Denton Ionwave #9087

City of Denton Solicits Workers Compensation Claims Administration Services

The City of Denton, Texas is seeking a qualified Third Party Administrator (TPA) to manage its workers compensation claims program. - Government Buyer: - City of Denton, Purchasing Office - Services Requested: - Comprehensive workers compensation claims administration, including: - Claim intake, investigation, and compensability determination - Medical and disability management - Litigation management and subrogation - Fraud prevention and reporting - Catastrophic injury claim handling - Coverage denial protocols - Quarterly claim reviews and aggressive claim handling - Robust data management and reporting (including RMIS integration and technology fees) - Transition and run-in claim management - Nurse case management (telephonic, field, catastrophic) - Bill review and PPO/network access - Optional services: utilization review, IME coordination, pharmacy benefit management, surveillance coordination - Notable Requirements: - Experience with public sector clients, especially in Texas - Detailed staffing plans and transition plan for run-in claims - Performance metrics and references from similar public sector engagements - Compliance with special handling instructions and insurance requirements - Pricing must be competitive and firm for the initial year, with provisions for adjustments - Cooperative purchasing agreements with other governmental entities are encouraged - No specific OEMs or vendors are named, as this is a service-based solicitation.

Description

The City of Denton is soliciting proposals from qualified Third Party Administrators (TPAs) to provide claim management services for workers compensation. The contract term is one year with options to renew for additional one-year periods. The selected firm must demonstrate innovative approaches, cost-effective solutions, and the ability to manage all aspects of workers compensation claims, including claim reviews, investigation, litigation management, and reporting. The solicitation emphasizes compliance with municipal challenges, quality assurance, and the use of technology for data management and reporting.

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