Provision of access to an established cost containment/re-pricing network of medical providers in North America (Албания - Тендер #67598897)

Description

The Secretariat of the United Nations Staff Mutual Insurance Society against Sickness and Accident (UNSMIS) of the United Nations Office at Geneva (UNOG) intends to launch a competitive tender with the aim of entering into a 5-year contract (3+2) with a service provider for access to an established and extensive Cost Containment Network in the USA. This network can either rely on a third party (must be fully disclosed) or can be an in-house network or both. The network needs to be as geographically extensive as possible. In line with common practice in the USA, the fees payable are to be a percentage of the discount obtained. The coverage sought extends beyond Staff members and includes also eligible family members and retirees of organizations, funds and programs participating in UNSMIS. The provider will engage in repricing of medical bills, mainly inpatient hospital bills, so as to reduce billed costs as much as possible. The end goal is to reduce overall costs to the medical plan and reduce any out of pocket costs for the insured member, whilst simultaneously guaranteeing access to quality medical facilities across the USA. The provider shall also advance of funds (direct pay agreement) to medical providers, mainly following inpatient care, arrange admissions and liaise with hospitals. Interested providers are required to appoint a dedicated account manager and have a network development team that can be dispatched with reasonable notice, should the need arise for agreements to be made with specific medical providers in specific areas/cities of the USA. Specific Requirements/Information Interested service providers should meet at a minimum, the following technical criteria: 1. Demonstration of having access to at least one (1) extensive network of preferred provider organizations (PPO"s) or health maintenance organizations (HMO"s) in the USA (GP"s, Specialists, clinics, hospitals, centres of excellence, etc.). 2. The Key Account Manager assigned to UNSMIS must have a minimum of ten (10) years of experience in the fields of repricing and/or discounting, PPO"s and HMO"s, as well as dental and pharmacy type discount networks. More information will be provided when the solicitation documents are published.