Medicare Claim Management and Revenue Cycle Management (RCM) Services

The agency is seeking a vendor to provide Medicare claim management and revenue cycle management services. The primary goal is to establish an efficient, streamlined process for Medicare claims management verification services. The agency needs to attain comprehensive eligibility information by making eligibility requests to Medicare in both real time and batches. The requested scope of work covers batch eligibility checks to determine the status of multiple patients at one time and integration between eligibility and claims functions. The agency requires a customizable dashboard to prioritize and assign patients, payers, and daily task lists to better manage workflow. The system must eliminate repetitive tasks by running multiple payers and patients in one session and must save time using batch imports of eligibility data files. The selected vendor must provide toll-free telephone and technical support during normal business hours from 7:00 AM to 7:00 PM, Monday through Friday, excluding government holidays. The agency also requires access to all eligibility transaction history to enhance record-keeping. Performance of the work will take place offsite. This bid is strictly set aside for Indian Small Business Economic Enterprises. Eligible bidders must be onshore USA organizations only. The agency is looking for proposals to determine the budget, and the resulting contract period will be for one year. All questions regarding this opportunity must be submitted no later than June 15, 2026.