25_123_ADD1.pdf

This is Addendum 1 to RFP Item #25-123 from Augusta, Georgia for Third Party Administrative Services for Workers Compensation, with responses due Monday, December 30, 2024 at 1:00 p.m. The addendum provides responses to 63 vendor questions about the RFP, addressing topics including claims management, medical bill review, pharmacy benefits, and nurse case management services. The city currently uses a 24/7 nurse triage program and expects approximately 105 takeover claims for the new TPA to handle.

The current program has 92 open claims, with Safety National as the excess carrier. Augusta maintains a bank account for the carrier that is replenished monthly based on payments. The city currently has one adjuster for MO claims and one dedicated adjuster for LT claims. The medical bill review program has processed 20,389 bills totaling $30.3 million in charges with $21.3 million in savings over the past 3 years. The city does not have any M/WBE participation goals for this contract. Various detailed claims data, loss runs, and contracts are provided on USB drive attachments to assist vendors in preparing their proposals.