This Government Contract opportunity from New York was posted on June 15, 2026. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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Medical Claims Processing and Adjudication

Closed

State & Local

Submission Closed07/15/2026, 05:00:00 PM UTC

Contract Overview

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

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NAICS: 561410

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Navajo Area Indian Health Svc

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Multiple-award Blanket Purchase Agreements (BPAs) for Area-wide Information Health Management (IHS) Medical Coding Services

Solicitation # 75H71026Q00276

Solicitation 75H71026Q00276 is a request for quotes to establish multiple-award Blanket Purchase Agreements (BPAs) for remote outpatient and inpatient medical coding and limited data entry services supporting the Navajo Area Indian Health Service (NAIHS). This is a total set-aside for Indian-owned, Small Business, Economic Enterprises (ISBEE) under NAICS code 561410. The period of performance is from November 1, 2026, to October 31, 2031. The scope includes coding for various encounter levels, ranging from simple outpatient visits to complex inpatient record reviews, requiring the use of ICD-10-CM, ICD-10-PCS, CPT, HCPCS Level II, DSM, and CDT classifications. All coders must hold current AHIMA or AAPC certifications and undergo HSPD-12 background investigations. The government will use a Lowest Price Technically Acceptable (LPTA) source selection process. Quotes are evaluated based on technical acceptability (Pass/Fail), a past performance confidence rating, and proposed firm-fixed per-encounter rates for the base year and four renewal periods. A 95% coding accuracy rate is required, and a Quality Control Plan must be submitted within 15 days of award. Due to the handling of protected health information, contractors must sign a Business Associate Agreement and comply with HIPAA and the Privacy Act. Quotes must be submitted electronically to Adrian.Segay@ihs.gov by September 15, 2026, at 2:00 PM MDT. Submissions must be organized into four volumes: Administrative, Technical Capability (maximum 20 pages), Past Performance, and a fourth volume. Between two and five Past Performance Questionnaires must be submitted directly to the Contracting Officer. Invoicing is to be processed electronically through the Department of Treasury Invoice Processing Platform (IPP). Labor standards are governed by Department of Labor wage determinations for Arizona and New Mexico.

Navajo Area Indian Health Svc

POSTED

12 days ago

DEADLINE

in 3 days

AI Contract Overview

This contract entails the comprehensive management of medical, dental, and pharmacy claims, ensuring that claims are processed, adjudicated, and paid in accordance with relevant plan documents as well as federal and state regulations. Key responsibilities include verifying claims accuracy, detecting and preventing fraud, and managing timely provider payments to maintain compliance and operational efficiency. The contract, titled "Medical Claims Processing and Adjudication," is a subcontract opportunity posted by the agency Centro, based in New York, with a solicitation posted on June 15, 2026, and a response deadline of July 15, 2026. The contract falls under the NAICS code 561410, indicating a focus on business support services, specifically claims processing. While specific geographic details for the place of performance and contact information are not provided, the opportunity is accessible through the stated online portal for interested parties to submit their responses by the specified deadline.

General Info

Manage medical, dental, pharmacy claims processing, verify accuracy, prevent fraud, ensure timely payments, compliance.

Agency

New York → CentroView Agency

NAICS

561410 - Document Preparation ServicesView NAICS

Place of Performance

NY, USA

Set-Aside

NONE

Documents

This scope was carved out of 2026-16.

The full solicitation package (8 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Third Party Administrator for Medical Services 2027-2032

AI Contract Breakdown

Uniform Contract Format

No contract breakdown available.

Cannot generate Contract Breakdown because no documents were found from this contract's source.

Timeline

PhaseClosed

PostedJun 15

subcontract

Response DeadlineJul 15

Deadline has passed

Submission Closed

07/15/2026, 05:00:00 PM UTC

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Organization & Contact Information

AgencyNew York → Centro

ContactsNo contacts available

OfficeN/A

Organization / Agency

New York → Centro

View Agency Profile

Office AddressN/A

ContactsNo contact information available

Full Description

Process, adjudicate, and pay medical, dental, and pharmacy claims in compliance with plan documents and federal/state regulations, including fraud detection and provider payments.

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