S000000390 Official Bid Price Sheet~1.xlsx
XLSX spreadsheet 17 KB Posted
- Attached to
- Managed Care for Workers' Compensation
- Solicitation number
- S000000390
- Issued by
- Arkansas
About this file
This is an official bid price sheet for a Managed Care for Workers' Compensation contract issued by the Arkansas Insurance Division Public Employee Claims Division. The document outlines pricing instructions and requirements for prospective contractors to submit costs for various medical management services, including PPO access fees, bill review, peer review, pre-certification, medical case management, and utilization review services. The pricing sheet is structured to capture estimated costs over a seven-year period, with specific service quantities outlined, including 14,000 annual bill reviews, 50 peer reviews, 250 pre-certifications, 5,500 hours of medical case management, and 600 hours of utilization review.
The pricing structure includes a PPO access fee calculated as a percentage of savings with a maximum charge of $15,000 per individual medical bill, based on estimated annual savings of $4,300,000. The price sheet also includes optional pass-through payment processing services for 14,000 bills with EOBs, featuring various payment methods including 8,000 ACH payments, 5,000 mailed payments, and 1,000 virtual card payments. The document requires contractors to provide comprehensive pricing that includes all associated costs such as travel, fees, and billable expenses. Additional tasks not specified by the State can be added by contractors in the designated sections of Tables 3 and 4.
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Text version
Price Instructions Official Solicitation Price Sheet* S000000390 Managed Care for Workers' Compensation Arkansas Insurance Division Public Employee Claims Division
Prospective Contractor Name:
| Instructions |
| 1. The Prospective Contractor should enter their name in the green-highlighted cell on this tab. |
| Table 1 |
| 1. Table 1 will automatically calculate the total estimated seven (7) year cost based on the pricing entered into Table 2, Table 3, and Table 4. |
| 2. This cost must include all costs associated with the activities and tasks that meet the Requirements of the RFP, including travel costs, fees, billable expenses, etc. and all additional activities and tasks identified in the Prospective Contractor's proposal. |
| 3. The total estimated costs from Table 2, Table 3, and Table 4 must add up to match the total estimated cost in Table 1. |
| 4. In the event of a discrepancy between Table 1, and Table 2, Table 3, and Table 4, Table 1 shall govern. |
| 5. Cost Points will be awarded based on the total estimated cost in Table 1. |
| Table 2 |
| 1. The Prospective Contractor shall enter the PPO access fee charge as percentage (whole #) of savings in the green-shaded cell in Table 2. |
| 2. The Prospective Contractor shall not charge the Division more than $15,000 in PPO access fee charges per individual medical bill. |
| Table 3 |
| 1. The Prospective Contractor shall enter the rates for each green-shaded cell in Table 3. |
| 2. The Contractor may identify additional tasks not specified by the State in the blank lines on Table 3 and may add lines to Table 3 as needed. |
| Table 4 |
| 1. The Prospective Contractor shall enter the hourly rates for each green-shaded cell in Table 4. |
| 2. The Contractor may identify additional tasks not specified by the State in the blank lines on Table 4 and may add lines to Table 4 as needed. |
| Table 5 - Not used in determining Cost Points |
| 1. The Prospective Contractor shall enter the excess mileage rate in the green-shaded cell in Table 5. |
| Table 6 - Not used in determining Cost Points |
| 1. The Prospective Contractor should enter the rates for each green-shaded cell in Table 6. |
Price Sheet Official Solicitation Price Sheet S000000390 Managed Care for Workers' Compensation Arkansas Insurance Department Public Employee Claims Division
Prospective Contractor Name: 0
| Table 1: Used in determining Cost Points | |
| Description | All-Inclusive Estimated Seven (7) Year Grand Total |
| Managed Care for Workers' Compensation | $ - 0 |
| Table 2: Used in determining Cost Points | |||
| Description | PPO Access fee charge as Percentage (whole #) of Savings | Estimated Total Amount of Savings | Estimated Annual PPO Access Fee Cost to the State |
| PPO Savings | $ 4,300,000.00 | $ - 0 |
| Table 3: Used in determining Cost Points | |||
| Description | Rate | Estimated Annual Quantity | Estimated Annual Total |
| Bill Review - Flat Rate Per Bill | 14,000 | $ - 0 | |
| Peer Review - Flat Rate | 50 | $ - 0 | |
| Peer Review - Each additional page | 200 | $ - 0 | |
| Pre-Certification - Flat Rate per each | 250 | $ - 0 |
Estimated Total $ - 0
| Table 4: Used in determining Cost Points | |||
| Description | Hourly Rate | Estimated Annual Hours | Estimated Annual Total |
| Medical Case Management | 5,500 | $ - 0 | |
| Utilization Review (Beyond Normal Bill Review) | 600 | $ - 0 |
Estimated Total $ - 0
| Table 5: Not used in determining Cost Points | |
| Description | Rate per Mile |
| Excess Mileage Rate |
| Table 6: Optional Pass-Through Payments | Not used in determining Cost Points | ||
| Description | Rate | Estimated Annual Quantity | Estimated Annual Total |
| Payments with EOB's - Flat Rate Per Bill & EOB | 14,000 | $ - 0 | |
| Payments by ACH (includes sending EOB) | 8,000 | $ - 0 | |
| Payments by Mail (includes sending EOB) | 5,000 | $ - 0 | |
| Payments by Virtual Card (includes sending EOB) | 1,000 | $ - 0 | |
| Estimated Total | $ - 0 |
File details come from the government source that posted it. Updated .