Quarterly Audit Of Health Centers Division Providers

Clackamas County is seeking proposals from qualified vendors to perform quarterly audits of its Health Centers Division providers, which include primary care, dental, and behavioral health services, to ensure compliance with regulatory and billing standards. The contract, with an estimated size ranging from $50,000 to $200,000, will span from the award date through December 31, 2030, with options for two additional two-year renewals. The scope involves reviewing provider documentation, coding accuracy (including CPT, CDT, HCPCS, and ICD-10-CM), and adherence to CMS and Oregon Medicaid guidelines, with deliverables consisting of quarterly audit reports, corrective recommendations, and training sessions. The work is to be performed primarily within Oregon, utilizing electronic health records and remote audit methods, emphasizing compliance with HIPAA and data security protocols through a Business Associate Agreement. The procurement process is structured as a competitive Request for Proposals, with submission deadlines on December 8, 2025, via an electronic portal. Evaluation will prioritize the scope of work (45%), proposer qualifications (30%), and fees (25%), with awards based on the highest scoring proposal. The contract includes provisions for confidentiality, conflict of interest certifications, and nondiscrimination commitments, but does not specify detailed contract clauses or include a formal list of attachments or detailed pricing structures upfront. Offerors must certify compliance with Oregon tax laws, non-discrimination policies, and conflict of interest statements, while the contract administration details, including invoicing and performance acceptance, are managed through the County’s procurement division. Overall, the contract emphasizes rigorous compliance auditing, data security, and adherence to public procurement standards within Oregon’s healthcare regulatory framework.