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. The selected provider must deliver comprehensive eligibility information by making eligibility requests to Medicare in both real time and batches. The scope of work requires the vendor to perform batch eligibility checks to determine the status of multiple patients simultaneously. The agency requires a customizable dashboard to prioritize and assign patients, payers, and daily task lists for better workflow management. The system must integrate eligibility and claims functions, eliminate repetitive tasks by running multiple payers and patients in one session, and allow batch imports of eligibility data files. The vendor must provide toll-free telephone and technical support from 7:00 AM to 7:00 PM, Monday through Friday, excluding government holidays. The system must also enhance record-keeping by providing access to all eligibility transaction history. All work must be performed offsite by an onshore, United States-based organization. This procurement is set aside exclusively for Indian Small Business Economic Enterprises. The agency is currently looking for proposals to determine the budget for this initiative. The resulting contract will have a performance period of one year. Bidders must submit all questions regarding this opportunity no later than June 15, 2026. The agency will evaluate proposals based on the vendor's ability to meet all technical, support, and eligibility requirements outlined in the request.