Third-Party Administration Services

The vendor required to provide third-party administrative (TPA) services to support the community care program, which serves medically underserved persons in county.
- These services may include, but are not limited to, claims for acute inpatient and outpatient hospital care, x-ray, laboratory, and primary medical care.
- The TPA will be responsible for processing and managing claims, verifying eligibility, coordinating payments, and reporting to the city.
- TPA provider will be responsible for processing healthcare claims submitted by contracted providers delivering medical, pharmaceutical, and mental health services through the program.
- Administrative responsibilities may include, but are not limited to:
•    Receipt and processing of provider claims
•    Verification of participant eligibility
•    Maintenance of documentation related to claims activity
•    Support for provider inquiries and reporting.

- Contract Period/Term: 1 year