HomeMy WebLinkAboutRESPONSE - RFP - 7649 DENTAL ADMINISTRATOR (7)RFP 7649 Dental Administrator
SECTION 7.0 PROPOSAL CHECKLIST
The following information is requested as part of the proposal process. Please indicate
your included attachments by duplicating this checklist and marking the appropriate
column (Yes or No):
Yes No Description of Item
X _____ Proposal for Group Dental
X _____ Signed Business Associate Agreement
X _____ Signed Proposal Compliance Letter
X _____ Signed Plan Design Confirmation
X _____ Completed and Signed Questionnaire(s)
X _____ Dental Network Access Analysis (if applicable)
X _____ Copy of your EOB for Dental Services (if applicable)
X _____ Proposed Implementation Timeline for the City.
X _____ Audited Financial Statements and/or Department of
Insurance filings for the past two years (Only if requested by
the City)
X _____ Provider “Report Cards” used to provide feedback on clinical
and non-clinical performance measures
X _____ Copy of your Policy Assuring Member Satisfaction
X _____ Samples of all Standard and Optional Reports you are
proposing to provide on an account specific basis
X _____ Data Specifications for all plans
In what format can you receive and transmit eligibility
data including additions and deletions?
Please submit a copy of your file format specifications for
electronic transmissions.
Do you have any limitations with electronic payroll
systems? Please describe your technology capabilities.
Describe the security parameters for your systems both
for the employer and the employees (ex: passwords).
Do you require an email address for online access?
X _____ Copy of your Banking Services Agreement
X _____ Copy of your Customer Satisfaction Survey
X _____ Copy of your Administrative Services Agreement or
Insurance Contract that will be in effect January 1, 2015
Signature of Authorized Representative: _____________________________________