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Medical Claims Clearinghouse SaaS Support

Active
Federal

Contract Overview

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

AI Contract Overview

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This subcontract for Medical Claims Clearinghouse SaaS Support provides the Indian Health Service with a secure, HIPAA-compliant, web-based system for electronic billing and insurance eligibility management. The service focuses on managing single and batch claim transmissions to private insurers, the VA, and Medicaid using EDI X12 standards, while utilizing cloud infrastructure for automated validation, error detection, and 837 file transfers. The contract is categorized under NAICS code 518210 and is managed by the Department of Health and Human Services. Performance of these services is based in Portland, Oregon, and the primary deliverable is an operational billing subscription to support prime contractors on Indian Health Service projects.

General Info

HIPAA-compliant SaaS for Indian Health Service electronic billing and claims management in Oregon.

Agency

Department Of Health And Human Services → Indian Health ServiceView Agency

NAICS

518210 - Computing Infrastructure Providers, Data Processing, Web Hosting, and Related ServicesView NAICS

Place of Performance

Portland, OR, 97209, USA

Set-Aside

NONE

Documents

This scope was carved out of 75H71326Q00076.

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

View the prime solicitation

Automated Medical Claims Billing

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Timeline

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Response Deadline

Submission deadline

Response Deadline

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Organization & Contact Information

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AgencyDepartment Of Health And Human Services → Indian Health Service
ContactsNo contacts available
OfficeN/A
Organization / Agency
Department Of Health And Human Services → Indian Health Service
View Agency Profile
Office AddressN/A
ContactsNo contact information available

Full Description

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Provides and maintains a secure, web-based, HIPAA-compliant electronic billing and insurance eligibility management system for prime contractors on Indian Health Service projects. Manages single and batch claim transmissions to Medicaid, VA, and private insurers via EDI X12 standards. Executes automated validation, error detection, ERA transactions, and 837 file transfers using HIPAA-compliant cloud infrastructure. Delivers an operational billing subscription.

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NAICS: 518210
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Solicitation 75H71326Q00076 is a request for quotation and notice of intent to award on a sole-source basis for the continuation of automated medical claims billing services. The Indian Health Service intends to award two independently funded firm-fixed-price purchase orders to Change Healthcare Operations, LLC for the Western Oregon Service Unit and the Warm Springs Service Unit. The period of performance for both orders is from October 1, 2026, through September 30, 2027, with no options for extension. The requirement is based on a 1,200 monthly subscription volume per unit for the Assurance Plus web-based service, which includes processing ERA transactions and 837 file transfers. The government is pursuing a sole-source award to avoid the costs and risks associated with transitioning to a new provider, such as duplicate account setup and potential interruptions to claims processing. To be considered, any alternate source must demonstrate the ability to provide uninterrupted service by October 1, 2026. Key requirements include strict HIPAA compliance, the execution of a Business Associate Agreement, and the maintenance of approved payer connections with the VA and state Medicaid gateways. Payment will be handled via the Department of Treasury Invoice Processing Platform, with separate monthly invoices required for each service unit.
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