The selected Broker will be responsible for providing the Non-emergency Medical Transportation (NEMT) services for the fee-for-service Medicaid population in an efficient and effective manner, within federal, state, and Agency specifications, ensuring the highest standards of performance, program integrity, and customer service at a reasonable cost to the State.
The selected Broker will be responsible for providing the Non-emergency Medical Transportation (NEMT) services for the fee-for-service Medicaid population in an efficient and effective manner, within federal, state, and Agency specifications, ensuring the highest standards of performance, program integrity, and customer service at a reasonable cost to the State.
PBA services are necessary to support several critical functions, including Point-of-Sale (POS) claims adjudication, automated and manual Prior Authorization (PA), Provider and Member communications, Drug Rebate, Utilization Management (UM), Clinical support, and Reporting and Analytics for the fee-for-service (FFS) population of Iowa Medicaid, as well as managed care program oversight.
Items Service Line Items There are no Items added to this event. 18 April 202418 April 202418 April 2024
Items Service Line Items There are no Items added to this event. 18 April 202418 April 202418 April 2024
The primary objective of this request for proposal (RFP) is to seek Claims processing via Software-as-a-Service (SaaS) and support Services for the state’s remaining fee-for-service (FFS) population and any program administered by SCDHHS pursuant to the Individuals with Disabilities Education Act Part C via an Administrative Services Organization (ASO).
care services; - to know the federal Centers for Medicare and Medicaid Services ("CMS") requirements for serving individuals who are fee-for-service and fee-for-service dually eligible; and - to have knowledge of the disparities that exist in the Medicaid population and subpopulations.
