Vendor needs to provide self–insured claims management service.• The Supplier shall manage the self–insured workers’ compensation program.• Provide administrative services for the insurer and manage claims.• Provide a dedicated claims management team of professionally trained, appropriately licensed claims staff to ensure excellence in all areas of claims management services requested.• Perform claims administration services in compliance with applicable laws, rules and regulations while ensuring that all claimants are treated in a fair and timely manner. Claimants are to receive all payments/benefits to which they are entitled within the prescribed statutory timelines as well as client specified timelines.• Third Party Administration of District Self–Insured Claims (TPA): The TPA shall manage Medicare Section 111 Mandatory Reporting requirements and claims management ancillary program support services.– The TPA shall not be guaranteed preference for ancillary services such as managed medical care and bill review.• Medical Bill Review Services (MBR): The District requires the services of a Supplier to provide medical bill review and repricing services. All medical bills incurred as part of the District’s Workers’ Compensation claims program are forwarded for review. Bills can range from medical visits, medications, hospitalizations and surgery.
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