All correspondence must be made through the Vendor Portal. Specifications include, but are not limited to: a. Management of at least one network of high quality medical facilities and professionals that have demonstrated their ability to achieve better health outcomes that will provide medical services at a lower cost than the surrounding community, with the willingness to expand this network within and around the State of Delaware if not already available. b. Coordination with the State’s medical third party administrators to accept eligibility files, process and pay claims from medical providers within the selected organization(s)’s network, and share data on plan payments and member cost-sharing to properly account for members’ annual cost-sharing limits. c. Ability to coordinate with medical third party administrators on behalf of plan sponsors with IRS-qualified high deductible health plans with HSAs to accept, process and pay claims from medical providers within the selected organization(s)’s network.15 d. Coordination with the State’s medical third party administrators to support the clinical management and care coordination of GHIP members. e. Dedicated, knowledgeable, and accessible member support services, which includes an online provider search tool for members to use in locating COE providers.
