Government Contract | Massachusetts
Medical Bill Review Services / HR

Bid Information

Bid Alert No: 00000414095

Bid Title: Medical Bill Review Services / HR

Agency Bid No. Title: CR-6450-W5

Received Date: 11/10/2015

Close Date: 12/02/2015

Purchase Type: Term: 01/01/2016 - 12/31/2016

Delivery Point: Worcester, Massachusetts

Delivery Date: Not Stated


Specifications include, but are not limited to: A. Medical Bill ReviewUpon receipt, for all claims, the contractor will:1. Scan, image, and index all bills received.2. Examine the bill for appropriateness according to state regulations, review and analyzebill for proper and necessary codes charges, bundling of procedures, and separation ofunrelated injury charges, and any other available reduction procedures.3. Adjust each bill to the lowest Massachusetts rate setting established by the MassachusettsDepartment of Industrial Accidents Board, application of fair and reasonable standards,PPO discounts, usual and customary schedules, negotiated rates (if applicable) and otherapplicable pricing services or by using city approved negotiated fees.34. Provide professional/Nurse audit review of bills from Hospitals that meet $5,000.00threshold.5. Provide an explanation of review for each bill.6. Contractor must agree to answer provider bill questions regarding cost reduction.7. Contractor must provide an account designee that the City can communicate with viatelephone or email about bill or claims issues.

Product Codes: 94610, 95327

Agency Information

Issuing Agency: City of Worcester

State: Massachusetts

Agency Type: State and Local

Contact: Christopher J. Gagliastro, Department of Public Works Purchasing Division, 455 Main Street, Room 201, Worcester, Massachusetts, 01608

Phone: 508-799-1220




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