This Solicitation opportunity from Oregon was posted on August 8, 2024. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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RFP 2024-13 IBR & DRG Billing Services

Closed

S-X26083-00011233State & Local

Submission Closed09/26/2024, 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: 541219

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Bureau Of Human Resources

POSTED

2 days ago

DEADLINE

in 25 days

AI Contract Overview

This contract involves the provision of Itemized Bill Review (IBR) and Diagnosis Related Grouping (DRG) billing services for high-dollar inpatient hospital claims, aimed at ensuring compliance with federal and state regulations. The initiative is driven by requirements from the Centers for Medicare and Medicaid Services (CMS) and the Oregon Health Authority (OHA), which mandate managed Medicare and Medicaid plans to establish robust payment integrity programs. By outsourcing these services to CareOregon, the organization seeks to effectively review and validate inpatient claims before they are finalized, thereby reducing the risk of overpayments and enhancing the accuracy of billing processes. The solicitation, titled "RFP 2024-13 IBR & DRG Billing Services," was posted on August 8, 2024, with a response deadline of September 26, 2024. The contract is valued between $500,000 and $2,000,000 and is categorized under NAICS code 541219, which pertains to other computer related services. The project is to be performed within Oregon, with CareOregon serving as the contracting agency. The initiative underscores a strategic effort to meet regulatory mandates while optimizing claims management and financial integrity within Oregon’s managed Medicare and Medicaid programs.

General Info

Agency

CareOregon

NAICS

541219 - Other Accounting Services

Place of Performance

OR, USA

Set-Aside

NONE

Documents

RFP 2024-13 Clarifying Questions #1

q-and-a

High

RFP #2024-13 IBR & DRG Billing Services Addendum #1

amendment

High

RFP #2024-13 IBR & DRG Billing Services Addendum #2

amendment

High

RFP 2024-13 IRB DRG Billing Services

rfp

High

AI Contract Breakdown

Uniform Contract Format

Timeline

PhaseClosed

PostedAug 8

Solicitation

Response DeadlineSep 26

Deadline has passed

Submission Closed

09/26/2024, 12:00:00 AM UTC

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Organization & Contact Information

AgencyCareOregon

ContactsNo contacts available

OfficeN/A

Organization / AgencyCareOregon

Office AddressN/A

ContactsNo contact information available

Full Description

The Centers for Medicare and Medicaid Services (CMS) and the Oregon Health Authority (OHA) require managed Medicare and Medicaid plans to implement payment integrity programs. Outsourcing Itemized Bill Reviews (IBR) and Diagnosis Related Grouping (DRG) for high dollar inpatient hospital claims prior to claim completion allowing CareOregon to meet these regulatory requirements and minimize claim overpayments.