This Solicitation opportunity from Texas was posted on December 20, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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Medical Claims Audit

Closed

18-25State & Local

Submission Closed01/21/2025, 12:00:00 AM UTC

Contract Overview

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

Active Opportunities Like This One

NAICS: 524291

New

SLED

Insurance Claims Administration ServicesThis subcontract for Insurance Claims Administration Services supports prime contractors on insurance projects for the Schertz-Cibolo-Universal City ISD in Texas. The scope of work involves executing claims adjudication, verifying member eligibility, and managing financial reporting. To ensure security and regulatory compliance, the provider must utilize HIPAA-compliant data portals and Claims Management Systems while maintaining professional liability insurance and adhering to all state insurance regulations. The primary deliverables for this engagement include processed claims reports and adjudicated payment vouchers. The opportunity was posted on October 23, 2026, with a response deadline of November 13, 2026. The services fall under NAICS code 524291, focusing on specialized insurance claims administration.

SCHERTZ-CIBOLO-UNIVERSAL CITY ISD

POSTED

DEADLINE

AUTO AND PROPERTY APPRAISAL SERVICES

Solicitation # 6100019640

The City of San Antonio Office of Risk Management is soliciting proposals under RFP 26-075 (RFx 6100019640) for a vendor to provide comprehensive automobile and property appraisal services. The primary objective is to assess property damages caused to third parties by the City, covering a wide range of assets including automobiles, trucks, motorcycles, heavy equipment, and both cosmetic and structural damages to residential and commercial properties. Beyond standard appraisals, the scope of work extends to medical reviews, the evaluation of appraisals submitted by third-party representatives, and special investigations of incidents involving interviews and data collection. Notably, these services do not include third-party workman's compensation claims. The solicitation was posted on October 21, 2026, with a response deadline of November 19, 2026, at 11:00 a.m. Central Time. Interested vendors must complete the SAePS Vendor Registration to view the full solicitation and submit their proposals through the SAePS portal. Primary points of contact for this procurement include Angela Alonso-Smith, Troy Elliott, and Angelica Mata. All responses must be submitted electronically, and strict communication restrictions are in place regarding City employees until the contract is approved during a City Council session.

POSTED

DEADLINE

Agricultural Crop Insurance AdjusterThis subcontract opportunity is for an Agricultural Crop Insurance Adjuster to provide professional loss adjusting and appraisal services for tree fruit and grape crops on behalf of the Province of British Columbia's Ministry of Agriculture and Food. The selected provider will be responsible for determining potential crop yields through plant counts, assessing damage from uninsurable causes, and measuring harvested volumes. Additionally, the contractor must sample crops for quality loss in accordance with the Canadian Grade Compendium: Volume 2 and deliver detailed appraisal reports and documented loss assessments. To successfully execute the contract, the provider must possess a digital camera, laptop, and cell phone. The solicitation was posted on October 9, 2026, with a response deadline of December 5, 2026. This role operates under NAICS code 524291 and involves working as a subcontractor for prime contractors managing these specific agricultural projects.

Ministry of Agriculture and Food

POSTED

DEADLINE

Solicitation # MULRFQ 2728-2

The Ministry of Agriculture and Food for the Province of British Columbia issued solicitation MULRFQ 2728-2 on October 9, 2026, to establish a Multi-Use List of Qualified Suppliers for Production Insurance Claims Adjusting and inspection services specifically for tree fruit and grapes. The scope of work involves conducting field inspections to assess crop and plant loss, determine causes of loss, estimate pre-harvest yields, and determine crop areas across various British Columbia regions, including the Okanagan Valley, Similkameen Valley, and Fraser Valley. While inspections occur year-round, the primary activity period is from April 1 to November 30. Quality loss sampling must adhere to the Canadian Grade Compendium: Volume 2 – Fresh Fruit or Vegetables. Qualified suppliers will be selected through a four-stage evaluation process consisting of mandatory criteria, desirable qualifications, reference checks, and final notification. To pass the second stage, respondents must achieve a minimum overall score of 73. Mandatory technical requirements include a valid Business BCeID and specific hardware, while desirable equipment includes ATVs and hand-held GPS software. Submissions must be in English and submitted via BC Bid or email by December 5, 2026, including the Respondent Qualification Form, Resource Qualification Form, and a resume. Per Addendum 1, submissions from U.S. suppliers will be disregarded unless submitted by a Canadian-based subsidiary that is a Canadian entity. Once established, the list will be used to issue non-exclusive Competition Notices on an as-needed basis, with resulting contracts likely following the Province's standard General Services or Professional Services Agreements.

Ministry of Agriculture and Food

POSTED

DEADLINE

Commercial Fleet and Heavy Equipment Subrogation SpecialistThe Commercial Fleet and Heavy Equipment Subrogation Specialist subcontract for the City of Fort Worth involves the end-to-end recovery of funds for prime contractors working on large vehicle and transit projects. The selected provider will be responsible for reviewing new, open, historical, and dormant insurance and liability files to identify recoverable elements. Key performance requirements include conducting initial liability assessments within 10 business days and issuing formal demands for payment, with a final delivery of recovered funds and detailed liability assessment reports. Qualified candidates must demonstrate a proven track record of success in commercial fleet and heavy equipment subrogation. This opportunity, categorized under NAICS code 524291, was posted on October 7, 2026, with a response deadline of October 29, 2026. Interested parties can find further details through the City of Fort Worth procurement portal.

POSTED

DEADLINE

RFP Large Vehicle Subrogation

Solicitation # 26-0297

The City of Fort Worth is soliciting proposals under solicitation number 26-0297 to establish an as-needed agreement for claims recovery and subrogation services for its Financial Management Services Department. The scope of work focuses on the recovery of funds from new, open, historical, and dormant files within the city's large vehicle, commercial fleet, heavy equipment, and transit portfolios. Selected vendors must demonstrate the ability to leverage telematics and specialized camera footage and provide a secure claims management platform featuring a client portal, analytics, and SLA tracking. Performance standards include acknowledging new referrals within two business days, completing initial liability assessments within ten business days, and targeting a net recovery success rate of 40-60 percent of costs. The contract utilizes a contingency-fee model where compensation is based on a percentage of the gross amount recovered, meaning no fees are owed if no recovery is secured. Evaluation is based on a point system covering small business participation, financial model, methodology, experience, technology, and capacity, with a minimum threshold of 50 percent of total available points required for award. A significant emphasis is placed on small business participation, with a 30 percent goal for firms located in Tarrant, Wise, Johnson, Parker, or Denton counties. Technical requirements include maintaining a SOC 2 Type II certification and adhering to strict encryption standards using TLS 1.3 and AES-256. Additionally, vendors must provide commercial general liability insurance of 1 million dollars per occurrence.

POSTED

DEADLINE

Medicaid Claims Management SoftwareThis subcontract for Medicaid Claims Management Software involves the supply and maintenance of a specialized claims submission system for prime contractors working on Spring Independent School District projects. The software is designed to validate SHARS billing requirements, specifically focusing on the verification of IEPs and parental consent, while ensuring strict adherence to Federal Compliance Guidelines for Medicaid billing. The contractor is responsible for delivering a fully operational and validated system capable of maintaining 99 percent accuracy with a permissible error rate of plus or minus 3 percent. This opportunity is associated with Arlington ISD in Texas, with a response deadline set for June 30, 2027.

POSTED

DEADLINE

Stop-Loss Claims AdministrationThis subcontract for Stop-Loss Claims Administration involves providing administrative processing for prime insurance carriers supporting Illinois State Toll Highway Authority employee benefits projects. The selected provider will be responsible for reviewing medical claims against established thresholds, validating member eligibility, and calculating reimbursement amounts. All operations must be conducted using claims management software and data handling systems that adhere to strict HIPAA compliance standards. The contract requires the provider to maintain HIPAA Compliance certification and Professional Liability Insurance to ensure data security and operational risk management. Key deliverables include the submission of processed claim reports and the execution of reimbursement disbursements. The work is associated with NAICS code 524291 and is centered in Downers Grove, Illinois.

Insurance

POSTED

8 months ago

DEADLINE

N/A

AI Contract Overview

North East Independent School District is soliciting proposals under solicitation number 18-25 for professional medical claims audit services. The scope of work involves auditing claims processed by Blue Cross and Blue Shield of Texas over a 24-month period, with specific sampling and audit criteria outlined in the Business Associate Agreement. This is a Request for Proposal rather than a guaranteed order, meaning the district will make purchases on an as-needed basis without guaranteeing specific quantities or dollar amounts. Interested respondents must submit their proposals electronically through the designated ebidding platform, although paper bids are legally accepted. Key deadlines include a question submission cutoff of January 17, 2025, and a final response deadline of January 21, 2025. Required documentation for submission includes insurance certifications, fingerprinting, and conflict of interest forms. The district emphasizes adherence to its standard terms and conditions and specific insurance requirements for all participating vendors.

General Info

NEISD seeks proposals for medical claims audit services by January 21, 2025.

Agency

Texas → North East Independent School District

NAICS

524291 - Claims Adjusting

Place of Performance

TX, USA

Set-Aside

NONE

Documents

18-25 Addendum 1 Medical Claims Audit RFP

rfp

High

RFP 18-25 Addendum 1 Medical Claims Audit NEISD

rfp

High

AI Contract Breakdown

Uniform Contract Format

Contract not broken down yet

CLEATUS splits the solicitation into Uniform Contract Format (UCF) sections: scope, pricing, deliverables, and evaluation criteria.

Timeline

1 update

PhaseClosed

PostedDec 20

Solicitation

Deadline changedDec 20

Response deadline changed from Jan 16, 2025 to Jan 21, 2025.

Response DeadlineJan 21

Deadline has passed

Submission Closed

01/21/2025, 12:00:00 AM UTC

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Organization & Contact Information

AgencyTexas → North East Independent School District

Contacts1 person available

OfficeN/A

Organization / AgencyTexas → North East Independent School District

Office AddressN/A

Contacts

Jill Jones

contact@example.gov

Full Description

North East Independent School District (NEISD) is seeking proposal responses for the following products or services: Medical Claims Audit in accordance with the instructions, terms and conditions, and requirements/specifications contained in this Solicitation. Bid responses are due on or before 9:00 A.M. Central Standard Time on Thursday, January 16, 2025 without exception. Proposals received after the specified time and date above will not be considered. NOTE: This is not an order, it is a Request for Proposal. North East ISD does not guarantee any purchase quantities or dollar amounts. Purchases will be made on an as needed basis. Although the District is legally required to accept paper bids, we strongly request that bidders submit this bid electronically through this ebidding platform. Respondents must register as a supplier to be able to respond electronically. For assistance with this submittal, please call +1 (555) 000-0000. Thank you for your interest in doing business with North East ISD!