PPO_Attachment C - Network.xlsx
XLSX spreadsheet 93 KB Posted
- Attached to
- TPA Services for PPO
- Solicitation number
- ITN-02203
- Issued by
- Leon County, Florida
About this file
This document is an Invitation to Negotiate (ITN) from the State of Florida, Department of Management Services ("Department") for Third Party Administrative (TPA) Services for Preferred Provider Organization (PPO) coverage. The ITN outlines the requirements for providers to submit details on their PPO network in Florida, including the number and geographic distribution of primary care providers, specialists, facilities, and mental health providers. Respondents are required to provide a disruption analysis based on a provided claims data file. The contract opportunity involves services for the state of Florida and its local jurisdictions of Leon County and Tallahassee City.
The ITN requests specific information to be provided in prescribed formats, including provider network details and disruption analysis. No pricing terms or set-asides are included. The contract term and any renewal options are not specified. Overall, this document outlines the state's requirements for TPA services for their PPO medical coverage and the information needed from prospective respondents to evaluate their provider networks and potential disruption.
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Other files
| File | Type | Posted |
|---|---|---|
| PPO_Attachment A - Administrative Requirements_07.27.2022.xlsx | XLSX spreadsheet | |
| PPO_Attachment D - Cost.xlsx | XLSX spreadsheet | |
| Revised Attachment A - Administrative Requirements_10.4.22.xlsx | XLSX spreadsheet | |
| Addendum No. 4.pdf | ||
| PPO_Attachment F - BAA.pdf | ||
| DMS-2223-073_Addendum No. 1_PPO_10.4.22.pdf | ||
| PPO Addendum No. 2.pdf | ||
| PPO_Attachment B - Technical.xlsx | XLSX spreadsheet | |
| PPO_Attachment G - Benefit Document_2023.pdf | ||
| PPO_Attachment H - Data Use Agreement.pdf | ||
| QA DMS-2223-073_PPO_10.4.2022.pdf | ||
| Revised Attachment B - Technical_10.4.22.xlsx | XLSX spreadsheet | |
| Addendum No. 3.pdf | ||
| DMS-2223-073 PPO ITN.pdf | ||
| PPO_Attachment E -Draft Contract.pdf | ||
| Revised Attachment E - Draft Contract_10.4.22.pdf |
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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 Attachment J - Scrubbed Claims Data. Attachment J must be requested per Section 1.10 of the ITN. |
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 Attachment J per Section 1.10 of the ITN | Enter Y/N indicator |
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