North Orange County Regional Occupational Program Opengov #MA01721010138

Award for Medical and Dental Claims Audit and Operational Assessment for County of Orange, CA

This award summary outlines the County of Orange, California's selection of Claim Technologies Inc (also known as CTI Audit Solutions Inc) to conduct a Medical and Dental Claims Audit and Operational Assessment for its Employee Benefits division. - Government Buyer: - County of Orange, Human Resource Services - Employee Benefits Division - OEMs and Vendors: - Claim Technologies Inc (CTI Audit Solutions Inc) (awardee) - Blue Shield of California (administrator of audited plans) - Products/Services Requested: - Medical and Dental Claims Audit and Operational Assessment - Scope includes: - Audit of self-funded PPO health and dental plans (administered by Blue Shield of California) - Review of claims processing accuracy, administrative effectiveness, and compliance for approximately 10,200 members - Deliverables: project plans, operational review reports, final audit reports, action plans, and follow-up consultation - Unique or Notable Requirements: - Fixed fee not to exceed $105,580 - All follow-up consultation hours must be used within 75 days after final report delivery - Compliance with confidentiality, insurance, and reporting requirements - Funded by the County's General Fund - Place(s) of Performance and Delivery: - County of Orange offices, Santa Ana, CA - Blue Shield medical claims office, Lodi, CA - Blue Shield dental claims office, International Falls, MN

Description

This contract was awarded by the County of Orange to Claim Technologies Inc (CTI Audit Solutions Inc) for providing a Medical and Dental Claims Audit and Operational Assessment. The contract term was from July 20, 2020, to July 19, 2021. The scope includes auditing medical and dental claims and assessing operational processes related to these claims. The contract was awarded through a Request for Proposal (RFP) process and is now ended.

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