Workers' Compensation Medical Bill Review Services
Suffolk County > Office of Central Procurement > Department of Law > Division of Risk Management > Workers' Compensation Unit
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Description
Suffolk County seeks proposals for medical bill review, repricing, and utilization review services for its self-funded and self-administered workers' compensation program. The contractor will review approximately 34,000 medical bills annually, audit billing codes and treatment, apply New York State fee schedules and preferred provider organization contracts, identify inappropriate or excessive treatment, prepare explanations of payment and objections, and negotiate applicable fees. The scope also includes reviewing treatment authorization and variance requests, responding to appeals, supporting litigated cases and hearings, resolving provider issues, maintaining medical records, providing a secure encrypted browser-based interface, and assisting with medical case-management guidelines. The contractor must provide phone and email consultation during normal business hours and have a representative on site at the Suffolk County Risk Management Office at least three days per week. Proposals must include qualifications, personnel information, financial statements, client history and references, technical services, subcontractor information if applicable, conflict disclosures, and a separate cost proposal.
Classification Codes
Smart Codes
Specifications
Timeline
Requirements
- Commercial General Liability — $2,000,000.00
- Automobile Liability — $500,000.00
- Automobile Liability - Property Damage — $100,000.00
- Professional Liability — $2,000,000.00
- Workers' Compensation and Employer's Liability
- Disability Benefits and Paid Family Leave
- Minimum 3 references
- Within the last 3 years
- Client point of contact required for each reference
Location
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