HFS - Healthcare and Family ServicesIssuing agency·Springfield, IL·via the Illinois BidBuy open-bids boardWe post new professional & consulting services opportunities in Illinois as agencies publish them. Get them in one email — free, and unsubscribe whenever.
EMERGENCY NOTICE. The Department of Healthcare and Family Services is declaring a third 90-day emergency contract to continue to provide quality assurance and utilization review in the fee-for-service hospital inpatient setting, and in other settings and levels of care, including but not limited to, hospital outpatient care, psychiatric residential treatment facilities, long-term acute care hospitals, integrated health home and community based treatment .
The vendor must provide utilization management and quality assurance services for Medicaid members across multiple levels of care, including medical necessity determinations, continued stay reviews for inpatient hospital care, review and oversight for hospital outpatient services, psychiatric residential treatment facilities, long-term acute care hospitals, and other community-based treatment settings. The vendor will also conduct pre-payment and post-payment utilization reviews, appeals and reconsideration reviews, investigations into potential quality of care concerns, operate and support the web-based referral and authorization platform, provide provider outreach, training, and technical assistance, complete standard and ad hoc reporting, perform special projects as directed by the Department, and transition all files/data to the vendor awarded under the competitive procurement.
Source: BidBuy (Illinois) (bid 27-478HFS-MEDPR-B-53500), retrieved via the Illinois BidBuy open-bids board. View the official posting , always confirm requirements and deadlines with the issuing agency.
