S24DWC008 UEBTF Bill Review

The California Department of Industrial Relations (DIR) is seeking one full-service contractor to review bills from healthcare providers submitted to the Uninsured Employers Benefits Trust Fund (UEBTF) and the Subsequent Injuries Benefits Trust Fund (SIBTF) for treatment or services provided to injured workers entitled to workers' compensation benefits. The scope of work includes conducting medical bill reviews, providing a bill review tracking system capable of interfacing with DIR's utilization review system, generating statistical reports, and training DIR staff. The contractor must have a minimum of five years' experience providing workers' compensation medical bill review services and employ certified medical bill reviewers. Proposals will be evaluated on the contractor's management plan, methodology, work plan, personnel experience, and pricing. The contract term is 36 months, with a total budget of $750,000. The proposal deadline is September 13, 2024, at 1:00 PM, and proposals must be emailed to the specified DIR email addresses.

This procurement opportunity is specific to the state of California, with the work to be performed within Los Angeles County. The RFP does not mention any set-aside designations or restrictions on the types of organizations that can respond. There is no information provided on any incumbent vendors or current contractors, nor any existing infrastructure or technology that requires integration. The RFP states that the contract will be awarded to the responsive proposer with the lowest cost.