Posted Date : February 21,2022
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : ACCT-13297
Government authority located in Jackson, Mississippi; USA based organization looking for expert vendor for recovery audit contractor services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide recovery audit contractor services to the government authority located in Jackson, MS.
- The contractor will perform medicaid improper payment recovery services to identify and facilitate recovery of improper payments made by division and managed care organizations for healthcare services provided to medicaid beneficiaries, with the overall purpose of implementing actions that will prevent future improper payments.
- The Contractor will be responsible for reviewing claims data, medical, professional and/or financial records to determine if billings to, and payments from, division and the managed care organizations were appropriate and accurate.
- The contractors audit plan shall describe in detail each claim identification process. the audit plan shall outline the various computer algorithms, predictive modeling and any other methods used for identification of improper payments, including review of any voided and/or adjusted claims subsequent to the original claim.
- The Contractor is to present evidence of primary patterns identified and effectiveness of methods, including cost benefit analysis.
(2) All questions must be submitted no later than March 4, 2022.
[C] Eligibility:
- Onshore (US Organization Only);
[D] Work Performance:
Performance of the work will be Offsite.
Budget :
Deadline to Submit Proposals: March 28,2022
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : ACCT-13297
Government authority located in Jackson, Mississippi; USA based organization looking for expert vendor for recovery audit contractor services.
[A] Budget: Looking for Proposal
[B] Scope of Service:
(1) Vendor needs to provide recovery audit contractor services to the government authority located in Jackson, MS.
- The contractor will perform medicaid improper payment recovery services to identify and facilitate recovery of improper payments made by division and managed care organizations for healthcare services provided to medicaid beneficiaries, with the overall purpose of implementing actions that will prevent future improper payments.
- The Contractor will be responsible for reviewing claims data, medical, professional and/or financial records to determine if billings to, and payments from, division and the managed care organizations were appropriate and accurate.
- The contractors audit plan shall describe in detail each claim identification process. the audit plan shall outline the various computer algorithms, predictive modeling and any other methods used for identification of improper payments, including review of any voided and/or adjusted claims subsequent to the original claim.
- The Contractor is to present evidence of primary patterns identified and effectiveness of methods, including cost benefit analysis.
(2) All questions must be submitted no later than March 4, 2022.
[C] Eligibility:
- Onshore (US Organization Only);
[D] Work Performance:
Performance of the work will be Offsite.
Budget :
Deadline to Submit Proposals: March 28,2022
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$