Workers Compensation Medical Bill Review Services

The State of Michigan's Department of Labor and Economic Opportunity is seeking a contractor to provide medical bill review services for workers' compensation claims. The contractor will be responsible for reviewing medical bills to ensure they are accurate and reasonable. The contract is expected to begin on October 1, 2026, and will last for three years, with the option to renew for up to two additional one-year periods. The contractor must have experience in medical bill review and must be certified with the Workers' Disability Compensation Agency (WDCA) or meet WDCA's certification requirements. Some key points of this RFP include: • The contractor must provide a detailed project plan within 30 days of the contract start date. • The contractor must attend meetings as requested by the State. • The contractor must submit monthly reports showing the number of bills reviewed, provisions, costs, and total charges. • The contractor must meet certain service level agreements, including timely deliveries and compliance with regulations. • The contractor must provide pricing for all services, including medical bill review, utilization review, and negotiations/out of network services.