DOL OWCP Medical Provider Network-Medical Bill Processor (MPN-MBP) Services - RFI/ Industry Day Notice
ID: 1638-DAO-24-NAT-0086Type: Special Notice
Overview

Buyer

LABOR, DEPARTMENT OFOFFICE OF THE ASSISTANT SECRETARY FOR ADMINISTRATION AND MANAGEMENTDOL - CAS DIVISION 3 PROCUREMENTWASHINGTON, DC, 20210, USA

NAICS

All Other Insurance Related Activities (524298)

Original Source

https://sam.gov/opp/f1155a03b84e49d9b3ae2a3b708c219c/view
Timeline
    Description

    The Department of Labor's Office of Workers' Compensation Programs (OWCP) seeks a contractor to manage its medical provider network and perform medical bill processing. The primary goal is to ensure prompt access to medical care and accurate bill processing for claimants. The selected vendor will facilitate a network of medical providers across the country, process bills from both in-network and out-network providers, and provide customer support and fraud detection.

    OWCP aims to improve efficiency, enhance claimant satisfaction, and minimize disruptions in service delivery. To achieve this, the contractor must meet key requirements, including managing provider enrollment, establishing a central mailroom, and implementing robust bill processing workflows. Additionally, they will maintain a call center, ensure compliance with federal security guidelines, and work towards achieving excellent performance metrics.

    This procurement process seeks to enhance OWCP's medical care and billing operations, focusing on provider network access and managing out-of-network billing to improve the overall experience. Industry feedback is encouraged to develop strategies and maximize the provider network's usage, especially in rural areas. The contract will be awarded following a comprehensive evaluation process.

    Contact emails are provided for interested parties to register for one-on-one sessions with OWCP, with deadlines specified for registration and submission of responses.

    Point(s) of Contact
    Kristen Hines
    Hines.Kristen.A@Dol.Gov
    Emily Pyatigorsky
    pyatigorsky.emily@dol.gov
    Files
    Title
    Posted
    Industry Day Questions-Medical Provider Network-Medical Bill Processing (MPN-MBP).pdf
    The U.S. Department of Labor's Office of Workers' Compensation Programs (OWCP) seeks industry input to maximize provider network usage. OWCP aims to prevent providers from billing out-of-network by jointly developing strategies. The focus is on enhancing provider access and outlining expectations for reasonable service levels, database accuracy, and improving provider coverage, especially in rural areas. OWCP seeks a vendor to manage network billing, offering solutions to encourage provider participation while ensuring access for claimants. The government plans to implement a connection with CMS for provider data, wanting industry views on the feasibility and potential challenges. OWCP also seeks efficient methods for out-of-network provider enrollment and multilingual communication capabilities. Industry feedback is invited on these challenges, with a view to improving access and reducing costs for workers' compensation programs. Can I assist you with another file summary?
    SOO-Medical Provider Network-Medical Bill Processing (MPN-MBP).pdf
    The Department of Labor's Office of Workers' Compensation Programs (OWCP) seeks a nationwide medical provider network and medical bill processing services. The goal is to ensure timely access to medical care and accurate benefits processing for OWCP claimants. The scope includes provider network access, bill processing, authorization management, and customer support. OWCP seeks to improve efficiency and maximize claimant satisfaction while reducing service interruptions. Key requirements include: - Establishing a searchable database of medical providers and processing their enrollment. - Receiving and processing medical bills, including scanning, data entry, and provider outreach. - Implementing OWCP fee schedules, coordinating benefits, and recovering overpayments. - Ensuring information security and compliance with federal standards, along with prompt payment adherence. - Providing a staffed call center, online portals for customer access, and training materials. - Achieving high performance metrics in areas like bill processing time, accuracy, and authorization disposition. The contract envisions a fixed fee for non-PPO bill processing, with administrative fees invoiced separately. Key dates include quarterly documentation deliveries and annual security audits. This comprehensive procurement aims to enhance OWCP's medical care access and bill processing, improving the experience for both claimants and providers.
    SOO-Medical Provider Network-Medical Bill Processing (MPN-MBP) - update 8-2-24.pdf
    The Department of Labor's Office of Workers' Compensation Programs (OWCP) seeks a contractor to manage its nationwide medical provider network and provide consolidated medical bill processing services. The primary objective is to ensure timely access to medical care and accurate bill processing for OWCP claimants. The contractor will facilitate a network of medical providers and process bills submitted by both network and non-network providers. Key requirements include establishing a central mailroom for document receipt and scanning, implementing robust bill processing and authorization workflows, and maintaining a call center for customer inquiries. Additionally, the contractor will handle data transmissions, provide fraud detection support, and ensure compliance with federal security guidelines. Performance metrics are outlined for areas like timely documentation, corrective actions, data accuracy, and response times for provider inquiries and bill processing. The contract envisions a fixed fee for non-PPO bill processing, with payments for medical services billed separately to OWCP.
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