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MB-2829 - USA (Ohio) - Third Party Administrator Services - Deadline April 5,2019

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-2829

Government Authority located in Ohio; USA based organization looking for expert vendor for third party administrator services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

(1) Vendor needs to provide third party administrator services to assist the school in its responsibilities for the administration of workers compensations claims so as to achieve the lowest possible workers’ compensation premiums.
- Provide all necessary claims administration to include any and all claims incurred prior to the date of the agreement.
- Verify the annual rates, review the accuracy of all reserves, verify the correct charging of awards and medical expenses to the experiences, and file requests for corrections as indicated. Appeal all contestable payroll audits as determined by the board.
- Analyze the feasibility of the alternative methods of financing the workers’ compensation obligation.
- Provide one key dedicated account person to resolve claim-related problem and issues.
- Aggressively manage claims to control and legal costs and to resolve the claim in the most favourable manner.
- Assist the Board in preparing for administrative hearings. Contact board’s risk manager and legal department prior to all hearings.
- Provide monthly semi-annual and annual statistical summaries of claims and cost data to the treasurer or risk manager for use in evaluation of the program in an easy-to-use and agreed format. Provide a dashboard cost-benefit premium analyses and plot trends.
- Provide the Board on-line access via an internet web site to computer system for monitoring the claim activity and electronic communication. The system should allow the board the capacity to perform claim sorts and the capability of correcting errors in non-financial fields. Board access shall include access to all entries, notes, hearing dates, and related information.
- Determine claimant’s eligibility for the authorized payment or audit the workers’ compensation fund’s payment of medical benefits and indemnity compensation.
- Coordinate the investigation with the Board on all new claims of questionable injuries and the status of disabled employees in order to assist in the adjustment or litigation of claims.
- Coordinate independent medical examinations to determine the nature and extent of disability.
- Assist the board in the coordination of procedures and practices to insure their compatibility of the board’s general policies with state laws and regulations by preparing manuals and training aides, providing periodic service letters and periodic consultations.
(2) A pre-proposal conference will be held on February 21, 2019.
(3) Contract term will be three years.

[C] Eligibility:

- Onshore (USA Only);

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Friday, 5 April, 2019

Pre-proposal Conference Date : Thursday, 21 February, 2019

Category : Medical Billing and Coding

Country : USA

State : Ohio

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