Government Contract | Missouri
Group Dental Coverage

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Bid Information

Bid Alert No: 00000576025

Bid Title: Group Dental Coverage

Agency Bid No. Title: 2016-14-TP

Received Date: 05/18/2016

Close Date: 05/27/2016

Purchase Type: Not Stated

Delivery Point: St. Louis, Missouri

Delivery Date: Not Stated


Specifications include, but are not limited to:. Dental Management i)The MCO will adequately credential, recredential and monitor its affiliated dental care providers in accordance with the current National Committee for Quality Assurance (NCQA) criteria relating to provider selection and quality management; ii)The MCO's utilization management reviewers will be clinically matched to the case under review; iii)The MCO's communications to Plan Participants and their dental care providers will include a clear statement confirming that the decision regarding what treatment is appropriate (i.e., level, duration of care, etc.) is always left to the discretion of the Participant and his or her attending provider, and confirming that precertification and other forms of utilization management relate solely to whether and the extent to which a procedure or service will be paid for by the Plan; iv)If the MCO's standardized communications are provided to Participants and/or the MCO's network providers, they will describe any Plan benefit reductions or other penalties that apply if the Participant (or his or her attending provider) does not comply with utilization management requirements imposed under the Plan and this Contract; v)The MCO's medical necessity and/or claim denial letters will contain adequate detail to satisfy current Employee Retirement Income Security Act of 197 4 (ERISA) and state law standards;

Bid Related Documents

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Product Code: 95348

Agency Information

Issuing Agency: County of St. Louis

State: Missouri

Agency Type: State and Local

Contact: Jen Dawkins




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