MB-10492 - USA (New York) - Medical Bill Review, Repricing and Utilization Review Services - Deadline October 19,2026

(1) Vendor needs to provide medical bill review, repricing and utilization review services for workers’ compensation claims.– Audit all workers’ compensation bills including verification of current procedural terminology billing codes to comply with actual treatment provided; reprice bills in accordance with state fee schedule and preferred provider organization (“PPO”) contracts.– Transfer all applicable reviewed/audited bills to the county contracted PPO on a daily basis. bills will be returned and the explanation of benefits adjusted.– Prepare an “explanation of payment” letter to be used for all bills that includes the amount claimed on the invoice, the amount of the claim that is deemed permissible and the valid reason, according to the Workers’ Compensation Board fee schedule.– Accept bills electronically and in paper format; and scan all paper medical bills and reports into digital format on a daily basis.(2) All question must be submitted no later than October 2, 2026.