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Dental Claims Adjudication and Prior Authorization Services

Active

State & Local

Contract Overview

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

General Info

Agency

Illinois → DirectorView Agency

NAICS

541219 - Other Accounting ServicesView NAICS

Place of Performance

Springfield, IL, 62704, USA

Set-Aside

NONE

Documents

This scope was carved out of 26-478HFS-DIREC-B-51894.

The full solicitation package (3 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

26-478HFS-DIREC-B-51894 | Sole Source: Dental Program for Fee-For-Service Customers

AI Contract Breakdown

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Timeline

PostedApr 8

subcontract

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Organization & Contact Information

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AgencyIllinois → Director

ContactsNo contacts available

OfficeN/A

Organization / Agency

Illinois → Director

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Office AddressN/A

ContactsNo contact information available

Full Description

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Performs technical review and processing of dental claims for prime contractors on Illinois Department of Healthcare and Family Services (HFS) projects. Processes dental claims for reimbursement, reviews prior authorization requests for medical necessity, and ensures compliance with federal Medicaid requirements. Utilizes dental claims processing software and Medicaid adjudication systems. Delivers processed and adjudicated claims and prior authorization determinations.

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