PROFESSIONAL SERVICE AWARD ANALYSIS
SERVICE: Utilization Review
SERVICE DESCRIPTION: Provide a Utilization Review process to determine if a proposed treatment requested for an injured worker is medically necessary.
VENDOR: ARISSA COST STRATEGIES (Workers’ Compensation Utilization Review) OVERALL RANKING: 1
SUBJECT MATTER EXPERTS/RATERS: 1. City of H.B. Risk Manager 2. City of Anaheim Workers’ Compensation Claims Manager 3. Risk Manager for El Monte Unified School District 4.
Managed Care Consultant 5. Director of Medical Services, MSA Settlements I. MINIMUM QUALIFICATIONS REVIEW
• Written Proposal Score: 1097.5
Arissa Cost Strategies – Minimum Qualifications Review
Criteria
Total Weighted
Score
Maximum
Score
Compliance with RFP 57.50 75
Approach & Methodology 275 375
Qualifications & Experience 275 375
Clarity 115 150
Proposed Cost/Pricing 300 375
References 80 150
Total 1097.5 1500
II. DUE DILIGENCE REVIEW
• Interview Ranking: 1
Arissa Cost Strategies – Summary of Review
• Successful compliance with RFP, inclusion of required URAC accreditation. They are the incumbent.
• Methodology is good, - has appropriate technology to
protect networks and data.
• Very qualified, serviced public agencies, counties, public works and school districts for 10 years; management has over 33 yrs experience.
• Value-added features include a powerful technological software that creates a highly-customizable platform for utilization review decisions.
Arissa Cost Strategies – Pricing
• Competitive - flat rates include $80/Non-Physician
review; $175/Phys; $175/Expert Phys; $85/Medical
Director; (best pricing of 7 bids submitted)
• Pricing for this new contract is even lower than their previous 3-yr contract (2018 – 2021) so we expect
continued savings.