Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: MB-7250

Government Authority located in New Mexico; USA based organization looking for expert vendor for remote coding, billing, and accounts receivable services.

[*] Budget: Looking for Proposal

[*] Scope of Service:

(1) Vendor needs to provide remote professional medical coding, billing and accounts receivable services.
- Coding:
- The contractor will assign and sequence icd-10 cm/cpt/hcpcs codes to diagnoses and procedures from documented
- The contractor will select the correct principal diagnoses and operations and procedures.
- The contractor will abstract all necessary information, assigning the appropriate evaluation and management levels of service, assigning the correct cpt/hcpcs code that accurately describes each medically documented procedure
- The contractor will abide by official coding conventions and rules established by the centers of medicare and medicaid
- The contractor will utilize the coding que to complete patient visits within the electronic health record with no errors
- The contractor will enter data from the patient visit as needed into rpms database with no errors.
- The contractor will code visits within four days from date of service.
- The contractor will report to the supervisory health system specialist (him manager) or contracting officer’s representative
- The contractor will complete the error reports are reviewed and corrected on a daily and or weekly basis
- The contractor will complete the incomplete coding report; review, research and correct weekly
- Claims processing:
-  The contractor will submit claims electronically or manually in a timely manner (not to exceed filing limit) for all payers (medicare, medicaid, pi, BMP, BCCP, WC, FMCRA, non-beneficiaries, etc.) or all outpatient visits and according to internal controls and department policies.
- The contractor will bill and submit claims within six business days from date of service.
- The contractor will assure claims are mailed or transmitted within one business day from approval and maintain a log and submit to business office manager on a monthly basis.
- The contractor will move forward to 100% for all payers to submit claims electronically. electronic transmits must be hipaa (837) compliant.
- The contractor will complete billing by accessing information, via the third party billing package that was input during the registration, ehr and coding queue process.
- The contractor will assure claims are analysed and the technician will maintain the total billing operation for third party programs and acts as an advocate for the indian health service in the collection of alternate resources by abiding aaahc, cms, state, ihs regulations and standards that govern business office department policies.
- The contractor will assure proper signatures are obtained for the medicare secondary payer and assignments of benefits
- The contractor will process the claim and assure that payer information is accurate and sequenced appropriately to guarantee the bill is submitted to the proper payer and includes identifying when employment related or accident related visits would designate a different responsible payer source from the patient’s usual primary payer
- The contractor will bill clinic type, visit type, bill type, proper mode of export, release of information, workman’s compensation or FMCRA (third party injury) information, and referring physician information will be verified, input and adjusted whenever necessary.
(2) This bid is set aside for buy Indian set-aside.

[*] Eligibility:

- Onshore (USA Organization Only);

[*] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office location.

Expiry Date : Wednesday, 29 March, 2023

Category : Medical Billing and Coding

Country : USA

State : New Mexico

RFP Expired

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