Posted Date : October 23,2021
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-5779
Government Authority located in Nebraska; USA based organization looking for expert vendor for Medicaid claiming services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide Medicaid claiming services to support proper Medicaid reimbursement for both direct medical services and administrative activities.
- Allows the contractor to send queries to direct service providers and school employees performing administrative activities to document the amount of time spent doing Medicaid allowable services,
- Allows school providers to certify financial data,
- Allows each user to have their own username and password, and
- Shall make the random moment online system available to the department in a production environment.
- Shall ensure the ability to duplicate each random sampling that is conducted.
- Shall develop and maintain a cost reporting online system.
- Develop and submit to the department a methodology to calculate school provider specific interim rates.
- Gather and analyze historical cost data from school providers to calculate a monthly school provider-specific interim rate of payment based on the department-approved methodology.
- Review all school provider-specific monthly rate-setting calculations for accuracy.
- Collect and analyze quarterly financial data from each direct service provider so that the interim rates can be adjusted mid-year if necessary.
- Shall complete an annual cost reconciliation process to compare interim payments to costs identified on each cost report.
- Audits shall include, but are not limited to claims reviews, cost reports, annual and quarterly financial reports.
- Shall provide ongoing email communication with direct service providers and school employees providing administrative activities as needed.
- Make recommendations for strategies to respond to changes in the overall healthcare market.
(2) All questions must be submitted no later than November 11, 2021.
[C] Eligibility:
- Onshore (US Organization Only);
[D] Work Performance:
Performance of the work will be Offsite.
Budget :
Deadline to Submit Proposals: December 15,2021
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-5779
Government Authority located in Nebraska; USA based organization looking for expert vendor for Medicaid claiming services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide Medicaid claiming services to support proper Medicaid reimbursement for both direct medical services and administrative activities.
- Allows the contractor to send queries to direct service providers and school employees performing administrative activities to document the amount of time spent doing Medicaid allowable services,
- Allows school providers to certify financial data,
- Allows each user to have their own username and password, and
- Shall make the random moment online system available to the department in a production environment.
- Shall ensure the ability to duplicate each random sampling that is conducted.
- Shall develop and maintain a cost reporting online system.
- Develop and submit to the department a methodology to calculate school provider specific interim rates.
- Gather and analyze historical cost data from school providers to calculate a monthly school provider-specific interim rate of payment based on the department-approved methodology.
- Review all school provider-specific monthly rate-setting calculations for accuracy.
- Collect and analyze quarterly financial data from each direct service provider so that the interim rates can be adjusted mid-year if necessary.
- Shall complete an annual cost reconciliation process to compare interim payments to costs identified on each cost report.
- Audits shall include, but are not limited to claims reviews, cost reports, annual and quarterly financial reports.
- Shall provide ongoing email communication with direct service providers and school employees providing administrative activities as needed.
- Make recommendations for strategies to respond to changes in the overall healthcare market.
(2) All questions must be submitted no later than November 11, 2021.
[C] Eligibility:
- Onshore (US Organization Only);
[D] Work Performance:
Performance of the work will be Offsite.
Budget :
Deadline to Submit Proposals: December 15,2021
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$