Third Party Healthcare Claims Administration Services

Agency: University of Wisconsin
State: Wisconsin
Level of Government: State & Local
Category:
  • D - Automatic Data Processing and Telecommunication Services
  • R - Professional, Administrative and Management Support Services
Opps ID: NBD15825566537635579
Posted Date: Jul 31, 2020
Due Date: Sep 4, 2020
Source: Members Only
Organization: VendorNet http://vendornet.wi.gov
Publish Dates: 7/13/2020 through 9/4/2020
Category: Procurement County:
Sub Category: Request for Bid Municipality:
Region: Entire State Status: Active
Third Party Healthcare Claims Administration Services
DOC institutions are located throughout the state. Included in this proposal is WRC which is managed by DHS and is located in Winnebago, WI. All the institutions for this proposal have a full service infirmary/clinic that includes: physician services, nursing services, mental health services, electronic medical record , pharmacy, imaging, and dental services. The medical services provided include:digital imaging, EKG services, optometry services, and a multitude of basic medical equipment. Prescriptions are filled in a timely manner and laboratory services are available. Inmates require primary care treatment of acute illness and management of chronic, communicable, or infectious diseases. Specialty medical services are referred by the primary care providers on-site and delivered at hospitals and clinics located throughout the state. Local ambulance and emergency services are used when necessary. Acute care hospitals throughout the state provide inpatient care. DOC has two locked acute care units, located in hospitals at Waupun and Madison. The scope of this proposal is for a Third Party Healthcare Claims Administrator(TPA) to the process payments, and collect data on claims for health care services provided to DOC and DHS inmates by health care providers. Included in the scope of this proposal are services provided at hospitals, clinics, physician servicess, ambulance, speciality clinics,medical institutions, etc. This processing also includes selected services provided in the DOC HSU(optometry, physical and occupational therapy services, etc.),. On an annual basis appoximately 101,000 claims are processed. (DHS/WRC accounts for an additional 5,000 claims annually)
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* 7/31/2020 11:06:30 AM System Admin Original Entry
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Solicitation Reference #: 7295
Title: Third Party Healthcare Claims Administration Services
Available Date: 7/13/2020
Due Date: 9/4/2020 3:00:00 PM
Bid Synopsis: DOC institutions are located throughout the state. Included in this proposal is WRC which is managed by DHS and is located in Winnebago, WI. All the institutions for this proposal have a full service infirmary/clinic that includes: physician services, nursing services, mental health services, electronic medical record , pharmacy, imaging, and dental services. The medical services provided include:digital imaging, EKG services, optometry services, and a multitude of basic medical equipment. Prescriptions are filled in a timely manner and laboratory services are available. Inmates require primary care treatment of acute illness and management of chronic, communicable, or infectious diseases. Specialty medical services are referred by the primary care providers on-site and delivered at hospitals and clinics located throughout the state. Local ambulance and emergency services are used when necessary. Acute care hospitals throughout the state provide inpatient care. DOC has two locked acute care units, located in hospitals at Waupun and Madison. The scope of this proposal is for a Third Party Healthcare Claims Administrator(TPA) to the process payments, and collect data on claims for health care services provided to DOC and DHS inmates by health care providers. Included in the scope of this proposal are services provided at hospitals, clinics, physician servicess, ambulance, speciality clinics,medical institutions, etc. This processing also includes selected services provided in the DOC HSU(optometry, physical and occupational therapy services, etc.),. On an annual basis appoximately 101,000 claims are processed. (DHS/WRC accounts for an additional 5,000 claims annually)
Agency Contact: Edward Bradley, Phone: 608-240-5572
eSupplier: https://esupplier.wi.gov

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