Clinical Denial Services

The University Medical Center of Southern Nevada (UMC) has released RFP No. 2025-12, seeking qualified vendors to provide Clinical Denial Services. This solicitation, with a submission deadline of December 8, 2025, at noon local time, is accessible via the Nevada Government eMarketplace website. The contract is structured for a three-year term with options for extension, focusing on supporting UMC’s efforts in managing clinical denials in healthcare billing and revenue cycle operations. Proposers are expected to demonstrate their experience, staff qualifications, and a detailed methodology for service delivery that aligns with UMC’s scope of work, as outlined in the evaluation criteria. Required proposal components include an executive summary, organizational information, references, and detailed staff resumes. Submissions are evaluated for compliance, quality of proposed solutions, relevant experience, and the capacity to meet UMC’s operational standards. Stringent compliance requirements accompany service delivery, including adherence to Nevada Revised Statutes, federal regulations such as HIPAA and HITECH, and UMC’s internal policies. Contractors must maintain various types of insurance coverage, comply with technology and information security standards, and follow strict vendor access and conduct policies to ensure patient safety and confidentiality. Additional administrative requirements include disclosure of ownership, business certifications, demographic self-identification, and documentation regarding subcontractor participation, with an emphasis on diverse and local business engagement. All vendors are required to sign representations and certifications attesting to legal standing, business conduct, and regulatory compliance. The Sample Business Associate Agreement further ensures protection and correct handling of protected health information. Overall, this contract emphasizes rigorous operational standards, legal and regulatory compliance, and a transparent, competitive selection process aimed at achieving high-quality clinical denial management for UMC.