Secure Healthcare Claims Clearinghouse Services

The contract solicits end-to-end electronic claims processing services for Medicare, Medicaid, and commercial insurance payers, encompassing claim scrubbing to ensure compliance and accuracy, secure submission to payers, timely resolution of claim errors or rejections, and receipt of electronic remittance advice to facilitate accurate payment posting and reconciliation. Services must be delivered in compliance with industry standards for data security and interoperability, with a focus on reliability, speed, and accuracy to support efficient revenue cycle management for healthcare providers serving Native American communities. This opportunity is designated as an Indian Small Business Economic Enterprise set-aside under the Department of Health and Human Services’ Albuquerque Area Indian Health Service, specifically targeting qualified Indian-owned small businesses. The NAICS code 518210 applies, indicating the work involves data processing, hosting, and related services. The performance location is Zuni, New Mexico, 87327, and proposals must be submitted by July 24, 2026. The contract is structured as a subcontract, and while the prime contracting agency is not specified, the work directly supports the health services mission of the Indian Health Service in a geographically and culturally specific context.