Specifications include, but are not limited to: The purpose and intent of this Request for Proposal (RFP) is to solicit sealed proposals from qualified sources to establish contract(s) through competitive negotiations associated with providing a Workers’ Compensation TPA Services for the City of Charleston, South Carolina. The objectives of the Administration of the Workers’ Compensation Self-Insured Program are: 1. To provide employees with quality and accessible care. To maintain open communication between the City, employee, treating physician, and TPA. 2. To manage care and expedite the employee’s return to work. 3. To responsibly utilize taxpayer dollars by effectively by taking advantage of cost and utilization management opportunities available in the marketplace. Provide high quality, efficient third party administration and claims adjudication of the City’s workers’ compensation self-insured program including, but not limited to: 1. Correctly adjudicate claims in accordance with the South Carolina Workers’ Compensation Act and Regulations; 2. Manage the administration and ensure that the City is in compliance with all applicable laws; 3. Compile and file notices, reports and any forms required for the City by the South Carolina Workers’ Compensation Act and Regulations; 4. Receive and record first reports of injury and investigations to determine the validity and compensability of any accidents or injuries claimed by City employees to be a workers’ compensation claim and to accept or deny such claims; 5. Determine all benefits due City employees on all compensable cases and to make payments of all benefits due under SC Workers’ Compensation Regulations through use of City funds in such a manner to be directed by the City; 6. Direct choice of medical care for all City employees under the SC Workers’ Compensation Act and Regulations using negotiated fee schedules or fee schedules as established by the SC Workers’ Compensation Commission. If possible, negotiating range discounts for physicians, hospitals, pharmacies, and medical providers;
