The City of Philadelphia (“City”), through the Philadelphia Department of Prisons (“PDP”) is seeking to contract with an organization to provide third party administration (“TPA”) of certain medical care services not provided at PDP, the Juvenile Justice Services Center (“JJSC”) or the Main Offender Processing Unit of the Philadelphia Police Department including: - Contracts assuring prompt access to outpatient medical care and related services from a comprehensive network of specialist physicians, hospitals and ancillary service providers in the County of Philadelphia. - Assertive negotiation of competitive provider reimbursement rates. - Accurate and timely claims adjudication and payment to in-network and out-of-network medical care providers (“providers”). - Assertive utilization management including assurance of timely delivery of appropriate levels, quality and timeliness of care. - Development of cost reduction programs that address off-site care costs. - Enhanced reporting, analysis and forecasting of PDP inmate health care service utilization and costs.
