The vendor is required to provide medical cost containment services for the crime victims’ compensation (CVC) program.
- CVC administers victim claims by utilizing a web-based claim and billing management system – IBM case management system that is referred to as the crime victim’s management system (CVMS).
- Service providers for victims and claimants submit billing documents to CVC, which are imaged and stored in CVMS.
- Computer and systems support for CVC is currently provided by the information technology support division of the attorney.
- The automated system provides data interchange by SSH (secure shell) file transfer protocol (or secure file transfer protocol) (sftp) between the current medical cost containment vendor and the attorney system(s).
- There are multiple separate electronic data interchanges (EDIS) utilizing secure sftp between attorney and CVC and the current cost containment vendor as follows:
• Billing data: attorney and CVC receives from the cost containment vendor, on a daily basis, completed billing data on cost-contained bills.
• Explanation of benefits - attorney and CVC receives from the cost containment vendor, on a daily basis, an electronic copy of all the explanation of benefits (“EOB”) for each day’s transmissions.
- CVC will accept bills from medical providers up to three years after the date services were rendered, unless good cause exists to accept the bills after that time.
- The date of service determines which medical fee guidelines schedule is used to cost contain the bill.
- The CVC program will attempt to avoid sending bills to the contractor if it can identify those collateral resources have not been utilized by the victim.
- CVC participated in a prescription drug program issued through the cost containment vendor to streamline the prescription coverage process.
- Contract Period/Term: 2 years
- Questions/Inquires Deadline: April 30, 2025