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Medical Claims Third-Party Administrator (TPA)

Active

State & Local

Response Deadline12/08/2026, 01:00:00 AM UTC

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 a Medical Claims Third-Party Administrator supports the California Department of State Hospitals by managing the intake, adjudication, and payment coordination of medical claims for prime contractors. The selected provider will be responsible for managing claims billing, applying specific adjudication rules, and delivering daily claim files along with comprehensive monthly financial reports. Operational requirements include the use of a web-based portal to facilitate financial transactions with the State Controller's Office. This engagement falls under NAICS code 541219 and is associated with the California Department of State Hospitals network projects.

General Info

Subcontract for medical claims administration, adjudication, and financial reporting for California State Hospitals.

Agency

California Department of State Hospitals

NAICS

541219 - Other Accounting Services

Place of Performance

CA, USA

Set-Aside

NONE

Documents

This scope was carved out of 26-70009-000.

The full solicitation package (1 document), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

26-70009-000 - Statewide Integrated Health Care Provider Network RFP

AI Contract Breakdown

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Timeline

PostedNov 2

subcontract

Response DeadlineDec 8

Submission deadline

Response Deadline

12/08/2026, 01:00:00 AM UTCin about 1 month

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Organization & Contact Information

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AgencyCalifornia Department of State Hospitals

ContactsNo contacts available

OfficeN/A

Organization / AgencyCalifornia Department of State Hospitals

Office AddressN/A

ContactsNo contact information available

Full Description

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Performs medical claims intake, adjudication, and payment coordination for prime contractors on California Department of State Hospitals (DSH) network projects. Manages claims billing, applies adjudication rules, and provides daily claim files. Utilizes a web-based portal for financial transactions with the State of California (SCO). Delivers adjudicated claims and monthly financial reports.

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