Request for Solutions (RFS): Autonomous Coding (AC) and Automated Appeals & Denials Management (ADM)

The Defense Healthcare Management Systems Modernization Program Management Office, under the Department of Defense’s Defense Health Agency, is soliciting innovative AI and machine learning solutions to transform healthcare billing and financial recovery operations within the Military Health System. This Request for Solutions, issued under 10 U.S.C. § 4022, aims to award one or more prototype Other Transaction Agreements to industry partners capable of delivering advanced, autonomous systems that operate without human intervention while remaining fully auditably and explainable. Two distinct capability areas are targeted: Autonomous Coding, which must accurately assign medical billing codes from clinical documentation using human-like AI processes, and Automated Appeals & Denials Management, which must systematically reduce aged accounts receivable, increase first-pass claim success, expedite documentation release, and automate the generation and submission of appeals to third-party payers. Industry participants may respond to one or both capability areas. Solicitation HT0038RFSACADM, posted on August 5, 2026, requires responses by August 19, 2026, and is governed by NAICS code 541511 for custom computer programming services. Proposals must be submitted to the Defense Health Agency’s office located in Rosslyn, Virginia, with all technical and procedural instructions detailed in the attached documentation. Primary point of contact is Sharjeel Javaid, with Dominique Brown serving as secondary contact, both reachable via official government email addresses. The opportunity is open to all qualified entities without set-aside restrictions, and performance will be conducted across Virginia. Interested parties are directed to the SAM.gov portal for full solicitation materials and submission guidelines, with emphasis placed on adherence to all requirements to ensure eligibility for consideration.