations.
- Properly administer the workers’ compensation claims of insolvent SIEs and SIAs in compliance with state statutes, regulations, and other legal authority.
- Provide the division with correspondence and reports to monitor the administration of the claims.
- Ensure that claimants receive their benefits and that the claimants’ medical providers receive payment in a timely manner for services provided to the claimant.
- Third-party administrators will administer workers’ compensation claims of insolvent sies and sias, including but not limited to claim management, excess recovery, subrogation, payment, and settlement in consultation with division staff and in accordance with state laws.
- Third-party administrators will enhance or modify its claim handling software, as needed, to administer claims according to the division’s requirements.
- Third-party administrators will receive electronic and hard copy versions, when available, of existing accepted claims and will integrate both versions of existing claim files into the third-party administrators claims administration system.
- Third-party administrators will review medical service provider invoices and will obtain additional information or corrections, as needed to ensure that services are correct when presented for payment.
- Third-party administrators will deliver to the division a weekly invoice and detailed request for funding of workers’ compensation claims.
- To facilitate funding, this funding request must be submitted at least three days prior to the proposed payment and include, at a minimum, the claimant’s name, provider name, type of payment, amount, and payment identification.
- Third-party administrators will provide to the Division quarterly summary reports regarding claims filings and recoveries for excess coverage and a copy of excess insurance filings with the excess carrier.
- Third-party administrators will, upon request, provide to the division other reports, information, and documentation regarding claims administered pursuant to the contract.
- Third-party administrators will prepare and file with the centers for Medicare and Medicaid services and required reports relating to claims administered pursuant to the contract. The third-party administrators will timely provide to the division a copy of such reports.
- Third-party administrators will consult with the Division prior to final settlement of a claim. Third-party administrators will provide to the division copies of all documentation pertaining to the negotiation and settlement of claims at hearings or through legal representation within 5 business days of receipt.
The successful third-party administrators will:
- Notify the division of any claim disputes.
- Represent the division and will testify at hearings or any other litigation related to claims against the insolvent employer.
- Keep the division apprised of hearing status, appeals, and settlement negotiations.
- Consult with the division prior to final settlement of a claim.
- Provide weekly claims reports and other reports, as required.
(2) All questions must be submitted no later than August 27, 2021.
[C] Eligibility:
- Onshore (US Organization Only);
[D] Work Performance:
Performance of the work will be Offsite.
Budget :
Deadline to Submit Proposals: September 09,2021
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-5618
Government Authority located in Nevada; USA based organization looking for expert vendor for self-insured insolvencies services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide self-insured insolvencies services that include administration of workers’ compensation claims for existing, future, and unknown future insolvent self-insured employers and self-insured associations.
- Properly administer the workers’ compensation claims of insolvent SIEs and SIAs in compliance with state statutes, regulations, and other legal authority.
- Provide the division with correspondence and reports to monitor the administration of the claims.
- Ensure that claimants receive their benefits and that the claimants’ medical providers receive payment in a timely manner for services provided to the claimant.
- Third-party administrators will administer workers’ compensation claims of insolvent sies and sias, including but not limited to claim management, excess recovery, subrogation, payment, and settlement in consultation with division staff and in accordance with state laws.
- Third-party administrators will enhance or modify its claim handling software, as needed, to administer claims according to the division’s requirements.
- Third-party administrators will receive electronic and hard copy versions, when available, of existing accepted claims and will integrate both versions of existing claim files into the third-party administrators claims administration system.
- Third-party administrators will review medical service provider invoices and will obtain additional information or corrections, as needed to ensure that services are correct when presented for payment.
- Third-party administrators will deliver to the division a weekly invoice and detailed request for funding of workers’ compensation claims.
- To facilitate funding, this funding request must be submitted at least three days prior to the proposed payment and include, at a minimum, the claimant’s name, provider name, type of payment, amount, and payment identification.
- Third-party administrators will provide to the Division quarterly summary reports regarding claims filings and recoveries for excess coverage and a copy of excess insurance filings with the excess carrier.
- Third-party administrators will, upon request, provide to the division other reports, information, and documentation regarding claims administered pursuant to the contract.
- Third-party administrators will prepare and file with the centers for Medicare and Medicaid services and required reports relating to claims administered pursuant to the contract. The third-party administrators will timely provide to the division a copy of such reports.
- Third-party administrators will consult with the Division prior to final settlement of a claim. Third-party administrators will provide to the division copies of all documentation pertaining to the negotiation and settlement of claims at hearings or through legal representation within 5 business days of receipt.
The successful third-party administrators will:
- Notify the division of any claim disputes.
- Represent the division and will testify at hearings or any other litigation related to claims against the insolvent employer.
- Keep the division apprised of hearing status, appeals, and settlement negotiations.
- Consult with the division prior to final settlement of a claim.
- Provide weekly claims reports and other reports, as required.
(2) All questions must be submitted no later than August 27, 2021.
[C] Eligibility:
- Onshore (US Organization Only);
[D] Work Performance:
Performance of the work will be Offsite.
Budget :
Deadline to Submit Proposals: September 09,2021
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$