Government Contract | California
Post Payment Audit and Recovery Services

Bid Information

Bid Alert No: 00000452954

Bid Title: Post Payment Audit and Recovery Services

Agency Bid No. Title: SD 14-00059

Received Date: 01/06/2016

Close Date: 02/09/2016

Purchase Type: Not Stated

Delivery Point: California

Delivery Date: Not Stated

Special Notices: Questions Due By 01/14/2016 05:00 PM


Specifications include, but are not limited to:The Contractor shall provide the following post payment audit and recovery services atthe request of the COCR:a. Oata integration, data mining, and analytics of one hundred percent (100%) of paidclaims on all provider types to identify potential recovery.b. Retrospective audit of paid claims.c. Retrospective duplicate payment audit of paid claims.d. Overpayment recovery.e. Credit Balance audit.f. Contract Compliance audit.g. Pharmaceutical audit.h. Fraud, abuse, waste, and error detection.IFB SO 14-000592) The Contractor shall also provide administrative services and collaborate with the COCRas follows:a. Use Recovery Audit Contractor (RAC) industry-standard expertise, tools,methodologies, analysis and technology to audit healthcare claims with dates ofservice beginning on or after July 1, 2013.b. Have the ability to receive claims data electronically through a .csv file using pipedelimiter from the Third Party Administrator (TPA) and through Microsoft Accessfrom the COCR's Contract Medical Database system.c. Maintain a lockbox to which providers are required to refund overpayments to theCOCR. The Contractor shall meet all SOX (Sarbanes-Oxley) compliancerequirements for handling refund overpayments received on behalf of the COCR. Nooffset on future claim payments is allowed.d. Collect refunds through a series of multiple, proven collection techniques used withhealthcare providers.

Product Code: 94620

Agency Information

Issuing Agency: State of California - Department of Corrections and Rehabilitation

State: California

Agency Type: State and Local

Contact: Jatin Nagin California Correctional Health Care Services, 8280 Long Leaf Drive, Bldg. D-2, Elk Grove, California, 95758

Phone: 916-691-3943




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