Government Contract | Delaware
Utilization Review

Bid Information


Bid Alert No: 00002681696

Bid Title: Utilization Review

Agency Bid No. Title: LAB21102_URC_OWC

Received Date: 07/09/2021

Close Date: 07/27/2021

Purchase Type: Term:

Delivery Point: Not Stated, Delaware

Delivery Date: Not Stated

Special Notices: Questions Due By 07/13/2021

Specifications

Specifications include, but are not limited to: Review treatment to determine whether or not the following health care treatmentadheres to the Delaware Workers Compensation Health Care Payment System(HCPS) and/or the Delaware Workers Compensation Health Care PracticeGuidelines (PGs):o Medical Treatment;o Chiropractic;o Diagnostic tests;o Hospitalization;o Outpatient Procedures;o Physical Therapy and other physical treatment modalities;o Surgery.o Prescription Drug Utilization Provide service requests within the applicable time standards and provided medicaladvice as warranted. All proposed, concurrent, and retrospective utilization review requests must bereviewed and a determination made within 3 working days from receipt of information, but not to exceed 15 calendar days from receipt of information, or less ifset forth in URAC guidelines. Provide certified, non-certified, and part-certified determinations using a uniformformat as specified by DDOL. Use like specialists to review and issue non-certification determinations. The likespecialists will meet the following criteria, which is slightly different from URACsWCUM-14 standard:a. Are appropriate health professionals;b. Are qualified, as determined by the medical director or clinical director, torender a clinical opinion about the medical condition, procedures, andtreatment under review;c. Hold a current and valid professional license to practice in the contiguousUnited States:i. In the same licensure category as the ordering provider orii. In the same licensure category as the treating provider

Bid Related Documents

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Amendments

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Product Codes: 91878, 94874

Agency Information


Issuing Agency: State of Delaware - Department of Labor

State: Delaware

Agency Type: State and Local

Contact: Allison Stein 4425 N. Market St., P.O. Box 9969, Wilmington, Delaware, 19809

Email: allison.stein@delaware.gov

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