CTR079343_Pricing.xlsx
XLSX spreadsheet 15 KB Posted
- Attached to
- Master Agreement AZ|CTR079343
- Contract number
- CTR079343
- Issued by
- Arizona
About this file
This document is a Pricing Document for Request for Proposal No. BPM006851 for Workers' Compensation Independent Medical Evaluation (IME) Scheduling Services, submitted by Alliance Evaluation Services, LLC. The document appears to be related to a state or local government contract for medical evaluation coordination services.
The pricing structure includes a base flat rate of $995.00 for single physician IME scheduling and coordination, with additional fees for various services. Supplemental charges include a base facility fee of $150.00, group facility fee of $300.00, addendum coordination fee of $75.00, and $25.00 per unit for excessive records over 500 pages. The contract allows for a potential 5% annual price increase and includes provisions for additional physician scheduling at $100.00 per physician. The pricing is specifically for IME services performed between 8:00 a.m. and 5:00 p.m., with the understanding that physician fees and chaperone needs may incur separate charges.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CTR079343_COI.pdf | ||
| CTR079343_Contract_Summary_Document.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Items
| Request for Proposal No. BPM006851 | |
| Workers' Compensation IME Scheduling Services | |
| Pricing Document | |
| Offeror Name: | Alliance Evaluation Services, LLC |
| Please provide a flat rate that will encompass all services as outlined in the Scope of Work. | ||
| IME Scheduling and Coordination | ||
| *Between the hours of 8:00 a.m. - 5:00 p.m. | ||
| Offeror Notes | ||
| Flat Rate: | $995.00 | Single physician IME scheduling and coordinating fee, Facility fee not always applied and may be more based on chaperone needs. Physician fees separate -Excessive records over 500 pages, each 250 pages (unit) in excess will receive a $25.00 charge per unit for sorting and handling. Each additional physician in the IME will increase the Flat rate. Flat rate is subject to 5% potential price increase annually if deemed necessary on annual review. |
| Any Additional Charges: | ||
| Base Facility fee when required | $150.00 | |
| Group Facility fee | $300.00 | |
| Addendum Coordination fee | $75.00 | |
| Excessive records per unit | $25.00 | |
| Additional fee per physician | $100.00 | |
| *If charging for excessive records, please indicate how many pages are included in the flat rate and/or the number of pages considered excessive. Please indicate how the additional records will be charged. |
BPM003345 Pricing Document
File details come from the government source that posted it. Updated .