Posted Date : January 20,2022
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-6000
Government Authority located in Nevada; USA based organization looking for expert vendor for third-party workers compensation administration service.
[A] Budget: Looking for proposal
[B] Scope of Service:
Vendor needs to provide third-party workers compensation administration service.
- Determine the compensability of all workers' compensation claims.
- Supply forms to the city as required by the agency, department of business and industry, division of industrial relations and division of insurance.
- Comply with regulations approved by the agency, department of business and industry, division of industrial relations and division of insurance.
- Issue payments for all medical bills, indemnity costs, rehabilitation expenses, and legal fees associated with workers' compensation claims.
- Represent the city at all hearing and appeals, and arrange legal representation for any resulting court actions.
- Monthly report of all open claims with reserves, closed claims during the month, and a summary by fiscal year of all claims filed, open, closed, and rejected;
- Annual report as required by the agency, department of business and industry, division of industrial relations and the department of insurance;
- Provide referrals to appropriate rehabilitation service agencies as required.
- Review permanent partial disability evaluations; determine permanent partial disability awards and notify claimants of their options. The Company shall communicate with the City on the disposition of all permanent partial disability awards.
- Review and audit doctor's bills and reports for accuracy and adjust payments accordingly. The company shall submit all bills requiring adjudication through its interface with Strata care.
- Assist the city in returning injured workers to light duty.
- Approve all requests for surgery and refer claimants for second opinions as needed on claims.
- Notify the city of all Subrogation and Subsequent injury potential. The company shall also pursue recovery from third parties as approved by the city.
- File claims on behalf of the city against subsequent injury fund when claims meet requirements established by the agency, department of business and industry, division of industrial relations.
- Advise the city of claims resulting in major surgery, possible rehabilitation and all claims concerning litigation.
- Review all claims to determine open and closed status on at least a monthly basis.
- Review all pending legislation, Nevada administrative codes, and any case law, which may affect the agency self-insurance program and advise the city of potential fiscal impact and options.
- In conjunction with its claims administration services, the Company will provide the city with legal bill review or audits services.
- On request, the company shall enter new claims for the city.
[C] Eligibility:
Onshore (USA organization Only)
[D] Work Performance:
Performance of the work will be offsite.
Budget :
Deadline to Submit Proposals: February 15,2022
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-6000
Government Authority located in Nevada; USA based organization looking for expert vendor for third-party workers compensation administration service.
[A] Budget: Looking for proposal
[B] Scope of Service:
Vendor needs to provide third-party workers compensation administration service.
- Determine the compensability of all workers' compensation claims.
- Supply forms to the city as required by the agency, department of business and industry, division of industrial relations and division of insurance.
- Comply with regulations approved by the agency, department of business and industry, division of industrial relations and division of insurance.
- Issue payments for all medical bills, indemnity costs, rehabilitation expenses, and legal fees associated with workers' compensation claims.
- Represent the city at all hearing and appeals, and arrange legal representation for any resulting court actions.
- Monthly report of all open claims with reserves, closed claims during the month, and a summary by fiscal year of all claims filed, open, closed, and rejected;
- Annual report as required by the agency, department of business and industry, division of industrial relations and the department of insurance;
- Provide referrals to appropriate rehabilitation service agencies as required.
- Review permanent partial disability evaluations; determine permanent partial disability awards and notify claimants of their options. The Company shall communicate with the City on the disposition of all permanent partial disability awards.
- Review and audit doctor's bills and reports for accuracy and adjust payments accordingly. The company shall submit all bills requiring adjudication through its interface with Strata care.
- Assist the city in returning injured workers to light duty.
- Approve all requests for surgery and refer claimants for second opinions as needed on claims.
- Notify the city of all Subrogation and Subsequent injury potential. The company shall also pursue recovery from third parties as approved by the city.
- File claims on behalf of the city against subsequent injury fund when claims meet requirements established by the agency, department of business and industry, division of industrial relations.
- Advise the city of claims resulting in major surgery, possible rehabilitation and all claims concerning litigation.
- Review all claims to determine open and closed status on at least a monthly basis.
- Review all pending legislation, Nevada administrative codes, and any case law, which may affect the agency self-insurance program and advise the city of potential fiscal impact and options.
- In conjunction with its claims administration services, the Company will provide the city with legal bill review or audits services.
- On request, the company shall enter new claims for the city.
[C] Eligibility:
Onshore (USA organization Only)
[D] Work Performance:
Performance of the work will be offsite.
Budget :
Deadline to Submit Proposals: February 15,2022
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$