RFP - Self-Insured Workers' Compensation Bill Review Services

The City of Bakersfield is seeking a qualified contractor to provide comprehensive, self‑insured workers’ compensation bill review services. The contractor will review all medical, pharmacy, and diagnostic bills, enforce fee‑schedule compliance, manage duplicate and unauthorized charges, maintain and negotiate PPO networks, and deliver detailed monthly and annual cost‑containment reports. Integration with the City’s third‑party administrator (AIMS) and any utilization‑review contractor is required, as is the ability to generate electronic EOBs for sample bills. The contract is a five‑year independent‑contractor agreement beginning 1 July 2026, with a mandatory hard‑copy submission of five proposal copies by 27 February 2026. • Review and reduce workers’ compensation medical bills, ensuring fee‑schedule adherence and eliminating duplicates/unauthorized items. • Manage PPO contracts, provide pharmacy PPO savings, and handle provider inquiries and lien defenses. • Supply monthly/annual reporting and maintain a technology platform that interfaces with the City’s TPA (AIMS) and utilization‑review systems. • Must possess proven municipal bill‑review experience, appropriate insurance coverage ($1M+ each line), and the ability to submit electronic EOBs for three sample bills by 27 March 2026.