Coding Reviews Service

The agency is seeking a vendor to provide professional coding reviews service to ensure billing, coding, and documentation accuracy and compliance with federal regulations and guidelines. The selected partner will conduct quarterly reviews of professional fee claims associated with agency clinic visits from the prior quarter, focusing on claims submitted to Medicare, Medicaid, and other payers. Currently, the agency has approximately 8,000 quarterly visits, and the average number of line items to be examined for accuracy is three per claim. The scope of work requires the vendor to deliver statistical analysis of findings and trends along with actionable recommendations. The contractor must perform all work offsite, and the contract period will run for one year. The agency is looking for proposals to determine the budget for this initiative. Eligibility is restricted to onshore organizations based in the United States. Bidders must submit all questions regarding this opportunity no later than June 17, 2026. The agency accepts digital response submissions via email or through their online portal.