Payer Verification Services

The Great Plains Area Indian Health Service, under the Department of Health and Human Services, awarded a Firm Fixed Price, Non-Personal Service contract for Payer Verification Services to support the Business Office at the Cheyenne River Health Center in Eagle Butte, South Dakota. This total small business set-aside contract provides for all payer eligibility and Medicare and Medicaid claims services, with an anticipated monthly volume of 1,800 eligibility checks and 1,500 claims submissions. The agreement includes a base year valued at 47,923.60 dollars and four subsequent one-year option periods, bringing the overall aggregated total to 239,648.56 dollars. As part of the contractual requirements, the selected provider must adhere to a Business Associate Agreement to ensure the safeguarding of Protected Health Information in strict compliance with HIPAA regulations. This includes mandatory reporting of data breaches and the secure use of the Master Patient Index. The procurement process emphasized technical expertise, problem-solving approaches, and past performance over price to ensure the delivery of critical healthcare administrative services.