Medical Bill Review and PPO Network Services

This subcontract for Medical Bill Review and PPO Network Services supports prime contractors on workers compensation projects for the Arizona Department of Administration. The scope of work involves the adjudication of medical bills in strict accordance with the Arizona Fee Schedule, PPO network agreements, and ODG Treatment Guidelines. Additionally, the provider is responsible for managing PPO networks across hospitals, physicians, and laboratories, while conducting specialized clinician screenings for any hospital bills exceeding 5,000 dollars. The service provider must integrate all processed data into the Origami Risk RMIS and deliver final adjudicated bills along with payment recommendations. This opportunity falls under NAICS code 621999, with a response deadline set for November 5, 2026.