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Canada (British Columbia) Collection and Reporting Services

RFP ID: MB-0025
We are British Columbia; Canada based organization looking for expert vendor (From CANADA Only) for Collection and Reporting Services. Vendor needs to provide physician billing and statistical reporting services for over 180 physicians contracted with us. Contract will be of two (2) years and can be extended further for three (3) years.
[A] Notice Type: Request for Proposal (RFP)
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Pick up physician billing and statistical data from the physician groups which are located throughout Vancouver Island. Service Provider will pick up documents from central locations in Victoria and Nanaimo or other locations as mutually agreed on a regular basis for processing.
(2) Follow up on missing billing and statistical data from physician contract groups.
(3) Entering data from service billing and encounter forms into database system. These forms will have an approximate of 13 data elements which are Physician Name, MSC-Billing Number, Date of Service, Patient Surname, Patient First Name, Date of Birth (DOB), Provincial Health Number (PHN), Fee Code, Diagnostic Code, Number of times seen/day, Referred to/by, Location Code (required for rural communities only) and Facility Code (required for specific fee codes only).
(4) Transmit Medical Services Plan (MSP) billings through Teleplan Electronic Medical Claims System
(5) Bill third party (WCB, ICBC, etc.) and follow up and collection of accounts receivables;
(6) Providing regular reporting on specified data including encounter record data, MSP billing data and third party billings, rejections and resubmission rates.
(7) Inform us of any long term third party bad debts which we then collect internally.
(8) Work with physician groups to improve billings as decided with Corporate Director, Medical Affairs or delegate, who is provided with adequate information to support appropriate revenue accruals and bad debt transactions at the end of each accounting period
(9) Service Provider will have to ensure:
a) Accurate and complete entry of data forms into the database system
b) All reasonable and appropriate efforts are taken to maximize revenues
c) All data is submitted in a timely manner to the Medical Services Plan (MSP) of British Columbia and meets Teleplan Specification for Transmission which can be found at http://www.health.gov.bc.ca/msp/infoprac/teleplanspecs/
d) Secure storage and confidential disposal of records per our appropriate policy.
e) a disaster recovery plan is in place
(10) Service Provider will maintain appropriate software and related updates to support the efficiency and effectiveness of systems and processes.
(11) Privacy and Security Requirements: Service Provider will maintain the confidentiality of the data.
(12) Quantity: Service Provider will be required to enter an estimated 269,000+ forms annually. Service Provider will commit to a reasonable volume of transaction entry daily, weekly and monthly recognizing that there will be fluctuations in workload.
[D] Eligibility:
Onshore (Canada Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within Canada.
[F] Deadline to Submit Proposals: July 8, 2010
Cost to Apply: $18.99

USA (Texas) Medical Billing and Collection Services for AIR AMBULANCE

RFP ID: MB-0024
We are Texas; USA based organization looking for expert vendor for Medical and Collection for Air Ambulance.
[A] Notice Type: Request for Qualifications (RFQ)
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Service Provider shall provide services that will achieve the following objectives for Air Ambulance:
(a) Improve timeliness and accuracy of patient care reports, the billing process, and accounts receivable.
(b) Increase revenue collections (including delinquent account collections).
(c) Boost customer service by decreasing errors.
(d) Decrease program business costs.
(2) Patient Charges: i) For Resident - 3400 USD and ii) For Non-Resident - 7500 USD. Mileage is set at 85 USD per loaded mile. In 2010, approximately 800 patient transports are expected.
(3) Service Providers within 50 miles from zip code 78701 are eligible to propose or send their responses for this tender.
(4) Since, Time is of the essence in this contract, Service Provider shall perform all the services and activities in a timely manner at highly professional and ethical standard.
[D] Eligibility:
Onshore (USA Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within USA.
[F] Deadline to Submit Proposals: July 19, 2010
Cost to Apply: $18.99

USA (Wisconsin) Billing Services for Pre-Hospital Emergency Medical Care - Deadline July 22, 2010

RFP ID: MB-0023
We are Wisconsin; USA based organization looking for expert vendor for Pre-Hospital Emergency Medical Care.
[A] Notice Type: Request for Qualifications
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Collect billing data electronically.
(2) Short-out the data, prepare an invoice, a statement or a claim for service to appropriate individual or agency.
(3) Verify dates, times and all other pertinent information to facilitate the billing process.
(4) Other standard process mentioned in RFP document in detail.
[D] Eligibility:
Onshore (USA Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within USA.
[F] Deadline to Submit Proposals: July 22, 2010
Cost to Apply: $19.99

USA (Texas) Medical services - Deadline June 30, 2010

RFP ID: MB-0022
We are Texas; USA based organization looking for expert vendor for Medical Services. Contract will be for the period of 3 years.
[A] Notice Type: Request for Qualifications
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Medical Control
- We are looking for qualified vendors to provide Medical Control Services.
- Physicians provided by the successful vendor must meet the qualifications of 22 TAC Section 197.3, as Medical Control physicians.
- Provide continuous physician coverage, by two-way voice communications twenty four hours a day, seven days a week.
- All Medical Control physicians utilized in fulfilling the terms of this contract shall be licensed to practice medicine in the State of Texas.
- All Medical Control physicians shall be ultimately responsible for pre-hospital care.
(2) Medical Training
- Vendor will submit an RFQ demonstrating the ability to perform education and certification services for the Emergency Management Services System (EMSS):
- Conduct advanced, special and supplementary courses for the EMSS for EMT-Basics, EMT-Intermediates, EMT-Paramedics and EMSS medical instructors as required for certifications by the Texas Department of State Health Services and as dictated by the needs of the Fire Chief or designee and the Medical Director.
(3) Infectious Control
- Provide Infectious Disease Control functions
- Develop programs for education, counseling, and standardization of equipment, procedures and policies involving exposure to infectious diseases
- Develop a system for the treatment, follow up and documentation of infectious disease exposure. Provide initial follow up for 100% of reported, suspected exposures.
(4) Immunizations Services
- Develop a program of immunizations for personnel selected by us.
- Coordinate with the us on the purchase of immunizations. We will provide the funds and specify the immunizations that will be purchased.
- Immunizations shall include, but are not limited to: Hepatitis A, Hepatitis B, TWINRIX, TDaP, PPD, Seasonal Flu, Pneumonia, and any vaccine recommended for first responders by the Center on Disease Control.
[D] Eligibility:
Onshore (USA Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within USA.
[F] Deadline to Submit Proposals: June 30, 2010
Cost to Apply: $18.99

USA (Illinois) Medicare B Billing services - Deadline June 29, 2010

RFP ID: MB-0021
We are Illinois; USA based organization looking for expert vendor for Medicare B Billing Services.
[A] Notice Type: RFP (Request for Proposals)
[B] Budget: Looking for Proposals
[C] Scope of Service:
Service Provider will provide medical record technical services including but not limited to:
(1) Retrieval of all identified records that are eligible for billing of Medicare B services.
(2) Must have knowledge and proficiency in the use of reference manuals as follows:
(a) ICD9- CM (International Classification of Diseases, Ninth Revision, Clinical Modification), CPT 4 (Current Procedural Terminology, 4th Edition) and HCPCS (Healthcare Common Procedure Coding System), and any additional reference manuals /materials that apply to assure accuracy.
(3) Process both quantitative and quality abstracting to identify Med B eligible services.
(4) Proficiency in applying proper codes for eligible services onto abstracting forms using both facility pre-determined policy and procedures and any applicable professional coding guidelines and standards.
(5) Process applicable data transactions from the coding abstract forms into the facility and reimbursement databases.
(6) Process all files to completion to include: abstracting forms, reports and refilling of records.
(7) Follow and apply all applicable confidentiality and HIPAA related regulations and procedures as directed by the facility.
(8) Services performed are professional and technical and must be performed by at least the equivalent of a certified coding specialist (CCS); registered health information technician (RHIT); or a registered health information administrator (RHIA)
(9) Service Provider will complete all billing procedures and provide reports in a timely manner as determined by us.
[D] Eligibility:
Onshore (USA Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within USA.
[F] Deadline to Submit Proposals: June 29, 2010
Cost to Apply: $17.99

USA (California) Emergency Medical Services (EMS or Ambulance Services) Billing - Deadline July 2, 2010

RFP ID: MB-0020
We are California, USA based organization requesting proposals from expert vendor (From USA ONLY) for Emergency Medical Services (EMS) Billing. The contract would be for three years with the option to extend for an additional two one-year periods.
[A] Notice Type: RFP (Request for Proposals)
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Service Provider shall provide in the proposal, detailed steps that will be taken once the account is received from us including the number of contacts and procedures that will be taken to secure payment for the service. This shall include research methods of patients’ ability to pay, and efforts to locate and correct any incorrect billing address for billable patients.
(2) Service Provider shall provide detailed information on how it will handle incomplete patient data. We will provide electronic pre-hospital patient care records from the ImageTrend program. We currently utilize ImageTrend to capture patient data electronically.
(3) Service Provider must have the ability to accept patient data via hard copy. Service Provider should have the ability to utilize a secure FTP platform for billing transfer or an alternative detailed description of the recommended process. Service Provider will also be able to receive supplement patient information (such as FACE sheets, if available), via fax, email, or mail.
(4) Service Provider will provide all software and hardware associated with the billing and collections process. The software should interface with ImageTrend.
(5) The software/hardware billing system should ensure complete and uninterrupted back-up systems and a data recovery plan/system should a disaster occur.
(6) Service Provider should screen each document for completeness of data and level of service; Advanced Life Support (ALS) 1-1, (Basic Life Support) BLS, medications and skills administered. Use of appropriate ICD9 diagnosis codes and procedure codes for billing purposes is essential.
(7) Service Provider should have the ability to bill electronically on their secure server for the various claim types: Medicare, Medi-Cal, commercial insurances and private payers following all guidelines of Centers for Medicare & Medicaid Services (CMS). Service Provider should also process denials for insurances including Medicare and Medi-Cal according to defined timelines.
(8) Service Provider shall agree to provide a minimum of 24 hours of operational training and 6 hours of management/finance training prior to transfer of responsibilities to Service Provider.
(9) Service Provider shall provide acknowledgement of account placement within 10 days of submission via the same method that the account was submitted.
(10) For all accounts that are assigned to the Service Provider, all customer contact, including notices, mailing, itemizations, small claims, bankruptcy filings, and miscellaneous requests and inquiries, is sole responsibility of the Service Provider. Service Provider will also be responsible for any and all costs incurred in and associated with the collection of debts referred to it by us.
(11) Service Provider shall provide CSRs that are available at a minimum from 8:00 AM – 5:00 PM (local time), Monday through Friday, excluding major holidays. A toll free number shall be provided, as well as fax and email. Spanish-speaking representatives shall also be available.
(12) Required reports will be provided by Service Provider on monthly, ad-hoc or as required basis.
(13) Service Provider shall be HIPAA compliant.
[D] Eligibility:
Onshore (USA Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within USA.
[F] Deadline to Submit Proposals: July 2, 2010
Cost to Apply: $17.99

USA (California) Offsite Medical Claims Review (Medical Billing & Coding) Services - Deadline June 30, 2010 - Budget 200000 USD

RFP ID: MB-0019
We are California; USA based organization looking for expert vendor for Offsite Medical Claims Review Services.
[A] Notice Type: RFP (Request for Proposals)
[B] Budget: 200000 USD
[C] Scope of Service:
(1) Vendor/Contractor will be contacted by telephone, facsimile, or other electronic media to confirm its availability to provide the services within 7 calendar days. The Contractor shall confirm by return facsimile or other electronic media its availability to provide the necessary services.
(2) Vendor/Contractor will have direct toll-free telephone access between 8:00 a.m. and 5:00 p.m. Pacific Standard Time, Monday through Friday, and have the capability to receive and act upon information, if necessary, 24 hours per day, 7 days per week (including holidays) if notified by telephone,
facsimile, electronic mail, or overnight delivery.
(3) Vendor/Contractor will distribute Case Review files to qualified medical consultants (physicians or other licensed medical claims professionals) of the appropriate specialty within 24 hours of receipt
(4) Vendor/Contractor shall provide sufficient administrative facilities and staff, organizational policies
and procedures, and available qualified medical reviewers free from conflicts of interest to provide timely, complete, and professional case analysis, documented opinions, and testimony as required regarding appropriate medical coding.
[D] Eligibility:
Onshore (USA Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within USA.
[F] Deadline to Submit Proposals: June 30, 2010
Cost to Apply: $17.99

Last Updated on Saturday, 19 June 2010 14:09

USA (Texas) Medical Billing Service - Deadline July 14, 2010

RFP ID: MB-0018
We are Texas, USA based organization requesting proposals from expert vendor (From USA ONLY) for Medical Billing, Collections and related services. The Contract will be for a period of thirty-six (36) months, with (2) two, one-year extension options.
[A] Notice Type: RFP (Request for Proposals)
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Service Provider will be responsible for receiving and translating transport records from our Fire Department into collectible accounts. This includes locating and billing ambulance service recipients, individual and/or third party clients, filing and collecting Medicare/Medicaid, private insurance claims and the processing of payments (including prompt notification to us for the issuance of refunds for duplicate payments or overpayments).
(2) The contract will also require collecting past due and delinquent accounts, resolving fee related inquires and complaints from ambulance users and reporting all such activity daily, monthly, quarterly and annually (fully reconciled) to us with the necessary supporting documents.
(3) Have adequate system capability and facilities for archiving and retrieving all ambulance transport services accounts and related data. Allow our staff to have access to data within twenty-four (24) hours or electronically.
(4) Respond to ambulance user’s inquiries and complaints regarding billing and collection of ambulance transport services fees within 48 hrs and resolve complaints within 5 days of receipt.
(5) Assist patients with claim preparation, proper assignment of claims, correction and re-file of rejected claims, within five days of request.
(6) Maintain high professional standards in all communications with the public on our behalf. Bilingual in primary languages of English and Spanish is preferred.
(7) Establish fully auditable billing, collection and accounts receivable systems in accordance with Generally Accepted Accounting Principles (GAAP) and Governmental Accounting Standards Board (GASB) guidelines.
(8) Service Provider’s application/service environment must efficiently integrate with our information environment through the use of industry standard technologies. Service Provider must provide for the electronic transfer of information (files/data) with standard secure data transfer; with encryption technology. As appropriate, Electronic Data Interface (EDI/BAI) may be required. Custom interfaces to our existing systems will be the responsibility of Service Provider.
(9) HIPAA Requirements: Service Provider will comply with the current regulations, as well as, any amendments or modifications, as required by law or mandated by us.
(10) The Electronic Patient Care Report system should be offered under the Software as a Service model. The system must be a commercially available or proprietary system supplied by Service Provider with minimal or no customization required meeting our requirements.
(11) Service Provider’s personnel must perform all initial Electronic Patient Care Report Training, including end-user training (200+ paramedics & 650+ additional personnel) within 60 days.
(12) System will be available 99.99% of time with the exception of planned maintenance upgrades. 
[D] Eligibility:
Onshore (USA Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within USA.
[F] Deadline to Submit Proposals: July 14, 2010
Cost to Apply: $17.99

USA (Texas) Offsite Claim Processing Service - Deadline June 25, 2010

RFP ID: MB-0017
We are Texas; USA based organization looking for expert vendor for Offsite Claim Processing Services.
[A] Notice Type: RFP (Request for Proposals)
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Vendor will provide claim processing services for prescription drugs (Pharmaceutical).
(2) We will provide data in File Transfer Protocol (FTP) files to the selected vendor.
[D] Eligibility:
Onshore (USA Only)
[E] Work Performance:
Performance of the work will be offsite; Contractor needs to carry work on their office premises within USA.
[F] Notice of Intent to Propose Due: June 25, 2010
[G] Deadline to Submit Proposals: July 14, 2010
Cost to Apply: $17.99

USA (Tennessee) Billing Services

RFP ID: MB-0016
We are Tennessee; USA based organization looking for expert vendor for Billing Services.
[A] Notice Type: Sources Sought
[B] Budget: Looking for Proposals
[C] Scope of Service:
Vendor/Contractor shall provide billing services as an extended business office solution with the generation, processing and submission of Hospital and Professional Medical claims to Third and First Party Payers on behalf of us.
[D] Eligibility:
Onshore (USA Only)
[E] Original Set Aside: Total Small Business
Interested Vendors are requested to submit proposals on or before June 18, 2010.
Cost to Apply: $10.99

USA (Texas) EMS Billing and Collection Services

RFP ID: MB-0015
We are based in Texas, USA and we are requesting proposals from experienced service provider (From USA Only), for EMS Billing and Collection Services. Initially the contract will be for 12 months and can be renewed further for four annual periods, only at our discretion.
[A] Notice Type: RFP (Request for Proposal)
[B] Budget: Looking for Proposals
[C] Scope of Service:
(1) Service Provider will need to use the necessary forms for the routine billing and collecting of Ambulance and Emergency Medical Services (EMS) fees from the following various types of payers: a) Self Pay (patient pays the bill); b) Commercial Insurance, including Medicare Supplements & Replacements; c) Medicare; d) Medicaid; e) Workers’ Compensation; f) Personal Injury Protection/Medical Payments (Auto Insurance) and g) Our Subscription Member (member prepaid; balance to be billed to any other insurance provider listed above, if applicable). Service Provider shall be responsible for maintaining the Ambulance Subscription List. The list will be provided each February from Fire Dept. The subscription program runs for a calendar year.
(2) Any programming costs incurred by Service Provider in relation to the downloading of the patient records into its billing system will remain the responsibility and cost of Service Provider.
(3) Service Provider must be able to accept electronic records from us in the NEMSIS format.
(4) Service Provider is required to be aware of and able to abide by the billing requirements dictated by Health Committee Finance Administration for Medicare Patients, National Heritage Insurance Company for Medicaid patients, T.W.C.C. for Workers Compensation Patients, Health Insurance Portability and Accountability Act (HIPAA), and all Red Flag rules (regulations).
(5) Provider may authorize self-pay patients to liquidate any balance on the installment method. Min. payment on installments shall be 25 USD a month. No interest shall be charged to patients.
(6) Should we hire another firm for the collection of delinquent accounts, Service Provider shall provide all delinquent accounts (those uncollected 60 days after transport) and related account information, in a manner deemed acceptable by us, to us or other firm.
(7) Sample monthly reports typically provided shall be included with the proposal response. Other reports may be requested as needed and be provided to us at no additional cost.
(8) All instructions for payment issued by Service Provider shall indicate that payments will be made to Service Provider, not to us. NOTE: All fees for this service shall be included in the percentage of collection. No other separate fees are acceptable.
(9) Service Provider shall maintain adequate records of services performed, invoicing, statement and dunning letter processing, and such records shall be available for audit by us at any time.
(10) Service Provider shall have a toll free local phone number to answer any questions regarding the bills or other services provided by Service Provider during regular business hours.
(11) Service Provider agrees to accept payment by major credit cards and shall be responsible for any related fees.
(12) OPTIONAL SERVICE: Please quote on the ambulance/EMS delinquent fees collection service.
[D] Eligibility:
Onshore (USA Only)
Interested Vendors are requested to submit proposals on or before June 23, 2010 via post, courier or hand delivery only.
Cost to Apply: $18.99

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