RFP 2780- MEDICAL NECESSITY DENIAL SERVICES

Agency: The City of New York
State: New York
Type of Government: State & Local
NAICS Category:
  • 621111 - Offices of Physicians (except Mental Health Specialists)
Posted Date: Dec 18, 2024
Due Date: Jan 17, 2025
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Description

Title: RFP 2780- Medical Necessity Denial Services

Procurement
Section

NYC Health + Hospitals (NYC H+H)
Agency Name

50 Water Street, New York, NY 10003
Request Address

Daniel Romagnoli
phone: (646) 815-3703
email: romagnod@nychhc.org
Contact Information

Current
Status

Services (other than human services)
Category

Request for Proposals
Selection Method

12/18/2024
Publication Date

Solicitation
Notice Type

PIN#2780 Due: 1/17/2025 5:00 PM

PIN - Due Date
Attachments 6
Description

Medical necessity denials account for the greatest percentage of denied dollars at NYC Health + Hospitals. The Vendor will provide denial management services for NYC Health + Hospitals by appealing medical necessity denials and other case management-related denials. The Vendor shall also provide denial trends with recommendations to reduce medical necessity denials and liaise with Managed Care on payer-related concerns.  The Vendor shall conduct all appeal work within the Epic system.

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