This Solicitation opportunity from Ohio was posted on April 3, 2025. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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OhioMHAS Utilization Review and Billing Consultant

Closed

SRC0000029322State & Local

Submission Closed04/21/2025, 12:00:00 AM UTC

Contract Overview

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

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NAICS: 333924

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W6QM Micc-Ft Drum

POSTED

about 6 hours ago

DEADLINE

in 5 days

AI Contract Overview

The Ohio Department of Mental Health and Addiction Services (OhioMHAS) is seeking to enhance and modernize its utilization review and billing processes through a contract with a qualified provider. The department, noted for its leadership in mental health and addiction services in Ohio, is focused on maintaining an efficient, high-quality, and accessible system that is valued by all citizens. With the recent integration of the Epic electronic health record system, there have been notable shifts in roles and processes related to utilization review and billing. This contract is specifically designed to evaluate and improve these processes, aiming for greater efficiency and accuracy. The contractor will visit six regional psychiatric hospitals throughout Ohio to assess current practices in utilization review and billing. They will identify areas for educational growth, particularly in administrative tasks like patient registration, medical coding, dealing with charging errors, and addressing claim denials. Education and support will be provided to onsite personnel as needed, and a continuous presence will be maintained to ensure comprehensive training. By the end of the contract term, which runs from April 1, 2025, to June 30, 2025, the contractor is expected to deliver a thorough report with suggestions for organizational enhancements. This initiative represents a strategic effort by OhioMHAS to achieve an improved and more reliable service structure that aligns with their core mission of providing exemplary mental health and addiction services statewide.

General Info

OhioMHAS contracts to improve utilization review and billing for mental health services by 2025.

Agency

Ohio Department of Mental Health - Financial Management

NAICS

333924 - Industrial Truck, Tractor, Trailer, and Stacker Machinery Manufacturing

Place of Performance

OH, USA

Set-Aside

NONE

Documents

Utilization Review and Billing Consultant RFP - OhioMHAS SFY 2025

rfp

High

AI Contract Breakdown

Uniform Contract Format

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Timeline

PhaseClosed

PostedApr 3

Solicitation

Response DeadlineApr 21

Deadline has passed

Submission Closed

04/21/2025, 12:00:00 AM UTC

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Organization & Contact Information

AgencyOhio Department of Mental Health - Financial Management

ContactsNo contacts available

OfficeN/A

Organization / AgencyOhio Department of Mental Health - Financial Management

Office AddressN/A

ContactsNo contact information available

Full Description

MISSION & GUIDING PRINCIPLES
The mission of the Ohio Department of Mental Health and Addiction Services (OhioMHAS) is to provide statewide leadership of a high-quality mental health and addiction prevention, treatment and recovery system that is effective and valued by all Ohioans. OhioMHAS strives to be a national leader in implementing a comprehensive, accessible, and quality-focused system of addiction and mental health care and wellness for all Ohio citizens. PURPOSE
The Ohio Department of Mental Health and Addiction Services (OhioMHAS) is seeking proposals from qualified contractors to provide a thorough evaluation and consultation of the structure and processes surrounding utilization review and billing to provide timelier filings and error resolution to improve internal processes and capture rate of billing BACKGROUND
The agency has recently adopted an Epic electronic health record and from that, many processes and job roles have switched with regards to UR and billing. There have been areas of opportunity identified in the structure and delineation of duties with the new EHR which would be augmented with an external review and modernization of the UR and billing processes. SCOPE OF WORK AND DELIVERABLES
The awarded vendor will need to complete the following: Visits to each of the 6 (six) regional psychiatric hospitals (RPH) to familiarize with the processes adopted at each site and the structure and delineation of roles. Identification of education opportunities primarily focused on patient registration, medical coding, charging errors, claim denial corrections, other administrative processes and support with regards to UR and Billing. Direct education provided as identified to onsite personnel. Continued onsite presence as identified by need during onsite visits for education and support. A written report detailing the areas of opportunities and recommendations for process or organizational change as appropriate.
MINIMUM QUALIFICATIONS OF CONTRACTOR
Five years of experience in hospital billing and or utilization review in a healthcare setting One year experience in hospital billing and or utilization review in a psychiatric healthcare setting. One year experience in hospital billing and or utilization review in a setting utilizing an electronic health record (Epic preferred) Certificates or education related to healthcare administration and or hospital billing and coding preferred
Contractor shall not be subject to an “unresolved” finding for recovery under Section 9.24 of Ohio Revised Code.