Insurance Contracting and Credentialing Services

The Garrett County Health Department in Oakland, Maryland, is seeking insurance contracting and credentialing services to improve its empanelment and billing processes. By expanding contracts with additional insurance providers, the agency aims to increase local access to covered clinical services for rural residents. This initiative intends to support earlier disease detection, improve chronic disease management, reduce reliance on high-cost acute care, and promote the long-term financial sustainability of rural public health services. The scope of work covers insurance provider enrollment, credentialing, payer relations, and the application processes required to contract with Medicaid managed care organizations and commercial insurance networks. The selected partner must manage coordination and direct communication with payers, including Medicaid, Medicare, and commercial insurers, while resolving any deficiencies, rejections, or requests for additional information. Additionally, the project requires ongoing support for revalidation, re-contracting, re-credentialing, and updates, alongside exploring the potential of aggregating rural clinicians to benefit from economies of scale in insurer contracts. Bidders must be onshore organizations based in the United States to be eligible for this opportunity. The agency expects the performance of the work to occur entirely offsite. Proposals must be submitted digitally via email or through the designated online portal, and the agency is currently looking for proposal submissions to determine the budget. The contract period will run for one year.