Revenue Integrity Management Services

The Nassau Health Care Corporation is issuing a Request for Proposals to select a qualified vendor to provide comprehensive Revenue Integrity Management services across its hospital, skilled nursing facility, and community health practices. The contract, anticipated to last three years with automatic renewal options, aims to optimize revenue capture, ensure regulatory compliance, and support financial sustainability through services such as charge description master maintenance, charge capture and reconciliation, outpatient pre-bill review, pricing and charge strategy, denial management, and coding compliance. Proposals are due by October 15, 2025, and must include detailed work plans, staffing models, fee structures, and supporting documentation. The procurement emphasizes a best-value evaluation process, considering factors like experience, service quality, cost, references, and compliance with diversity participation goals—specifically a 20% MWBE and 6% SDVOB participation target. The contractual framework incorporates standard clauses via Schedule B and Exhibit JC, governed by New York State laws and NHCC policies, with no specific FAR clauses referenced. Key legal requirements include insurance coverage, indemnification, compliance with procurement laws, and conflict of interest disclosures. The contract stipulates that all work is deemed a work made for hire or assigned to NHCC, with intellectual property rights transferred accordingly. Administrative procedures specify that payments are made in arrears upon invoice review, with no explicit mention of electronic invoicing platforms. The primary contact for proposals and contract administration is Margaret Lowe in the Legal Department, and all submissions must be sealed and delivered to the specified address. The scope of services and contractual obligations are detailed, but there are no explicit packaging, marking, or delivery location requirements beyond the primary performance site at Nassau University Medical Center. Overall, the RFP emphasizes compliance, diversity participation, and a holistic evaluation process to select the proposal that best aligns with NHCC’s operational and financial objectives.