Third Party Administrator Services

Seeking a provider to offer third party administrator services, including claim intake, comprehensive reporting, data import/audit, and claims management support for a Texas district.

Offer Third Party Administration for Workers’ Compensation services
Have licensed Adjusters on Staff
Directly provide or subcontract Medical Bill Review and Utilization Review services
Directly provide or subcontract Nurse Case Management services
Risk Management Information System (RMIS) software must fully support work injury reporting and claim creation via RLDatix Safety Center
Ability to support Workday for claim demographics
Directly provide or subcontract Texas 504 Network Administration services with current and relevant experience managing a government 504 workers’ compensation network
Review and respond to all items in Exhibit C - Technology & Security Requirements
Register with vendor credentialing service Symplr within five business days of contract effective date
Comply with Texas Ethics Commission (TEC) Form 1295 requirements if contract value is $1 million or more or requires Board action
Verify no boycott of Israel if company has 10+ employees and contract value is $100,000+
Verify no boycott of energy companies if company has 10+ employees and contract value is $100,000+
Verify no discrimination against firearm and ammunition industries if company has 10+ employees and contract value is $100,000+
Certify no contracts related to critical infrastructure with certain countries (China, Iran, North Korea, Russia, etc.)
Warrant name is not on Comptroller’s List of companies with foreign terrorist organization contracts
Submit one original proposal and one Exhibit D - Pricing Schedule and all Exhibit B Documents, separately sealed
Submit one electronic copy of proposal documents (including separate pricing schedule) to Parkland Supplier portal
Proposals must not exceed 75 pages (excluding required attachments)
Obtain District’s approval for claim reserves exceeding authorized amount
Allow District to retain sole right to select defense counsel
Comply with all applicable CMS rules and regulations, including MMSEA Section 111
Provide online claims management system access for ten District users
Import all prior claims data from inception and conduct an audit
Maintain a separate, dedicated bank account for issuing claim payments
Conduct comprehensive claims investigations including timely contact, recorded statements, third-party liability analysis, and compensability determination
Ensure timely posting and updating of claim reserves
Obtain District’s consent prior to denying claims, setting claims, retaining experts, assigning surveillance, nurse case management, and pursuing subrogation
Audit medical bills in accordance with Texas Fee Guidelines
Pay medical bills timely and in compliance with statutory requirements
Ensure timely filing of all required Division of Workers’ Compensation (DWC) forms
Comply with Texas Electronic Data Interchange (EDI) requirements
Adhere to all applicable state and federal laws and regulations
Attend DWC hearings when attorney representation is required or hire District-approved outside defense
Ensure Claims adjusters document activity in claim file at least every thirty days
Ensure Supervisory file reviews are documented at least every ninety days
Agree that District shall approve the indemnity claims adjuster assigned to its account
Agree that District or its designated representative shall have the right to audit claims files at any time
Provide monthly and upon request, a detailed accounting of all incurred costs
Upon termination, immediately provide District with access to all claims files and deliver data in industry-standard format upon request
System shall interface with District’s Safety Center system for FROI, routing claims to Workers’ Compensation Specialist prior to setup
Have predictive modeling capabilities and projected AI usage
Provide resumes of personnel assigned to District’s account upon request, with preferred minimum of five years indemnity claims handling experience
Maintain caseload limitations for Indemnity Adjuster (max 135 claims) and Medical-Only Adjuster (max 275 claims)
Offer a designated claims team
Maintain an average monthly system availability of 97% uptime, excluding scheduled maintenance
Provide advance notice of any non-emergency system changes
Provide telephone support and designate a primary contact with a direct phone number
Collaborate with District to establish Performance-Based Oversight (PBO) metrics and processes
Offer four claim pricing levels: Report Only, Exposure, Medical Only, Indemnity/Disputed
Provide ad hoc reports as requested
Provide a monthly financial reconciliation report
Provide benchmarking reports comparing District’s program to similar entities
Provide monthly reports by department, accident type, occupation, and time metrics
Provide MMSEA reporting for workers’ compensation, professional liability, and general liability claims
Adhere to District’s established coding structures
Provide a monthly executive summary of loss funds and expenditures in spreadsheet format
Participate in bi-monthly telephonic claim reviews
Attend quarterly in-person Claims Review meetings
Provide Occupational Safety and Health Administration (OSHA) reportability/recordability determination reports
Enable District access to run ad hoc reports
Provide monthly claim, safety, financial, and loss reports
Provide online claim intake functionality
Provide narrative reports upon request
Provide monthly exposure reports
Provide bi-monthly workplace violence/assault reports
Administer District’s established 504 network or have an existing subcontractor relationship
Provide all services required to support network participation or establishment, including claims and bill audit history analysis, provider contracting and credentialing, training materials, and provider directory access
Develop and implement a comprehensive implementation plan for 504 network
RMIS system should offer a claims dashboard and analytic capabilities
Adhere to current security and information protection best practices (HIPAA, HITRUST, NIST, PCI)
Support common and current 2FA/MFA approaches for user-based authentication security
Support Parkland’s SAML/SSO-based systems approach
Provide a current system or device certificate for NIST or other framework certification, if applicable
Provide flexible and extensible logging facilities engine capable of being routed to common log aggregation solutions or other standard SIEM approaches
Provide flexible and capable method of alerting and reporting on common access, system, and security events with proper tamper protections
Support 24x7x365 service and support, preferably with continental U.S.-based personnel
Conduct background and/or clearance checks for support staff accessing Parkland resources
Comply with onsite response times for critical (4 hours), severe (4-8 hours), and intermittent (24 hours) outages
Utilize Parkland’s Secure Link system for vendor connectivity
Support current secure protocols and connectivity options for data encryption in transit and at rest
Not transmit or store unencrypted PII, PHI, or other protected data
Be continually graded and scored on security posture and compliance adherence by Parkland
Attach an architectural diagram of the proposed solution
Meet requirements for the selected application Tier (refer to Capacity, Scalability, and Disaster Recovery section)
Application or System must support the latest stable operating system (greater than or equal to N-1)
Application or System must support the latest versions of .Net, Java, and/or native web browsers where applicable
Application or System must integrate with Active Directory (AD) or support Parkland’s SSO solution and unique user identification
Sign Parkland’s Business Associate Agreement if handling PHI
Return Parkland’s data in an industry standard format and purge content upon termination of cloud-based solution
Ensure Parkland’s cloud-based instance/segment is logically separated from other businesses
Support encryption in transit and at rest using standard cipher mechanisms and protocols approved by Parkland
Allow Parkland to perform security assessments and vulnerability scanning on the solution at a jointly agreed upon frequency
Allow Parkland to perform a vulnerability scan and security assessment before applying patches to their solution
Notify Parkland of cyber security attack or breach within 24 hours
Use service accounts or system accounts for automatic services, running in non-interactive mode and without local administrator or root-level access
Make internal practices, books, and records relating to PHI use and disclosure available to Covered Entity or Secretary of HHS upon request
If a business-to-business VPN is required, use non-RFC1918 IP addressing
Leverage groups for Role Based Access Control (RBAC)
If application sends email, senders should support common mail security framework (SPF, DMARC, DKIM)
If application is hosted at vendor’s facility, support continuous service availability and disaster recovery process
If application is hosted at vendor’s facility, availability must be protected by a disaster recovery process capable of restoring services within an agreed-upon timeframe
Provide appropriate backup and restore solutions if Parkland standard solutions are not supported
All mobile applications must be capable of supporting current Mobile Device Management
Mobile application data must be encrypted in transit and at rest
Mobile application must not store PHI local to the device
Mobile application must not integrate with social media
Endpoints must support DNS/DHCP for device network autoconfiguration and fully qualified name registration & resolution
Cloud-hosted applications must support authentication to Parkland’s directory through SAML or OIDC
On-prem server-based applications must support authentication to Parkland’s directory through SAML or LDAP
Application must work on a routed enterprise network (L3 network)
If solution requires a database, it should be capable of supporting an environment where the database is hosted on a separate server
Actively supported SQL versions must be used (2016 and up)
All components of the database software must be patched
All database cluster nodes and/or HA/DR environments must be patched
All cumulative rollups, patches, and/or 0-day hotfixes must be applied when released and found applicable
Vendor must ensure that Parkland Data, EHI, Identifiable Health Information, PII, PHI, or Sensitive Personal Information is not re-appropriated, re-used, copied, or exposed beyond what is allowed contractually

$5,000,000 – $25,000,000

Issue Date: March 11th, 2026

Questions Due Date: March 18th, 2026, 12:00 PM CT

Proposal Due Date: April 8th, 2026, 2:00 PM CT

Dallas County Hospital District d/b/a Parkland Health

Organization overview and procurement intelligence available on paid plans.

The selected contractor shall deliver comprehensive third party administrator services, including providing an online claim intake system for district use. The contractor will be responsible for submitting narrative reports upon request and furnishing monthly exposure reports, as well as bi-monthly workplace violence and assault reports.

The contractor must enable district access to ad hoc reporting capabilities and supply regular monthly reports on claims, safety, financials, and losses. Adherence to the district's established coding structures is required. Additionally, the contractor is expected to import and audit all prior claims data from inception, ensuring the integrity and accuracy of the data transferred.

Further responsibilities include timely posting and updating of claim reserves and obtaining district consent prior to key claim decisions such as denial, settlement, retaining experts, assigning surveillance, nurse case management, and pursuing subrogation. The objective is to ensure transparent, compliant, and efficient administration of the district’s claims processes.

Third Party Administrator Services

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