Healthcare and Drug Prescription Program Administration Services
Overview
Fit Score
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SUMMARY
KEY REQUIREMENTS
TIMELINE
May 27th, 2026: Release date
May 27th, 2026 – June 9th, 2026: Question and answer period
June 19th, 2026: Deadline for receipt of proposals (Noon)
June 23rd, 2026: Oral Interviews with selected respondents
June 25th, 2026: Selection completed / Final Negotiations / Decision
QUESTION DEADLINE
Issuing Agency
Dickenson County Public Schools
Organization overview and procurement intelligence available on paid plans.
DESCRIPTION
A vendor is sought to provide comprehensive healthcare and drug prescription program administration services, including the automated processing and payment of medical and prescription drug claims in alignment with plan documents and contracted network reimbursement fee schedules. Services encompass utilization review, case management, stop loss reporting, third-party recovery, and coordination of medical coverage.
The selected provider will be responsible for maintaining master files of plan documents, summary plan descriptions, benefit provisions, claims administration policies, and handling benefit changes in accordance with applicable state and federal law. Additional responsibilities include the design, printing, delivery, and periodic updating of all necessary forms and form letters for claims processing at the administrator’s expense.
Claims processing and robust customer service are required, with prompt and professional responses to all forms of inquiries regarding eligibility, claims payment, benefit provisions, and related questions from authorized individuals. The provider will also deliver a prescription drug program and provide extensive utilization review services, including hospital pre-admission certification, concurrent utilization review, length of stay monitoring, discharge planning, and preauthorization processes. Finally, a medical review system utilizing qualified medical professionals is also required.
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Frequently asked questions
- When is the submission deadline?
- Submissions are due June 19, 2026. Questions must be submitted by June 9, 2026.
- Who issued this RFP?
- It was issued by Dickenson County Public Schools. The work is located in Clintwood, Virginia, United States.
- Who is a good fit for this opportunity?
- Experience administering large-scale healthcare and prescription drug benefit programs
- Expertise in claims processing and compliance with state and federal healthcare regulations
- Capability for utilization and medical review using qualified medical professionals
- Proven track record in customer service and third-party medical administration
- Ability to design, print, and manage relevant claims and program documentation
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