Workers Compensation Utilization Review Services

Overview

Healthcare Services, Wellness & Biotech

San Bernardino, California, United StatesPosted about 1 month agoDeadline: May 21st, 2026

Fit Score

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SUMMARY

Request for workers' compensation utilization review services in California requiring evidence-based assessments, timely determinations, and comprehensive reporting over a five-year term.

KEY REQUIREMENTS

Must register with the ePro system prior to the proposal submission deadline
Must have sufficient service facilities and personnel to operate and provide utilization review services
Must be able to establish and maintain an electronic data link with the County claims system provider
Utilization reviews must be conducted by registered nurses (RN) and/or physicians with at least one-year experience
Must provide evidence of ability to insure as stated in Section X, Paragraph B
Must comply with HIPAA and HITECH Act regulations
Must have no record of unsatisfactory performance with the County in the twenty-four (24) month period preceding the date of issuance of the RFP
Must be registered with the California Secretary of State if a business entity
Must not be debarred, suspended, or declared ineligible for the award of contracts by any federal department or agency

BUDGET

Estimate

$250,000 – $500,000

CONTRACT DURATION

60 months

TIMELINE

Release of RFP: March 30th, 2026

Deadline for Submission of Questions: April 20th, 2026

Tentative date for response to questions: May 7th, 2026

Deadline to submit proposals: May 21st, 2026

Tentative dates for proposers’ presentations: June 22nd, 2026 through June 26th, 2026

Tentative date for Intent to Award Notifications: September 14th, 2026

Tentative date for Contracts to be approved by the Board of Supervisors: October 20th, 2026

QUESTION DEADLINE

April 20th, 2026

Issuing Agency

San Bernardino County Department Of Risk Management

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DESCRIPTION

The selected vendor will provide comprehensive workers' compensation utilization review services aimed at ensuring medical treatments for injured workers are appropriate, evidence-based, timely, and cost-effective, with a focus on recovery and return to work. The program requires the use of nationally accepted treatment guidelines for the review and assessment of medical reports, and includes electronic transmission of medical records and referrals. Occasional on-site visits may be scheduled at the discretion of the county.

The vendor will be responsible for confirming receipt and making utilization review determinations via email, with a 24-hour response time for all inquiries related to referrals, timelines, review outcomes, appeals, billing, and service levels. The contract necessitates standard monthly and utilization review reports that detail itemized services and dates, as well as comprehensive statistical reporting. These reports are essential for the county to measure the value and effectiveness of the utilization review program. The contract period will be for five years.

Source attribution

This Settle analysis is based on the issuing organization’s public RFP listing.