RFP_5800_SLW3033_ATT_7_v1.xlsx

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Attached to
Worker's Compensation Third Party Administration Service
Solicitation number
RFP 5800 SLW3033
Issued by
Texas

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Written by GovTribe AI ·

This is an Excel spreadsheet attachment to an RFP for Worker's Compensation Third Party Administration Services issued by the City of Texas. The document serves as a supporting exhibit to solicitation number 5800 SLW3033 and contains detailed information relevant to the procurement of workers' compensation third party administrator services for public sector operations. The spreadsheet appears to function as a data table or reference document that provides specifications, requirements, or historical information necessary for qualified firms to prepare competitive proposals.

The specific contents of the spreadsheet include structured data relevant to evaluating third party administrator capabilities and performance metrics. The document is designed to support respondents in understanding the City's requirements and current operational parameters for workers' compensation administration services. This attachment would typically contain information such as claims volume, historical data, service level expectations, or other quantitative metrics that inform bidders' understanding of the scope and scale of the third party administration services required under this solicitation.

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RFP_5800_SLW3033_ATT_1_v1.docx DOCX document
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FY TOTALS

PERFORMANCE MEASURES RECORDResponsible OrganizationOctNovDec1st
QuarterJanFebMar2nd
QuarterAprMayJun3rd
QuarterJulAugSep4th
QuarterFYTD 2026FYTD 2027FYTD 2028
CLAIMS MANAGEMENTTPA
Benefits (DWC Rules)
(1) TIBS initiated timey and accurately (by 15th day )
(2) TIBS week to week (by day after thru date of check)
(3) Waiting Period timely and accurately (by 15st day)
(4) IIBS initiated timely and accurately (by 5th day from receipt of DWC-69)
(5) IIBS week to week (by day after thru date of check)
(6) SIBS/LIBs initiated timely and accurate
(7) SIBS/LIBs subsequent payments timely and accurate
(8) Death Benefits initiated timely and accurately to proper benefciaries
(9) Death Beneits subsequent payments timely and accurate to proper beneficiaries
(10) PLN's-1,2, 3,4, 5, 6, 7 9;10; 12 & 14 filed timely.
UTILIZATION MANAGEMENT/BILL REVIEWTPA
Medical Bill Processing
(8) Medical Bills processed within 45 days after receipt
(9) Medical Bills denied when received after 95th day from date of service
(10) Medical bills audit accurately
Pre-Authorization
(11)Timeliness to requestor (3 working days)
(12) Preauthorization processed accuratelly
EDITPA
(13) FROI Timeliness (percentage)
(14) FROI Accuracy (percentage)
*(15) SROI Timeliness (percentage) - IP only
(16) SROI Accuracy (percentage) - IP only
(17) Medical Bill Reporting Standard - timely and accurate submission of processed medical bills
(16) Pharmacy Bills (PBM) - timely and accurate submission of processed medical bills (combined with #14)

*(15 and 16) SROI timeliness and accuracy reports are measuring Initial Pays (IP) only; based on current TDI-DWC monitoring and oversight under PBO criteria

&"Arial,Bold"&16FY 10/11 JI Performance Measures Summary By Month And Quarter

&"Arial,Bold"&16

COA

RFP BCR

EXHIBIT 3 -PERFORMANCE LOG

1ST QTR

1ST QUARTER - FY 01/02CORPORATE PERFORMANCE INDICATORS
City-wide and by Department1ST QUARTER - FY 01/02PAF WORKSHEET - 1ST QUARTER
OCTOBERNOVEMBERDECEMBER1ST

QTR

DEPARTMENTPAYROLL ERROR RATEPAF ERROR RATELOST TIME INJURY RATE% EMPL COMPLETING EXIT SURVEYGRIEVANCES & APPEALS PER 100 EMPLSICK LEAVE UTILIZATION PER 1000 SCHED HRSEMPLOYEE TURNOVER RATETOTAL # (ALL)
INJURIESDEPARTMENTTOTAL
PAFsPAF
ERRORSTOTAL
PAFsPAF
ERRORSTOTAL
PAFsPAF
ERRORSPAF

Error Rate

AUSTIN ENERGYERROR:#DIV/0!1.25033.471.02%19AUSTIN ENERGYERROR:#DIV/0!
SOLID WASTE SERVICESERROR:#DIV/0!4.51035.683.83%24SOLID WASTE SERVICESERROR:#DIV/0!
WATER & WASTEWATER TOTALERROR:#REF!ERROR:#DIV/0!3.620.1135.162.51%38WATER & WASTEWATER TOTALERROR:#DIV/0!
DEV SVCS & WATERSHED PROTECTIONERROR:#DIV/0!0.000.2935.841.39%0DEV SVCS & WATERSHED PROTECTIONERROR:#DIV/0!
MAYOR & CITY COUNCIL OFFICESERROR:#DIV/0!0.00021.9522.22%0MAYOR & CITY COUNCIL OFFICESERROR:#DIV/0!
MANAGEMENT SERVICESERROR:#DIV/0!0.00030.253.13%0MANAGEMENT SERVICESERROR:#DIV/0!
OFFICE OF THE CITY CLERKERROR:#DIV/0!0.00020.816.67%0OFFICE OF THE CITY CLERKERROR:#DIV/0!
MUNICIPAL COURTERROR:#DIV/0!0.00034.322.95%4MUNICIPAL COURTERROR:#DIV/0!
TRANSP PLANNING & SUSTAIN.ERROR:#DIV/0!0.00039.532.21%0TRANSP PLANNING & SUSTAIN.ERROR:#DIV/0!
INFRASTRUCTURE SUPPORT SERVERROR:#DIV/0!0.00038.571.36%6INFRASTRUCTURE SUPPORT SERVERROR:#DIV/0!
ECONOMIC DEVELOPMENTERROR:#DIV/0!0.00053.790%0ECONOMIC DEVELOPMENTERROR:#DIV/0!
INFORMATION SYSTEMSERROR:#DIV/0!0.00032.350.91%1INFORMATION SYSTEMSERROR:#DIV/0!
LAW DEPARTMENTERROR:#DIV/0!0.00039.022.42%0LAW DEPARTMENTERROR:#DIV/0!
HUMAN RESOURCES DEPTERROR:#DIV/0!0.00039.893.93%1HUMAN RESOURCES DEPTERROR:#DIV/0!
PUBLIC INFORMATION OFFICEERROR:#DIV/0!0.00026.403.80%0PUBLIC INFORMATION OFFICEERROR:#DIV/0!
DEPARTMENT OF PUBLIC WORKSERROR:#REF!ERROR:#DIV/0!3.09033.074.13%5PUBLIC WORKS & TRANSPORTAT TOTALERROR:#DIV/0!
NEIGHBORHOOD PLANNING & ZONINGERROR:#DIV/0!0.00024.1910.07%0NEIGHBORHOOD PLANNING & ZONINGERROR:#DIV/0!
OFFICE OF CITY AUDITORERROR:#DIV/0!0.00035.770%0OFFICE OF CITY AUDITORERROR:#DIV/0!
NEIGHBORHOOD HOUSING & COM DEVERROR:#DIV/0!0.00045.303.64%0NEIGHBORHOOD HOUSING & COM DEVERROR:#DIV/0!
FINANCIAL & ADMIN SERVICES TOTALERROR:#REF!ERROR:#DIV/0!6.04030.872.08%16FINANCIAL & ADMIN SERVICES TOTALERROR:#DIV/0!
SMALL & MINORITY BUSINESS RESOURCESERROR:#DIV/0!0.00037.470%0SMALL & MINORITY BUSINESS AFFAIRSERROR:#DIV/0!
AVIATION DEPARTMENTERROR:#DIV/0!4.77028.763.17%12AVIATION DEPARTMENTERROR:#DIV/0!
AUSTIN FIRE DEPTERROR:#DIV/0!2.01050.991.07%57AUSTIN FIRE DEPTERROR:#DIV/0!
LIBRARY DEPARTMENTERROR:#DIV/0!0.00033.782.36%6LIBRARY DEPARTMENTERROR:#DIV/0!
PARKS & RECREATION DEPTERROR:#DIV/0!2.79034.162.07%25PARKS & RECREATION DEPTERROR:#DIV/0!
AUSTIN POLICE DEPTERROR:#DIV/0!2.23033.981.47%89AUSTIN POLICE DEPTERROR:#DIV/0!
HEALTH & HUMAN SERV DEPTERROR:#DIV/0!0.87037.614.42%11HEALTH & HUMAN SERV DEPTERROR:#DIV/0!
AUSTIN CONVENTION CENTERERROR:#DIV/0!5.77039.871.44%4AUSTIN CONVENTION CENTERERROR:#DIV/0!
EMERGENCY MEDICAL SERVICESERROR:#DIV/0!5.05034.875.64%16EMERGENCY MEDICAL SERVICESERROR:#DIV/0!
PRIMARY CAREERROR:#DIV/0!0.00034.634.84%0PRIMARY CAREERROR:#DIV/0!
ENTIRE CITY TOTALERROR:#REF!ERROR:#DIV/0!2.290.0236.361.98%334ENTIRE CITY TOTAL000000ERROR:#DIV/0!

&"Arial,Bold"&11 1ST QUARTER, FY 01/02 CORPORATE PERFORMANCE MEASURES SUMMARY BY DEPARTMENT AND CITY-WIDE Page &P of &N

&"Arial,Bold"&11 1ST QUARTER, FY 01/02 CORPORATE PERFORMANCE MEASURES SUMMARY BY DEPARTMENT AND CITY-WIDE Page &P of &N

&8Data Completed: &"Times New Roman,Regular"&8BM\FY 2000-01\Per-Measures\Reports-Outgoing\Monthly\&F - &A

&8Data Completed: &"Times New Roman,Regular"&8BM\FY 2000-01\Per-Measures\Reports-Outgoing\Monthly\&F - &A

Sheet1

DEPT.PAF ERROR RATEDEPT.LOST TIME INJURY RATEDEPT.SICK LEAVE UTILIZATION PER 1000 EMPL. HRS.DEPT.EMPLOYEE TURNOVER RATEDEPT.% EMPL COMPLETING EXIT INTERVIEW
ECON DEV0.00%CTY AUD0.00MAYOR18.62ECON DEV0.00%ACC0.00%ENERGY
HRD0.00%CTY CLRK0.00CTY CLRK22.68AFD3.03%AFD0.00%SWS
ISS0.00%ECON DEV0.00MGT SVC27.11ACC4.82%CTY AUD0.00%WWW
MAYOR0.00%HRD0.00PIO28.63INFO SYS5.56%DPW0.00%DV SVC WP
MGT SVC0.00%ISS0.00NP&ZONE29.23ENERGY7.00%ECON DEV0.00%MAYOR
NHCD0.00%LAW0.00INFO SYS31.40APD7.62%ISS0.00%MGT SVC
NP&ZONE0.00%MAYOR0.00NHCD32.14DV SVC WP8.72%NP&ZONE0.00%CTY CLRK
PIO0.00%MGT SVC0.00AVIATION32.37WWW9.21%PIO0.00%MUNI CT
SMBR0.00%MUNI CT0.00ACC33.68CITYWIDE9.68%TP&SUSTA0.00%TP&SUSTA
HHSD0.16%NHCD0.00APD33.78NHCD10.74%DV SVC WP3.85%ISS
AFD0.31%PIO0.00EMS34.23PIO11.03%PARD5.36%ECON DEV
MUNI CT0.45%PRIM CARE0.00ECON DEV34.27TP&SUSTA11.37%FASD8.77%INFO SYS
DPW0.46%SMBR0.00PARD34.32PARD11.87%ENERGY9.21%LAW
CTY CLRK0.63%TP&SUSTA0.00ENERGY34.77SMBR12.58%AVIATION10.42%HRD
APD0.73%DV SVC WP0.30CTY AUD34.80FASD12.80%CTY CLRK16.67%PIO
LIBRARY0.78%INFO SYS0.45LIBRARY35.12DPW13.02%MGT SVC16.67%DPW
SWS0.79%ENERGY0.50FASD35.31HRD14.26%WWW17.14%NP&ZONE
TP&SUSTA0.88%APD0.67PRIM CARE35.62MUNI CT14.61%PRIM CARE19.57%CTY AUD
DV SVC WP0.94%LIBRARY0.68DPW35.90SWS14.70%CITYWIDE22.70%NHCD
CITYWIDE2.18%HHSD0.76DV SVC WP35.97LAW14.81%INFO SYS25.00%FASD
INFO SYS2.20%AFD0.80HRD36.74ISS14.87%MAYOR25.00%SMBR
ACC2.54%AVIATION1.16MUNI CT36.77LIBRARY15.97%SMBR25.00%AVIATION
PRIM CARE2.62%CITYWIDE1.18CITYWIDE36.90AVIATION18.25%LIBRARY25.53%AFD
CTY AUD3.03%DPW1.55WWW37.57EMS18.76%MUNI CT26.09%LIBRARY
WWW3.12%PARD1.81HHSD37.81HHSD19.87%EMS26.32%PARD
ENERGY4.12%WWW1.91TP&SUSTA38.61CTY AUD21.02%SWS26.32%APD
EMS4.90%NP&ZONE2.10LAW39.38CTY CLRK23.61%LAW27.27%HHSD
AVIATION5.10%FASD2.64ISS40.04MGT SVC23.63%APD30.40%ACC
PARD6.93%ACC2.57SWS40.35PRIM CARE24.29%NHCD40.00%EMS
LAW7.50%EMS3.41SMBR47.23NP&ZONE26.56%HRD70.00%PRIM CARE
FASD7.54%SWS4.62AFD48.78MAYOR58.14%HHSD77.53%CITYWIDE

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