RFI for Third Party Liability and Coordination of Benefits Services

The Connecticut Department of Social Services is seeking information on third party liability and coordination of benefits services to identify unreported active commercial insurance, Medicare, and Tricare coverage. The agency aims to resolve the latency between a member obtaining other insurance and the state systems being updated by implementing continuous, real-time or near real-time verification processes. The selected partner must possess capabilities to identify and recover funds for claims previously paid by Medicaid where a liable third party existed, utilizing advanced analytics, artificial intelligence, or machine learning to predict liability and streamline workflows. The scope of work covers managing complex billing and recovery processes with commercial carriers and Medicare. The agency requires a system architecture that aligns with the Centers for Medicare and Medicaid Services and the State of Connecticut Medicaid Enterprise Systems. All performance of the work must occur offsite, and the agency is looking for proposals to determine the budget for these services. Eligible respondents must be onshore organizations based in the United States. The agency will accept response submissions digitally via email or through an online portal. Bidders must submit all questions regarding this request for information no later than June 18, 2026.