(USA New Jersey) Medical Case Management & Medical Billing Services
We are New Jersey; USA based organization looking for qualified and experienced service provider for Medical Case Management and Medical Billing Services.
Type : Tender | RFP
Id : 53856079
Category : Medical Billing
Title :(USA New Jersey) Medical Case Management & Medical Billing Services
Estimated Budget :Looking for Proposals
[A] Scope of Service:
We are looking for proposals for medical case management and related services, including payment of all medical bills and other services, for our program. Proposer should be able to provide a web based tracking program to manage the following services
1) On Site Medical Case Management – upon request, accompany injured employee to all medical appointments, as well as on site visits in hospital, rehabilitation facilities, or other inpatient facilities. Identify and coordinate treatment with Claims Investigator to determine appropriate level of care and ensure efficacy of treatment in a timely manner.
2) Obtain authorization from Claims Investigator to schedule all diagnostic testing and specialist appointments.
3) Maintain electronic communication via fax, website, e-mail, or telephone between employee, medical providers and the County to ensure compliance with all Workers’ Compensation requirements.
4) Provide immediate verbal and written update to County following medical appointments, advising work status, follow up appointments, referrals for diagnostic testing, referrals to specialists, etc.
Immediately following appointment, fax work status notes, prescriptions, referrals, obtain authorization for additional testing/treatment and schedule those appointments within a 12 hour time frame from the scheduled appointment.
5) Wherever possible work with Claims Investigator to expedite employee’s return to work to full
or modified duty in accordance with return to work policy.
6) Calculate medical cost projections to assist in setting accurate medical reserves. This will be done on an ongoing basis for those files referred for medical case management, and other files from time to time, as requested by the County.
7) Provide medical direction to claims or legal staff as necessary and/or requested.
8) Serve as expert witness in legal proceedings as necessary and/or requested.
9) Enhance positive working relationship between the medical community, the employee and us.
10) Provide a chronological summary of medical treatment on requested claims.
11) Every effort should be made to ensure that patients under active authorized medical treatment remain under the care of that physician/facility. The County’s physician list is provided in Exhibit “B”.
Vendor should make every effort to utilize the same physicians.
12) Consulting services related to medical direction should be provided to the investigators at no cost to the County.
[B] Work Performance:
Performance of the work will be Onsite.
[C] Eligibility: Onshore (USA Only)
[D] Budget: Looking for Proposals
Interested service providers are requested to submit proposals till November 17, 2010. For more details check attachment.
Country : United States
Posted On :10/26/2010
Price : $16.99 Click here to purchase Buyer contact information
