(1) Vendor needs to provide third–party administrator services to process payments for claims and invoices for an incarcerated individual(s) healthcare services.1. Healthcare providers will bill contractor directly for incarcerated individuals’ healthcare provided off–site or on–site of a facility. will notify contractor if services are to be billed as an exception to the contract, i.e., Medicaid, direct billing;2. Individuals on parole or individuals in the custody of on behalf of a county jail will not be factored into the average daily population and at this time are considered outside the scope of services.3. Pay networked provider claims in accordance with contractor’s internal network provider agreement.4. approved dental services.5. Pregnancy care: This will include prenatal and postnatal care for the mother only not covered by Medicaid.6. Prosthetics/Orthotics when placed at the time of surgery.7. Other Specialty Out–Patient Services.(2) All question must be submitted no later than November 22, 2024.(3) A contract term will be for four years.
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