MB-6668 - USA (New York) - Special Investigations Unit Services - Deadline August 25,2022

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-6668

Government Authority located in New York; USA based organization looking for expert vendor for special investigations unit services.

[A] Budget: Looking for Proposals

[B] Scope of Service:

Vendor needs to provide post payment claim review including identifying, investigating, and recovering overpayments; and recognizing and flagging billing abnormalities indicative of fraud, waste or abuse.
• Evaluate and audit claims on a line-by-line basis as they were adjudicated or as they should have been adjudicated after medical record review;
• Communicate detailed audit findings to identified aberrant providers and their representatives via print, electronic, telephonic and virtual means;
• Present options for recovery of overpayments;
• Initiate overpayment recovery actions on a case specific basis, as directed and in collaboration with agency;
• Provide, manage and update a secure case file management system with capability to store case notes and documents. Any such system must contain a customer interface with full access by designated agency personnel;
• Ensure regular meetings take place with agency in online or virtual format to discuss casework;
• Possess a robust cadre of trained coding and auditing personnel who are experienced in performing medical and clinical audits;
• Describe staffing model including the provision of dedicated investigative staff
• Ensure the appropriate expertise and necessary training of assigned investigative staff. Such staff should have access to third party investigative databases, such as LexisNexis, Accurint, etc.

[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.

Expiry Date : Thursday, 25 August, 2022

Category : Medical Billing and Coding

Country : USA

State : New York

RFP Expired

You can either pay for Single RFP/Bid document or Subscribe with Monthly Subscription for whole Medical Billing and Coding Category/Categories.

If you will obtain monthly subscription for Medical Billing and Codingcategory/categories, you will be able to access all the RFPs from that Category. Here are the Monthly Subscription offers. So, subscribe for Monthly offers and get rid of Individual RFP payment.

*No commitment =
(1) There is no minimum commitment.
(2) You can subscribe for as less as 1 month and cancel it any time. If you subscribe for annual offer, you can cancel it any time within year.
(3) There is no partial refund policy after Monthly or Annual subscription. You will be required to use services for a Month (Or Year since you have availed discounted pricing).
(4) You can cancel your subscription any-time directly from your PayPal account to stop further recurring charges before next due date.
(5) You will be able to download all RFPs for subscribed Category or Location without any extra cost.

Similar RFPs