Workers Compensation Third-Party Administrator Services

The Vendor is required to provide a third-party administrator (TPA) for a self-insured workers’ compensation claims program.
- The TPA shall perform the following services not limited to:
•    Program/Claims Administration
•    Assume Administration without interruption to existing claims
•    Provide a Web-based Claims Administration System
•    Provide Data Conversion Services without loss of data
•    Indemnity payment processing
•    Temporary Partial Disability payment processing
•    Permanent Partial Disability payment processing
•    Medical Cost Control services
•    Medical Bill Review per Georgia Fee Schedule
•    Fraud Control
•    Report and Submit Administrative Reports required by State and Federal Law
•    Maintain and Protect Data and Privacy of Data
•    Attendance at Claims Meeting and other Requested agency Meetings
•    TPA Evidence of SAS 70 Certification
•    Claims Software Capacity to Interface with agency current Quick Internet Solutions Software (QISS)
•    Medical Case Management
•    Investigative Services
•    Collaborate with APS regarding safety recommendations
•    Physician network
•    Physical Therapy network
•    Pharmacy benefits network
•    Other services deemed within the scope of this program