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HEALTH-3094 - USA (California) - Medical Third Party and Behavioral Health Administrative Services - Deadline November 9,2021

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: HEALTH-3094

Government Authority located in California; USA based organization looking for expert vendor for medical third party and behavioral health administrative services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

Vendor needs to provide medical third party and behavioral health administrative services
- Medical TPA Minimum Qualifications
a. Must have a minimum of at least 1,200,000 members currently under management. Membership counts can be a combination of insured lives and members. Membership counts cannot include ancillary programs.
b. Supplier must not offshore any functions of medical benefit administration
c. Supplier guarantees readiness for an August 1, 2022 go-live date. This includes referral and claim readiness, connectivity with other administrators, contracting and connectivity with campus SHS/IT
d. Administration must mirror all current benefits and plan designs for all subgroups
e. Must agree that agency will retain control over plan design modifications and changes during the contract term
f. Supplier must be able to administer multiple subgroups with benefit start/stop dates based on the academic year
g. Must agree to reimburse campus Family providers based on reimbursement methodology provided.
h. Must agree to produce a Benefit Booklet, custom card and be responsible for conducting an annual email survey as directed.

[C] Eligibility:

- Onshore (USA Organization Only);

[D] Work Performance:

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

Expiry Date : Tuesday, 9 November, 2021

Category : Health and Related Services

Country : USA

State : California

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