PPO_Attachment C - Network.xlsx
XLSX spreadsheet 92 KB Posted
- Attached to
- TPA Services for PPO
- Solicitation number
- ITN-01869
- Issued by
- Leon County, Florida
About this file
This document is an Invitation to Negotiate (ITN) issued by the State of Florida, Department of Management Services' Division of State Group Insurance for Third Party Administrative (TPA) Services for Preferred Provider Organization (PPO) coverage. The ITN requests interested Respondents to submit Replies to provide comprehensive medical and mental health/substance abuse provider networks to serve a subscriber population of approximately 167,047 members. Respondents are required to complete detailed network access charts indicating the number and geographic coverage of various provider types, as well as provide a disruption analysis file identifying in-network and out-of-network providers. The ITN is for the State of Florida and the local jurisdictions of Leon County and the City of Tallahassee.
The ITN does not provide specific pricing terms or funding information. Respondents are instructed to request a subscriber census file and disruption data from the Procurement Officer to complete the required network access and disruption analysis. The ITN does not identify any incumbent TPA providers or the current contract environment. The contract term and any renewal options are also not specified in the ITN.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| PPO_Attachment A - ARs.xlsx | XLSX spreadsheet | |
| DMS-2223-048 PPO ITN.pdf | ||
| PPO_Attachment G - Benefit Document_2023.pdf | ||
| Addendum 1 PPO.pdf | ||
| PPO_Attachment E -Draft Contract.pdf | ||
| PPO_Attachment F - BAA.pdf | ||
| PPO_Attachment B - Technical.xlsx | XLSX spreadsheet | |
| PPO_Attachment D - Cost.xlsx | XLSX spreadsheet | |
| PPO_Attachment H - Data Use Agreement.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
GEO Access
| Invitation to Negotiate (ITN) for the State of Florida, Florida Department of Management Services ("Department") |
| PPO Medical Self-Insured |
| GEO Access |
| Respondent Name: |
| [Insert Respondent Name Here] |
Instructions: Please complete the below charts using the subscriber census file. Please request the census file from the Procurement Officer. Please provide access, based on your broadest provider network in Florida. Note that it is important that you follow exact parameters of the charts below. Provide a geo-access report in electronic format as well. Name the file: [Respondent's Name]_Geo Access Med_Plan Type.
Current Count of Medical Subscribers 167,047
PPO - Broad
| Access Criteria | Insert Plan Name Here (Broadest Network PPO) | ||||
| 1. | Type of Provider | Number of Providers | Miles from Residence | Percentage Meeting Access | |
| Primary Care Provider (PCP) | Adult Physicians/Family/General Practitioner/Internists | 2 | 8 | ||
| Specialist Providers | Pediatricians | 2 | 8 | ||
| Obstetricians/Gynecologists | 2 | 8 | |||
| Anesthesiologist | 2 | 8 | |||
| Cardiologists | 2 | 8 | |||
| Neonatologist | 2 | 8 | |||
| Neurologists | 2 | 8 | |||
| Nutritionists | 2 | 8 | |||
| Dermatologists | 2 | 8 | |||
| Oncologists | 2 | 8 | |||
| Orthopedists | 2 | 8 | |||
| Ophthalmologists | 2 | 8 | |||
| Optometrists | 2 | 8 | |||
| Psychiatrists | 2 | 8 | |||
| Clinical Psychologists | 2 | 8 | |||
| Licensed Medical Social Workers | 2 | 8 | |||
| Facilities | Acute Care Hospitals | 1 | 15 | ||
| MHSA Inpatient Facilities | 1 | 15 | |||
| MHSA Outpatient Facilities | 1 | 15 | |||
| MHSA Outpatient Specialty Facilities (alternative facilities, e.g. Halfway houses, intensive outpatient treatment) | 1 | 15 | |||
| 2 | Briefly describe your methodology for geo-analysis, including: | ||||
| a. | Software used and when last updated | ||||
| b. | Definition of distance if not driving distance |
Count of Providers
| Invitation to Negotiate (ITN) for the State of Florida, Florida Department of Management Services ("Department") |
| PPO Medical Self-Insured |
| Count of Providers |
| Respondent Name: |
| [Insert Respondent Name Here] |
| Instructions: Please enter total number of providers based on Type of Provider in column F. | ||
| PPO Broad - Type of Unique Providers | ||
| Primary Care Provider (PCP) | Adult Physicians/Family/General Practitioner/Internists | |
| Specialist Providers | Pediatricians | |
| Obstetricians/Gynecologists | ||
| Anesthesiologist | ||
| Cardiologists | ||
| Neonatologist | ||
| Neurologists | ||
| Nutritionists | ||
| Dermatologists | ||
| Oncologists | ||
| Orthopedists | ||
| Ophthalmologists | ||
| Optometrists | ||
| Psychiatrists | ||
| Clinical Psychologists | ||
| Licensed Medical Social Workers | ||
| Facilities | Acute Care Hospitals | |
| MHSA Inpatient Facilities | ||
| MHSA Outpatient Facilities | ||
| MHSA Outpatient Specialty Facilities (alternative facilities, e.g. Halfway houses, intensive outpatient treatment) |
Disruption
| Invitation to Negotiate (ITN) for the State of Florida, Florida Department of Management Services ("Department") |
| PPO Medical Self-Insured |
| Disruption |
| Respondent Name: |
| [Insert Respondent Name Here] |
| Instructions: Please complete the below chart using the disruption file. Please request the disruption file from the Procurement Officer. |
Please provide a disruption file based on the parameters below for the PPO based on your broadest provider network in Florida. Please indicate whether or not each provider/facility participates in your proposed networks. Name the file: [Respondent's Name]_Disruption Med_PPO.
| # | Tax ID | Provider Name | State | Zip | Provider Specialty | Place of Service | PPO Broad In-Network Indicator (Y/N) |
| Request disruption file data from Procurement Officer | Enter Y/N indicator |
image1.png
File details come from the government source that posted it. Updated .