Posted Date : July 21,2022
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MEDI-4178
Government Authority located in Gretna, Louisiana, USA; based organization looking for expert vendor for group Medicare advantage plan services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
Vendor needs to provide group Medicare advantage plan services with a Nationwide Provider Network for all Medicare Eligible Retirees and Dependents to the government authority located in Gretna, LA.
- to all covered retirees to be received prior to commencement of open enrollment meetings on an annual basis.
- Materials will include plan summary, all inclusive network provider list/booklet, prescription drug coverage information, material describing ancillary coverage, such as dental, vision, etc.
- healthcare provider must mail subscriber and dependent ID cards annually prior to the first of each year after open enrollment. - Establish, maintain, and update Master Record file
- Review, in a consultative capacity, summary plan descriptions and other similar material to be distributed to plan participants.
- Maintain and update eligibility file
- Review claims submitted for medical services that appear excessive and/or establish medical necessity for services rendered or expenses incurred.
- Make available the services of field claim consultants and/or professional services resources for the evaluation of complex claims.
- Maintain peer review relations
- Maintain and store claim detail data elements for statistical analysis.
- Provide online and mobile claim viewing access to participants.
[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: August 18,2022
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MEDI-4178
Government Authority located in Gretna, Louisiana, USA; based organization looking for expert vendor for group Medicare advantage plan services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
Vendor needs to provide group Medicare advantage plan services with a Nationwide Provider Network for all Medicare Eligible Retirees and Dependents to the government authority located in Gretna, LA.
- to all covered retirees to be received prior to commencement of open enrollment meetings on an annual basis.
- Materials will include plan summary, all inclusive network provider list/booklet, prescription drug coverage information, material describing ancillary coverage, such as dental, vision, etc.
- healthcare provider must mail subscriber and dependent ID cards annually prior to the first of each year after open enrollment. - Establish, maintain, and update Master Record file
- Review, in a consultative capacity, summary plan descriptions and other similar material to be distributed to plan participants.
- Maintain and update eligibility file
- Review claims submitted for medical services that appear excessive and/or establish medical necessity for services rendered or expenses incurred.
- Make available the services of field claim consultants and/or professional services resources for the evaluation of complex claims.
- Maintain peer review relations
- Maintain and store claim detail data elements for statistical analysis.
- Provide online and mobile claim viewing access to participants.
[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: August 18,2022
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$