Medical Bill Review and Cost Containment Services

This subcontract for Medical Bill Review and Cost Containment Services supports prime contractors on EOEEA agency projects within Boston. The selected provider will deliver administrative managed care services, including auditing medical bills for accuracy, applying PPO repricing fee schedules, and performing utilization reviews to determine treatment necessity. Additionally, the contractor is responsible for coordinating care through nurse case management, which requires the use of Certified Case Managers. The provider must adhere to EOTSS information security standards and deliver specific outputs, including repriced bills, utilization review determinations, and detailed case management reports. This opportunity falls under NAICS code 621610 and is associated with the Executive Office Groups in Massachusetts, with a response deadline of October 6, 2026.