Posted Date : May 06,2020
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-4149
Government Authority located in Louisiana; USA based organization looking for expert vendor for pharmacy benefit management services.
[A] Budget: Looking For Proposal
[B] Scope of Service:
(1) Vendor needs to provide pharmacy benefit management services
- Establish and implement data utilization edits that identify and deny duplicate claims, claims filed too soon, claims requiring authorization when such authorization is not in place, as well as messages to the pharmacist for review and approval or denial of the claims(s) due to safety issues,
- Facilitate system programming, file transfer set up between Supplier and Third Party Administer,
- Perform comprehensive systems testing and quality assurance audits, with results reported to LSU prior to the contract start date, at no additional cost,
- The Supplier shall be responsible for development of pharmacy benefit information including, but not limited, to annual and special enrollment brochures and promotions, other Plan-related printed materials such as but not limited to: promotional, correspondence forms, plan participant education, preformatted letters, system generated letters, notifications and other written materials and forms,
- Furnish a dedicated toll-free number for incoming customer service calls, including telephone technology for the hearing impaired and multi-lingual support. The dedicated call center for pharmacies, plan participants, and account management must be staffed and available to receive calls 24/7,
- prescription benefit management services including, but not necessarily limited to, general support and advisory services regarding pharmacy benefit design and implementation, network and rebate management, administrative and claims processing services, clinical management programs, reporting, marketing, customer service, quality management, and utilization management functions,
- Perform all aspects of Claims processing, coordination of benefits including non-Medicare and Medicare, Claims reimbursement, point-of-sale transactions, adjudication, and payment. The Supplier shall verify benefits and eligibility before authorizing Prescriptions and paying Claims,
- Implement a specialty pharmacy program that will provide cost-effective care and positive patient outcomes through increased adherence, as well as provide an enhanced patient experience through the convenience of scheduled delivery, disease management programs and compliance monitoring employing a care coordination model.
(2) All questions must be submitted no later than May 15, 2020.
[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.
Budget :
Deadline to Submit Proposals: June 09,2020
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 : MB-4149
Government Authority located in Louisiana; USA based organization looking for expert vendor for pharmacy benefit management services.
[A] Budget: Looking For Proposal
[B] Scope of Service:
(1) Vendor needs to provide pharmacy benefit management services
- Establish and implement data utilization edits that identify and deny duplicate claims, claims filed too soon, claims requiring authorization when such authorization is not in place, as well as messages to the pharmacist for review and approval or denial of the claims(s) due to safety issues,
- Facilitate system programming, file transfer set up between Supplier and Third Party Administer,
- Perform comprehensive systems testing and quality assurance audits, with results reported to LSU prior to the contract start date, at no additional cost,
- The Supplier shall be responsible for development of pharmacy benefit information including, but not limited, to annual and special enrollment brochures and promotions, other Plan-related printed materials such as but not limited to: promotional, correspondence forms, plan participant education, preformatted letters, system generated letters, notifications and other written materials and forms,
- Furnish a dedicated toll-free number for incoming customer service calls, including telephone technology for the hearing impaired and multi-lingual support. The dedicated call center for pharmacies, plan participants, and account management must be staffed and available to receive calls 24/7,
- prescription benefit management services including, but not necessarily limited to, general support and advisory services regarding pharmacy benefit design and implementation, network and rebate management, administrative and claims processing services, clinical management programs, reporting, marketing, customer service, quality management, and utilization management functions,
- Perform all aspects of Claims processing, coordination of benefits including non-Medicare and Medicare, Claims reimbursement, point-of-sale transactions, adjudication, and payment. The Supplier shall verify benefits and eligibility before authorizing Prescriptions and paying Claims,
- Implement a specialty pharmacy program that will provide cost-effective care and positive patient outcomes through increased adherence, as well as provide an enhanced patient experience through the convenience of scheduled delivery, disease management programs and compliance monitoring employing a care coordination model.
(2) All questions must be submitted no later than May 15, 2020.
[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.
Budget :
Deadline to Submit Proposals: June 09,2020
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$