Schedule R Payment Discrepancy Report Template.xlsx

XLSX spreadsheet 16 KB Posted

Attached to
HMO Services for MPSERS
Solicitation number
RFP - 171 - 230000003226
Issued by
Ingham County, Lansing City, Michigan

About this file

This document is a Schedule R Payment Discrepancy Report Template associated with RFP No. 230000003226 for HMO health coverage services for the Medicare-Eligible Members and non-Medicare Eligible Members, including Retirees, beneficiaries, COBRA participants, and Dependents, of the Michigan Public School Employees' Retirement System (MPSERS), administered by the Michigan Office of Retirement Services (ORS). The RFP seeks proposals for fully-insured HMO offerings, including both non-Medicare and Medicare products inclusive of prescription drug coverage, to be provided and administered by the selected Contractor. The resulting contract will have a term of one (1) year, with four (4) one-year options.

The state and local jurisdictions involved are Ingham County and Lansing City. A revised Schedule M HMO Census Data document has been added, and a Question and Answer document is now posted. Bidder proposals must reflect fully-insured offerings only, and the Contractor must be able to provide the required products and services to the Eligible Members who elect enrollment in an HMO.

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Text version

Sheet1

Schedule R Payment Discrepancy Report Template
RFP No. 230000003226

SUBSCRIBER NAME SSN MEMBER # MONTH OCCURRED DESCRIPTION/NOTES TYPE NOTES MONTH ADJ FOR AMOUNT BILLED GROUP PAYMENT AMOUNT BALANCE MPSERS RESPONSE

File details come from the government source that posted it. Updated .