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MB-3894 - USA (California) - Third-Party Administration Services - Deadline March 13,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-3894

Government Authority located in California; USA based organization looking for expert vendor for third-party administration services.

[A] Budget: Looking for Proposal

[B] Scope of Service:

(1) Vendor needs to provide third-party administration services to provide workers’ compensation claims administration in connection with the District’s self-insured workers’ compensation program and related services.
- Claims Administration Services
A. Determine liability for claimed injuries and illnesses on a timely basis and in accordance with the California Labor Code.
B. Determine eligibility for and authorize payment of medical and indemnity benefits on a timely basis.
C. Review, compute, and, after approval by the District, pay all informal ratings, findings and awards, settlements and life pensions; arrange for informal disability ratings whenever possible to avoid unnecessary litigation.
D. Pay any and all penalties due in accordance with the California Labor Code. Such penalties shall be paid by the claims administrator and reimburse to District within 14 days of notice should the penalties be from the error of the Third Party Administrator (TPA) and its representatives or subcontractors.
E. Establish files containing medical and factual information on each reported claim, together with complete accounting records and maintain same in accordance with statutory time requirements and District policy.
F. Arrange and supervise rehabilitation services where indicated, in accordance with the California Labour Code.
G. Maintain all payroll and loss information as required by the State of California, Department of Self-Insurance.
H. Provide the District with information and recommendations for implementation strategies for changes or proposed changes in statutes, rules and regulations affecting the District under the California Labor Code for workers' compensation.
I. Conduct seminars and training to the District’s staff regarding workers’ compensation claims and laws in the state of California.
J. Prepare and file in a timely manner all reports and forms required by the State of California regulating self-funded programs.
K. Review with the District, on quarterly basis, the program's progress, including identification of problem areas and recommended solutions thereto, and selected claims identified by the District, and attend other meetings required by the District relative to the workers' compensation program.
L. Arrange for and supervise all necessary investigations to determine eligibility for compensation benefits and liability of negligent third parties.
M. Provide efficient and accurate systems for financial reserves and payments of benefits and allocated expenses in accordance with sound claims practices.
(2) All questions must be submitted no later than February 28, 2020.
(3) Contract period will be for 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, 13 March, 2020

Question Answer Deadline : Friday, 28 February, 2020

Category : Medical Billing and Coding

Country : USA

State : California

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