Request for Proposal: TPA and PBM

Request for Proposal: TPA and PBM

The structure of an RFP that addresses all the needs of a self-insured entity requires a thorough understanding of the components of the plan.  KBM has developed an RFP template that, when customized, requests claim management cost and processing information that will allow for an apples to apples comparison of qualified Third Party Administrators and Pharmacy Benefit Managers.

KBM Account Executives and their support staff analyze the submissions, develop addenda and create a detailed written report documenting the respondents’ customer service capabilities, financial impact, and provider network costs/penetration.  Recommendations are made regarding finalists who will then be scheduled to present to client representatives.  Final recommendations for TPA/carrier services are presented in a written report and presented formally when requested.

Requests for Proposal for Workers’ Compensation claim and Pharmacy Benefit Management services are often the result of a thorough Workers’ Compensation claim audit. The results of the audit lead to a recognition of deficiency or areas of concern that can be incorporated into the RFP to achieve a cost effective improvement in claim administration.

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