Posted Date : April 01,2022
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-6233
Government Authority located in Tennessee; USA based organization looking for expert vendor for employee pharmacy benefit administrative services.
[A] Budget: Looking for proposal
[B] Scope of Service:
(1) Vendor needs to provide employee pharmacy benefit administrative services.
- Will perform "desk-top audits," which review claims for potential issues (key stroke errors, fraudulent claims) or trends, on a daily basis such that issues can be resolved quickly, and the results will be reported to Client at least on an annual basis
- Daily review of claims greater than $1,000 in gross cost and ensure the claims were administered and adjudicated appropriately.
- Perform on-site pharmacy audits, which will cover at least 3% of the pharmacies in its retail network, and the results will be reported to Client at least on an annual basis.
- Perform audits of Vendor's mail pharmacies and the results will be shared with Client at least on an annual basis.
- Provide advanced notice about coverage rules / utilization management programs that are available for New-to-Market products prior to adding New-to-Market products to the formulary.
- Will produce and provide a detailed claims file monthly, which is in addition to files requested for auditing purposes.
(2) A pre-bid conference will be held on April 14,2022.
(3) All question must be submitted no later than April 28, 2022.
[C] Eligibility:
Onshore (USA organization Only)
[D] Work Performance:
Performance of the work will be offsite.
Budget :
Deadline to Submit Proposals: May 09,2022
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-6233
Government Authority located in Tennessee; USA based organization looking for expert vendor for employee pharmacy benefit administrative services.
[A] Budget: Looking for proposal
[B] Scope of Service:
(1) Vendor needs to provide employee pharmacy benefit administrative services.
- Will perform "desk-top audits," which review claims for potential issues (key stroke errors, fraudulent claims) or trends, on a daily basis such that issues can be resolved quickly, and the results will be reported to Client at least on an annual basis
- Daily review of claims greater than $1,000 in gross cost and ensure the claims were administered and adjudicated appropriately.
- Perform on-site pharmacy audits, which will cover at least 3% of the pharmacies in its retail network, and the results will be reported to Client at least on an annual basis.
- Perform audits of Vendor's mail pharmacies and the results will be shared with Client at least on an annual basis.
- Provide advanced notice about coverage rules / utilization management programs that are available for New-to-Market products prior to adding New-to-Market products to the formulary.
- Will produce and provide a detailed claims file monthly, which is in addition to files requested for auditing purposes.
(2) A pre-bid conference will be held on April 14,2022.
(3) All question must be submitted no later than April 28, 2022.
[C] Eligibility:
Onshore (USA organization Only)
[D] Work Performance:
Performance of the work will be offsite.
Budget :
Deadline to Submit Proposals: May 09,2022
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$