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Automated Medical Claims Billing

Active
75H71326Q00076Federal

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

General Info

Agency

Department Of Health And Human Services → Indian Health ServiceView Agency

NAICS

518210 - Computing Infrastructure Providers, Data Processing, Web Hosting, and Related ServicesView NAICS

Place of Performance

Portland, OR, 97209, USA

Set-Aside

NONE

Documents

(3)

75H71326Q00076 - Performance Work Statement for Automated Medical Claims Billing Services

PDFsow

IHS1525685 & IHS1528590 - Single Source Justification

PDFjustification-and-authorization

Attachment 1 - Schedule of Items

XLSXspecifications

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Timeline

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Organization & Contact Information

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AgencyDepartment Of Health And Human Services → Indian Health Service
Contacts1 person available
OfficePORTLAND, OR, 97209, USA
Organization / Agency
Department Of Health And Human Services → Indian Health Service
View Agency Profile
Office AddressPORTLAND, OR, 97209, USA

Full Description

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This is a notice of intent to award on a sole-source basis and a Request for Quotation (RFQ) for commercial services prepared in accordance with RFO FAR Part 12. This notice and the attachments constitute the solicitation. This is not a request for competitive proposals; however, any responsible source may submit a timely capability statement and quotation for consideration.



Solicitation No. 75H71326Q00076 is issued for continuation of the existing automated medical claims billing services used by the Indian Health Service (IHS), Portland Area, Western Oregon Service Unit (WOSU) and Warm Springs Service Unit (WSSU).



This single SAM.gov posting covers two separate Service Unit requirements. The Government anticipates issuing two independently funded and administered purchase orders, one for WOSU and one for WSSU. Each purchase order will have separate funding, acceptance, invoicing, and payment records.




INTENDED SOURCE AND BASIS FOR SOLE SOURCE



The Government intends to issue the contemplated purchase orders to Change Healthcare Operations, LLC, 424 Church Street, Suite 1400, Nashville, Tennessee 37219-2367, UEI C7DYEBLK3PE1, doing business under the Optum/Change Healthcare brand.



The intended source currently provides the Assurance Plus medical claims billing service used by the supported facilities. Continued use for the one-year interim period avoids duplicate transition, account setup, payer-connection, testing, and training costs and reduces the risk of interruption to claims processing and reimbursement. See Attachment 3 - Single Source Justification for details.



A timely submission from another responsible source will be considered before award. An alternate source must demonstrate that it can provide the required service by October 1, 2026 without material transition delay, unpriced implementation work, or interruption to current claims-processing operations.




SOLICITATION INFORMATION



Solicitation Number: 75H71326Q00076


Request Type: Notice of Intent to Sole Source and Request for Quotation


Contract Type: Firm-fixed-price commercial services; one monthly Assurance Plus subscription line item for each Service Unit


Set-Aside: Full and Open Competition


NAICS Code: 518210 - Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services


Product Service Code: DA10 - IT and Telecom - Business Application/Application Development Software as a Service


Issue Date: September 15, 2026


Questions Due: September 16, 2026 at 12:00 PM Pacific Time


Quotation/Capability Statement Due: September 16, 2026 at 5:00 PM Pacific Time


Anticipated Award Date: September 17, 2026


Submit To: jacob.blalock@ihs.gov and PORAOAcquisition@ihs.gov


Email Subject Line: 75H71326Q00076 - Medical Claims Billing Services



PERIOD OF PERFORMANCE



The anticipated period of performance for each order is October 1, 2026 through September 30, 2027.




LOCATION



  • Western Oregon Service Unit. Chemawa Indian Health Center, 3750 Chemawa Road NE, Salem, Oregon 97305.
  • Warm Springs Service Unit. Physical Address: Warm Springs Health & Wellness Center, 1270 Kot-Num Road, Warm Springs, OR 97761. Mailing Address: Warm Springs Health & Wellness Center, PO Box 1209, Warm Springs, Oregon 97761.


ASSURANCE PLUS SUBSCRIPTION BASIS



Each Service Unit requires a 12-month continuation of Assurance Plus based on 1,200 monthly subscription volume. The respondent shall quote current pricing for each Service Unit and disclose all rates or charges that could apply.



Western Oregon Service Unit


Monthly subscription volume: 1,200


Current account reference: Change Healthcare customer no. 1207343; site identifier 691-S15Y


Current purchase order: 75H71321P00153


Performance period: 12 months



Warm Springs Service Unit


Monthly subscription volume: 1,200


Current service reference: Existing Warm Springs Assurance Plus service; prior renewal proposal dated January 23, 2026


Performance period: 12 months


Pricing basis: 1,200 monthly subscription volume; maintain current scope



For each Service Unit, the Offeror shall enter the proposed monthly Assurance Plus subscription price and 12-month total in Attachment 1. In the quotation, also state the applicable per-transaction overage rate, Paper Claims rate, HC Direct rate, and any other mandatory or usage-based charge; state N/A if not applicable. Existing ERA Transactions, Assurance Plus 837 Files Transfer, Assurance Plus Transactions, and related current functions are expected within the existing Assurance Plus scope unless the Offeror clearly identifies otherwise.



ATTACHMENTS


- Attachment 1 - Schedule of Items


- Attachment 2 - Performance Work Statement


- Attachment 3 - Single Source Justification



QUOTATION REQUIREMENTS



The intended source shall submit:


  • Legal business name, address, UEI, quotation point of contact, and confirmation of current SAM.gov registration.
  • A completed Attachment 1 with the proposed monthly Assurance Plus subscription price and 12-month total for each Service Unit, based on 1,200 monthly subscription volume.
  • Confirm whether the quoted monthly subscription includes ERA Transactions, Assurance Plus 837 Files Transfer, Assurance Plus Transactions, payer-response/status/eligibility functions, and standard support; identify any exception.
  • Confirmation of current Business Associate Agreement status and identification of any agreement or amendment required before performance.
  • Any commercial service terms proposed for incorporation into the purchase orders. The quotation shall remain valid for at least 60 calendar days after the response deadline.


An alternate source shall submit the same information and a concise capabilities statement showing that it can meet Attachment 2 and begin uninterrupted production service by the required date.



BASIS FOR AWARD



The Government intends to issue two (2) purchase orders to Change Healthcare Operations, LLC if the company accepts the requirements, submits complete pricing for both Service Units, and the Contracting Officer determines the price to be fair and reasonable. No separate technical proposal is required from the intended source. The Government may issue one, both, or neither purchase order; request clarification; negotiate price or terms; or cancel the solicitation.



ORDER TERMS



  • The 1,200 monthly subscription volume stated in this RFQ and Attachment 1 is the pricing basis for each Service Unit. The Offeror shall state what is included in the monthly subscription and how any overage is calculated. Any overage, Paper Claims, HC Direct, or other usage-based rate will apply only if expressly incorporated into the resulting purchase order.
  • Each facility shall be invoiced separately, monthly in arrears, through IPP unless the applicable purchase order states otherwise. The annual base subscription amount will equal 12 times the awarded monthly subscription price.
  • Invoices shall identify the purchase order, service period, monthly Assurance Plus subscription amount, and any separately authorized usage-based charge for the applicable Service Unit.
  • No charge or rate is payable unless it is expressly incorporated into the applicable purchase order or a written modification signed by the Contracting Officer.
  • No option, automatic renewal, evergreen term, or work outside the awarded scope is authorized without a written modification signed by the Contracting Officer.
  • The Contractor shall comply with the applicable Business Associate Agreement and the privacy, security, and accessibility requirements stated in Attachment 2 and the resulting purchase order.



HHSAR 352.232-71 Electronic Submission of Payment Requests. (APR 2026) (RFO DEVIATION)



(a) Definitions. As used in this clause -


Payment request means a bill, voucher, invoice, or request for contract financing payment with associated supporting documentation. The payment request must comply with the requirements in FAR 32.905(b) and the applicable payment clause included in this contract.


(b) Submission instructions. Except as provided in paragraph (c) of this clause, the Contractor must submit payment requests electronically using the Department of Treasury Invoice Processing Platform (IPP) or successor system. Information regarding IPP, including IPP Customer Support contact information, is available at www.ipp.gov or any successor site.


(c) Alternate submission procedures. The Contractor may submit payment requests using other than IPP only when the Contracting Officer authorizes alternate procedures in writing.


(d) Submission of alternate payment procedures authorization. If alternate payment procedures are authorized, the Contractor must include a copy of the Contracting Officer's written authorization with each payment request.


(End of clause)



End of Sole Source Notice/Request for Quotation.

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