Real-Time Insurance Eligibility Verification

This contract involves providing both real-time and batch insurance eligibility verification services for Medicare and commercial payers. The scope includes integrating with fiscal intermediaries to ensure seamless communication and secure data exchange through 276/277 transaction sets, which are standard formats used for eligibility inquiries and responses in healthcare transactions. The work will be performed primarily in Harlem, with the contract focused on supporting health services under the Department of Health and Human Services, specifically the Billings Area Indian Health Service. Designated as a subcontract opportunity, the contract is set aside for Indian Small Business Economic Enterprises (ISBEE), reflecting its alignment with supporting Native American business participation. This initiative supports the critical need for accurate and timely verification of insurance coverage to streamline medical billing processes and reduce delays in patient care. The solicitation was posted on June 4, 2026, with a response deadline of June 26, 2026, and is classified under the NAICS code 518210, which pertains to data processing and related services.