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Medicare Claims Processing & Payment

Active
Federal

Contract Overview

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

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The Medicare Claims Processing and Payment subcontract, managed by the Department of Health and Human Services Office of Acquisition and Grants Management, focuses on the adjudication of Medicare Part A and Part B fee-for-service claims. The scope of work includes processing specialized workloads such as Home Health and Hospice claims to ensure payment accuracy and timeliness for prime contractors on CMS Medicare Administrative Contractor projects. This opportunity is categorized under NAICS code 541219 and is slated for performance in Baltimore. The solicitation was posted on August 4, 2026, with a response deadline of November 2, 2026.

General Info

HHS subcontract for Medicare Part A and B claims processing in Baltimore.

NAICS

541219 - Other Accounting Services

Place of Performance

Baltimore, MD, USA

Set-Aside

NONE

Documents

This scope was carved out of 75FCMC27R0001.

The full solicitation package (9 documents), including the RFP, is on the prime solicitation, not on this scope.

View the prime solicitation

Medicare Administrative Contractor (MAC) Jurisdiction 8 (J8) - Synopsis/Draft RFP / Presolicitation

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Organization & Contact Information

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AgencyDepartment Of Health And Human Services → Ofc Of Acquisition And Grants Management
ContactsNo contacts available
OfficeN/A
Office AddressN/A
ContactsNo contact information available

Full Description

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Processes Medicare Part A and Part B claims and facilitates payments for prime contractors on CMS Medicare Administrative Contractor (MAC) projects. Adjudicates Medicare fee-for-service (FFS) claims and processes specialized workloads, including Home Health and Hospice claims. Ensures payment accuracy and timeliness using Medicare claims adjudication rules. Delivers adjudicated claims and processed payments.

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