RFP - Consultant (Jobs in Bismarck, ND)   Requirement id 116916 Job title Consultant Job location in Bismarck, ND Skills required Consulting Services, RFP, -, Open Date 24-May-2021 Close Date Job type Contract Duration 12 Months Compensation DOE Status requirement --- Job interview type --- Apply    Email Recruiter: coolsoft Job Description Consultant: Consulting Services, RFP, -, Start Date :07/15/2021 Submission Deadline :06/21/2021 04:00 PM CT Client Info: Human Services, Department of Description : North Dakota has six prospective payment system (PPS) hospitals. Each hospital has a provider-specific DRG base rate, capital rate, APC conversion factor, inpatient cost-to-charge ratio, and outpatient cost-to-charge ratio. PPS inpatient hospital services are paid based on classification to a diagnosis-related group (DRG). The current DRG classification and grouper system is 3M™ All Patient Refined Diagnosis Related Groups (APR DRG) version 32. STATE currently uses an untrimmed, average arithmetic length of stay. STATE has a cost outlier and day outlier reimbursement policy. If the thresholds for both a cost outlier and a day outlier are met, only the day outlier will apply. APR DRGs 580-640 use the same outlier formula but have higher input thresholds. A capital payment is made on each discharge. A capital payment is not made on a transfer. STATEs current reimbursement policy for transfers is to reimburse a per diem rate for each covered day. Any related outpatient services, diagnostic and non-diagnostic, provided by the hospital must be included on the claim for the inpatient hospital services. PPS outpatient hospital services, exclusive of lab and professional services, are paid based on simplified Ambulatory Payment Classifications (APC) and outpatient cost-to-charge ratio. Lab services are paid based on the Medicare fee schedule and professional services are paid using the ND Medicaid physician fee schedule. 2.02 Scope of Work STATE is seeking an offeror to perform all deliverables identified in this RFP. Successful offeror shall submit a final detailed work plan within 20 days of contract execution. The final plan must include a project timeline with milestone and steps necessary to complete all deliverables. All work product (unless identified as proprietary by offeror prior to execution of the contract) is the intellectual property of STATE and is to be provided to STATEs contact at agreed upon intervals. All work product that includes calculations or variables shall be in Excel format. Deliverable One: Analysis and Recommendations for Development of STATE Reimbursement Policy for PPS Outpatient Hospital Services; 3M™ Enhanced Ambulatory Patient Grouping System (EAPG) Fiscal Impact Analysis; and Calculation of EAPG Provider-Specific Base Rates using the most recent EAPG version. Successful offeror shall: 1. Perform analysis and rate calculations using at least 12 months of North Dakota Medicaid outpatient hospital fee-for-service paid claims data utilizing ICD-10 codes. 2. Analyze and evaluate the outpatient dataset for improvement opportunities to include, at a minimum, the following areas: a. Identify and remove duplicate and aberrant records, if necessary. b. Review frequency of reporting of key fields, such as CPT and HCPC codes. c. Combine same-day services billed as separate claims into a single claim, when appropriate. d. Identify and remove claims for services outside of scope of project. e. Determine outpatient grouper classifications. f. Format the outpatient claims data for grouping. g. Assign EAPGs. h. Review error reports and claims with “invalid” EAPG assignment. i. Review claims data to assign valid EAPGs. j. Remove claims that have no valid EAPG assignment. k. Assign inpatient APR-DRG classifications, weights, and provider-specific base rates. 3. Update, prepare, and provide to STATE the outpatient claims analysis datasets for EAPGs. 4. Provide analysis and recommendations on updates to STATEs PPS outpatient hospital services reimbursement policy for implementation of EAPGs. 5. Submit to STATE a fis   Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 116916 while calling.   Other jobs in ND: Consulting Services job openings in Bismarck, ND Jobs List Consulting Services Including Development - 110.7-24-035-NSP Create date: 17-May-2024 Job Title : WSI CAPS Consulting Services Including Development and Application Architecture - 110.7-24-035 Start date : 6/10/2024 Submission deadline : 05/24/2024 05:00 PM CT Client info : Management & Budget, Office of Description : The Workforce.... (This job is for - Jobs in ND Bismarck Consultant - (in Bismarck, ND)) Investment Performance Measurement Reporting - 110.7-24-016 Create date: 15-Mar-2024 Job Title : Investment Performance Measurement Reporting And Consulting Services - 110.7-24-016 Start date : July 1, 2024 Submission deadline : April 12, 2024, by 12:00 PM, CT Client info : State Procurement Office Description : The Retirement an.... 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