Workman’s Compensation Claims Services

The Vendor is required to provide workman’s compensation claims internally; requiring third party services to be acquired.
- Existing claims
• Transfer all active claims to the new claims administrator.
• The claims administrator must be prepared to immediately take over the administration of approximately fifty claims that are all in different stages of the process.
• The active claimants must be able to continue treatment with their approved providers and services.
• Changes can be discussed if it won’t have a substantial impact on the claim
- Medicare and Medicaid reporting
• Claims administrator will be required to manage all steps of the Medicare and Medicaid reporting process (MSA reporting).
• Assume responsibility for penalties attributable to reporting errors or failures within its control
- Risk management information system (RMIS)
• RMIS must include claims tracking, financial tracking (payments and reserves), document storage, reporting (standard and ad-hoc), and role-based access.
• The city would prefer it also include dashboards with advanced visualization requirements, mobile apps, and automated loss analytics.