Posted Date : May 13,2021
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-5302
Government Authority located in Louisiana; USA based organization looking for expert vendor for fully insured medicare advantage plan services.
[A] Budget: Looking for proposal
[B] Scope of Service:
(1) Vendor needs to provide fully insured medicare advantage plan services to retirees of the university system.
- To provide excellent customer service to members as well as timely, thorough consultation with university and partner suppliers to develop a cost-effective, high-value benefit program.
- Five continuous years of experience providing and implementing medicare advantage plans with a group size of three thousand or more covered lives.
- Authorized to transact business in the state.
- Approval by the center for medicare and medicaid services to offer one or more medicare advantage plan in the state.
- Staff and maintain a dedicated toll-free customer service unit and phone line to assist plan participants with questions on claims, benefits, and networks in compliance with PPACA Section 1557 and any other applicable laws. Furnish a toll-free telephone number for incoming customer service calls, including telephone technology for the hearing impaired and multi-lingual support.
- Medical claims administration to include, but not limited to, the following, in compliance with all applicable laws: process claims and remit timely payment to providers; furnish to any claimant notices of payment, explanation of benefits, and denials for claims; provide review of plan participants’ appeals and grievances; maintain medical and carved out pharmacy claims for integrated Medical or Rx out-of-pocket maximum accumulation; adjudicate and process all claims with service dates prior to termination date.
(2) All questions must be submitted no later than May 28, 2021.
[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 15,2021
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
![]()
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-5302
Government Authority located in Louisiana; USA based organization looking for expert vendor for fully insured medicare advantage plan services.
[A] Budget: Looking for proposal
[B] Scope of Service:
(1) Vendor needs to provide fully insured medicare advantage plan services to retirees of the university system.
- To provide excellent customer service to members as well as timely, thorough consultation with university and partner suppliers to develop a cost-effective, high-value benefit program.
- Five continuous years of experience providing and implementing medicare advantage plans with a group size of three thousand or more covered lives.
- Authorized to transact business in the state.
- Approval by the center for medicare and medicaid services to offer one or more medicare advantage plan in the state.
- Staff and maintain a dedicated toll-free customer service unit and phone line to assist plan participants with questions on claims, benefits, and networks in compliance with PPACA Section 1557 and any other applicable laws. Furnish a toll-free telephone number for incoming customer service calls, including telephone technology for the hearing impaired and multi-lingual support.
- Medical claims administration to include, but not limited to, the following, in compliance with all applicable laws: process claims and remit timely payment to providers; furnish to any claimant notices of payment, explanation of benefits, and denials for claims; provide review of plan participants’ appeals and grievances; maintain medical and carved out pharmacy claims for integrated Medical or Rx out-of-pocket maximum accumulation; adjudicate and process all claims with service dates prior to termination date.
(2) All questions must be submitted no later than May 28, 2021.
[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 15,2021
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$