The Definitive Blog

2013-06-13 – Medical Billing Management Services

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RFP Category: Coding/Patient Billing/Revenue Cycle
RFP Sponsor: Knox County

Due Date: 2013-06-13

Contact Name: Mike Reeves
Contact Title: Purchasing Coordinator
Contact E-mail:
Contact Phone: 865.215.5798

Description: The intent of this proposal is to set forth and convey to prospective proposers the general requirements for vendor(s) to provide Knox County Schools a comprehensive medical billing management service designed to obtain reimbursement for speech and language therapy, occupational therapy, physical therapy, nursing, and other eligible medical services provided to students by KCS. These billing management services will include the provision of a medical service documentation software system which will integrate with KCS’ student information system and individualized educational plan (IEP) management system.
The service documentation system should be accessible using web-based technologies and run inside and outside the district’s existing Wide Area Network (WAN).

Billing management services should address, at a minimum, the following functions and processes: Administrative services for determination and documentation of student Medicaid eligibility; Administrative services for enrolling eligible KCS related authorized service providers with relevant managed care organizations (MCO). Cost solution must include enrollment, obtain both provider facilitation and certification and on-going management of providers eligibility. All costs associated with this solution will be borne by the awarded Contractor; Administrative services for management of physician authorization of medical services provided to eligible students; Submission of billing claims to MCOs; Provision, management, and maintenance of web-based medical service documentation system.

June 25, 2013