Posted Date : October 28,2020
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : PHAR-0551
Government authority located in Lincoln, Nebraska; USA based organization looking for expert vendor for pharmacy benefit manager services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide pharmacy benefit manager services for formulary directly to enrolled ADAP clients who do not have health insurance, and the Insurance Assistance Program, which provides health insurance coverage and covers health-insurance related expenses to ensure
access to HIV-related pharmaceuticals from an approved formulary for enrolled to the government authority located in Lincoln, NE.
- to purchase health insurance for eligible clients and for services that enhance access to, adherence
to, and monitoring of drug treatments.
- Coordinating insurance benefits, including payment of health insurance premiums
- Processing point-of-sale pharmaceutical purchases, including payment of health insurance plan deductible, co-insurance, and co-payment amounts
- Adjudicating pharmaceutical-related claims
- Coordinating with Medicare, Medicaid, and private insurance carriers
- Collecting and reporting data on pharmaceutical and insurance-related claims
- Billing third-party payers when clients are found to be retro-eligible for other benefit programs
- Other services include point-of-sale claims adjudication; screening for other benefit homes or programs that a client may be enrolled in; client adherence counseling; utilization management; data collection, analytics, and reporting; and customer service, including access to real-time claims data
- Maintain adequate records for complete financial and programmatic audits
- electronic claims processing that allow s pharmacies to do online adjudication and split billing/cross-over claims, such that pharmacies and/or clients are not required to submit manual claims for secondary payer
- maintain a secure data system that is capable of receiving and managing confidential client eligibility information, processing claims; creating reports; and transferring data securely
- Allow for confidential communications of claims, product cost, individual prescription
history, and client demographics.
(2) All questions had been submitted no later than October 23, 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: November 24,2020
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
Image may be NSFW.
Clik here to view.
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : PHAR-0551
Government authority located in Lincoln, Nebraska; USA based organization looking for expert vendor for pharmacy benefit manager services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide pharmacy benefit manager services for formulary directly to enrolled ADAP clients who do not have health insurance, and the Insurance Assistance Program, which provides health insurance coverage and covers health-insurance related expenses to ensure
access to HIV-related pharmaceuticals from an approved formulary for enrolled to the government authority located in Lincoln, NE.
- to purchase health insurance for eligible clients and for services that enhance access to, adherence
to, and monitoring of drug treatments.
- Coordinating insurance benefits, including payment of health insurance premiums
- Processing point-of-sale pharmaceutical purchases, including payment of health insurance plan deductible, co-insurance, and co-payment amounts
- Adjudicating pharmaceutical-related claims
- Coordinating with Medicare, Medicaid, and private insurance carriers
- Collecting and reporting data on pharmaceutical and insurance-related claims
- Billing third-party payers when clients are found to be retro-eligible for other benefit programs
- Other services include point-of-sale claims adjudication; screening for other benefit homes or programs that a client may be enrolled in; client adherence counseling; utilization management; data collection, analytics, and reporting; and customer service, including access to real-time claims data
- Maintain adequate records for complete financial and programmatic audits
- electronic claims processing that allow s pharmacies to do online adjudication and split billing/cross-over claims, such that pharmacies and/or clients are not required to submit manual claims for secondary payer
- maintain a secure data system that is capable of receiving and managing confidential client eligibility information, processing claims; creating reports; and transferring data securely
- Allow for confidential communications of claims, product cost, individual prescription
history, and client demographics.
(2) All questions had been submitted no later than October 23, 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: November 24,2020
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
Image may be NSFW.
Clik here to view.
