Procurement for Medical Management and Utilization Review Services
Pursuant to the State Purchasing Act (Official Code of Georgia Annotated (O.C.G.A) §§50-5-50 et seq.), this electronic Request for Proposals (“eRFP”) is being issued to establish a contract with a single qualified supplier who will provide Medical Management and Utilization Review (UR) services to the Georgia Department of Community Health (hereinafter, “DCH” or “the State Entity”) as further described in this eRFP. This procurement will also serve children in the CHIP program who are awaiting an assignment to a Care Management Organization (CMO).
For the procurement announcement, please visit the following link: http://ssl.doas.state.ga.us/PRSapp/PublicBidNotice?bid_op=164190041900-DCH0000101
All questions regarding the RFP must be directed to the DCH Issuing Officer, Mr. Percival Griffiths at pgriffiths@dch.ga.gov.
The following Resource Library is provided to assist Bidders in preparing responses to the RFP:
1.
Copy
of Offeror’s Transaction Numbers in Excel Format
1a.
Copy
of Offeror's Transaction Numbers in .pdf format
2.
DMA6
Nursing Facility ICFID
- Posted 09/21/15
3.
DMA6A
Pediatric Form
- Posted 09/21/15
4.
DMA
80 Prior Authorization Request
- Posted 09/21/15
5.
DMA
81 Prior Approval for Medical Service
- Posted 09/21/15
6.
Prior
Authorizationfor Hospital Admissions Form
- Posted 09/21/15
7.
PASSR
Form Redacted rev
- Posted 09/21/15
8.
DCH
Medicaid Data Management Strategy
- Posted 09/21/15
9.
Appendix
1, Hospital/Healthcare Acquired Conditions/Never Events
- Posted 09/25/15
10.
Appendix
2, Deeming/Katie Beckett Optional Eligibility Category and HCBS Waivers
- Posted 09/25/15
11.
SOURCE
Manual, Appendix F, Level of Care Placement
- Posted 09/25/15
12. S
OURCE
Manual, Appendix I, Level of Care Justification for Intermediate Nursing Facility Care
- Posted 09/25/15
13.
SOURCE
Manual, Appendix S, MDS-HC Form
- Posted 09/25/15
14.
SOURCE
Manual, Appendix C, SOURCE Assessment Addendum
- Posted 09/25/15