Posted Date : July 02,2019
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MEDI-1430
Government Authority located in Las Vegas, Nevada; USA based organization looking for expert vendor for utilization review services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide utilization review services to the government authority located in Las Vegas, NV.
- Medical and Dental Benefit Options include self-funded program with preferred provider organization incentives, long term disability coverage, group life insurance plan and voluntary supplemental group life insurance.
- County Self-Funded Program, administered by Healthscope benefits, provides a comprehensive
employee benefits plan to approximately 8,134 active employees and cobra participants, 2,081 retirees, and approximately 10,224 dependents.
- Utilization review services will be included in the self- funded program, such services shall be
included, but not limited to, the following in-patient and out-patient services pre-admission certification, concurrent review, discharge planning, retrospective in-patient hospitalization review, large case management, pre-certification of out-patient test/procedure, retrospective review of out-patient test/procedure, substance abuse case management, mental health case management, medical advisor to plan, medical director opinion for appeals, perform chart reviews and visit patients in hospital and hospital bill audit.
- Third Party Claims Administrator, audit hospital bills referred for review. provider shall review charges submitted by hospital for billed services, and validate billed charges were provided. auditor must work in cooperation with the hospital in scheduling hospital bill audits and provide a detailed copy of the complete audit findings to the third-party claims administrator.
(2) A pre-proposal conference will be held on July 17, 2019.
[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: July 31,2019
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 : MEDI-1430
Government Authority located in Las Vegas, Nevada; USA based organization looking for expert vendor for utilization review services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide utilization review services to the government authority located in Las Vegas, NV.
- Medical and Dental Benefit Options include self-funded program with preferred provider organization incentives, long term disability coverage, group life insurance plan and voluntary supplemental group life insurance.
- County Self-Funded Program, administered by Healthscope benefits, provides a comprehensive
employee benefits plan to approximately 8,134 active employees and cobra participants, 2,081 retirees, and approximately 10,224 dependents.
- Utilization review services will be included in the self- funded program, such services shall be
included, but not limited to, the following in-patient and out-patient services pre-admission certification, concurrent review, discharge planning, retrospective in-patient hospitalization review, large case management, pre-certification of out-patient test/procedure, retrospective review of out-patient test/procedure, substance abuse case management, mental health case management, medical advisor to plan, medical director opinion for appeals, perform chart reviews and visit patients in hospital and hospital bill audit.
- Third Party Claims Administrator, audit hospital bills referred for review. provider shall review charges submitted by hospital for billed services, and validate billed charges were provided. auditor must work in cooperation with the hospital in scheduling hospital bill audits and provide a detailed copy of the complete audit findings to the third-party claims administrator.
(2) A pre-proposal conference will be held on July 17, 2019.
[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: July 31,2019
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$