Medical Bill Review and Audit Services

The contract seeks qualified providers to perform independent reviews and audits of medical bills associated with workers’ compensation claims in Florida, focusing on assessing the reasonableness of charges, compliance with established fee schedules, and the medical necessity of services rendered. The scope includes detailed analysis of billing practices to ensure adherence to state regulations and industry standards, with the goal of reducing improper or excessive payments while maintaining appropriate care for injured workers. The work is classified as a subcontract under NAICS code 541611, which corresponds to administrative management and general management consulting services, and must be performed in alignment with the requirements set forth by the Human Resources, Risk Management Division of the State of Florida. Interested parties must submit responses by August 12, 2026, and the opportunity is open to firms capable of delivering accurate, timely, and legally compliant medical bill review services. The contract does not specify a set-aside for small or disadvantaged businesses, and there are no listed point of contact details or physical performance locations beyond the state level. Subcontractors are expected to utilize established methodologies and data standards to provide defensible audit outcomes, with all activities conducted under the oversight of Florida’s risk management authority. The procurement is publicly accessible via a designated online portal for submission and further procedural details.