230084_Third_Party_Administration_for_Workers_Compensation-_Price_Page.xlsx
XLSX spreadsheet 16 KB Posted
- Solicitation number
- 230084
- Issued by
- Pima County, Arizona
About this file
The document is a Price Proposal (RFP No. 230084) from the City of Tucson, Arizona, seeking Third Party Administration (TPA) services for workers' compensation claims. The city is requesting bundled and/or unbundled proposals from specialist firms to manage workers' compensation claims for approximately 4,750 employees, with an average of 453 claims filed annually over the past five years. The non-mandatory pre-submittal conference is scheduled for May 9, 2023, at 10:30 am via Microsoft Teams, with proposals due on May 25, 2023, at 2:00 P.M. local Arizona time. The contract is structured as a multi-year agreement, with the city reserving the right to potentially perform some services in-house in subsequent years.
The pricing document includes detailed pricing sections for annual administration fees, ancillary services, and additional cost categories. The city is seeking comprehensive services including comprehensive bill review and audit, utilization review, pharmacy benefit management, PPO and network services, Medicare Set-aside preparation, CMS lien investigation, and case management services. The TPA is expected to provide data demonstrating successful outcomes and added value of ancillary services every six months and list vendors providing these services. The City of Tucson is a full-service, qualified self-insurer authorized by the Industrial Commission of Arizona, with a claims history showing between 351 to 530 total claims annually, indicating a stable and predictable workload for the selected TPA.
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Text version
Sheet1 Price Proposal 230084 Third Party Administration for Workers Compensation Supplier to complete the Yellow Highlighted fields ONLY
| DESCRIPTION | TOTAL |
| Annual Adminstration Fee |
Explain what services are included in the annual administration fee. The explanation should be an itemized breakdown of all services that would be provided and provide the cost below. Supplier to complete the Yellow Highlighted fields ONLY
| ANCILLARY SERVICES | ||
| DESCRIPTION | Unit Price | |
| Comprehensive Bill Review and Audit | ||
| Utilization Review | ||
| Pharmacy Benefit Management | ||
| PPO and Other Network Services | ||
| MSA Preparation | ||
| CMS Lien Investigation | ||
| Telephonic Case Management | ||
| Field Case Management | ||
| Other | ||
| TOTAL | $ - 0 |
Please provide all costs associated as broken down for these additional categories. Supplier to complete the Yellow Highlighted fields ONLY
| DESCRIPTION | Unit Price | |
| Annual Escrow Bank Account Fee: | ||
| Access to online Claims System Fee: | ||
| Claim Reporting Fee: | ||
| Cost of claims transferred from prior TPA | ||
| ISO Claim Search Fee: | ||
| Medicare Reporting Fee: | ||
| Bill Review Fee: | ||
| Percentage of savings Fee: | ||
| Ebill transaction Fee: | ||
| Per Line | ||
| Per Bill | ||
| PPO Network Fee: | ||
| Durable Medical Equipment Fee: | ||
| Pharmacy Fee: | ||
| Hospital Bill Review Fees: | ||
| Percentage of savings Fee: | ||
| Managed Care Network Fee: | ||
| Out of Network Negotiation Fee: | ||
| Telephonic Nurse Case Management | ||
| Field Case Management Fee: | ||
| Pharmacy Benefit Management: | ||
| Generic/Brand | ||
| Mail Order Brand/Generic | ||
| Pharmacist Medication Review | ||
| Dental Program Fee | ||
| Pharmacist Intervention Program | ||
| Third Party Lien Resolution | ||
| Subrogation Recovery | ||
| Full/Final and Structured Settlement Reports | ||
| TOTAL | $ - 0 |
Provide a detailed list of any anticipated additional services that the Offeror can provide at no additional cost. *Add additional rows as needed
DESCRIPTION
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