25-123 Third Party Administrative Services for Worker Compensation

Augusta, Georgia, through its Finance Department, is seeking Third Party Administrative Services for Workers Compensation via a competitive Request for Proposal (RFP) process. The procurement covers comprehensive workers' compensation claims management services, including claims processing, medical bill review, nurse case management, and customer service support. The city requires a Third Party Administrator (TPA) to handle approximately 105 takeover claims, with the current program having 92 open claims and Safety National serving as the excess carrier. Proposals are due on Monday, December 30, 2024, at 1:00 p.m. via a ZOOM meeting, with Augusta intending to award a three-year contract that includes two potential one-year renewal options. Evaluation criteria will encompass vendor qualifications, organizational approach, scope of services, financial stability, references, geographical proximity, and cost. Proposers must submit detailed documentation demonstrating their capability to manage claims, implement cost-saving programs, and provide comprehensive workers' compensation administrative services.

The RFP does not specify any specific set-aside designations or restrictions for disadvantaged enterprises, and notably, there are no Minority/Women-owned Business Enterprise (M/WBE) participation goals for this contract. The current program utilizes a 24/7 nurse triage system and maintains a monthly replenished bank account for carrier payments, with existing infrastructure including one adjuster for medical-only (MO) claims and another for long-term (LT) claims. The medical bill review program has historically processed 20,389 bills, resulting in $30.3 million in total charges and achieving $21.3 million in savings over the past three years. While specific budget ranges are not explicitly stated, vendors will be required to submit detailed fee proposals as part of their response. Supplemental claims data, loss runs, and contract information will be provided to potential vendors via USB drive attachments to support comprehensive proposal preparation.