Approve a Request for Proposal for Third Party Claims Administration Medical Bill Review Services and Utilization Review Services for the Workers Compensation Program. City of Culver City California City Council Agenda Item Report Meeting Date: 01/08/07 AGENDA ITEM: Approve a Request for Proposal for Third Party Claims Administration Medical Bill Review Services and Utilization Review Services for the Workers Compensation Program. Contact Person/Dept.: Nick Kimball Administration/Budget & Finance Fiscal Impact: Yes X No Public Hearing: Public Notification: Master Notification List 01/ /07; General Fund: Yes X No Attachments: X Action Item: X Item Number: A 2 Phone Number: (310) 253 6013 Department Approval: Marlee Chang (01/03/07) City Controller Approval: Marlee Chang (01/03/07) RECOMMENDATION: City Manager Approval: Jerry B. Fulwood (01/03/07) City Attorney Approval Heather Iker (01/03/07) Staff recommends the City Council approve the Request for Proposal (RFP) for third party claims administration medical bill review services and utilization review services for the workers compensation program and authorize its release. BACKGROUND/DISCUSSION: The Risk Management Division is seeking proposals for three key components to the effective administration of the workers compensation program; 1) third party claims administration 2) medical bill review services and 3) utilization review services. Third Party Claims Administration (TPA) Services A third party claims administrator (TPA) is responsible for administering the City s self insured workers compensation program. As such a TPA must be very familiar with current labor code requirements and industry best standards. The primary duties of a TPA include setting initial claim reserve amounts; reviewing medical treatment to ensure that it is appropriate; acting as a liaison between employees doctors attorneys and the City; generating and mailing statutorily required notices to employees; processing and filing required form...
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