Medicaid School-Based Claiming Services

The buyer requires a vendor to provide Medicaid school-based claiming services. The requested scope includes providing third-party administration experience for claims processing, reimbursement, education, outreach, and federal and Medicaid program support. The vendor must develop, implement, and administer an annual compliance review program alongside policies and procedures for annual desk reviews, health aide prepayment reviews, and comprehensive compliance reviews. Furthermore, the vendor must adhere to the most current Medicaid school-based administrative claiming guide, process administrative claim submittals and adjustments, and handle denied claims. Eligibility restricts participation to onshore US organizations, and the vendor will perform all work offsite. The buyer is looking for proposals to determine the budget, and reimbursement depends on available federal funds. Vendors must submit all questions by September 24, 2026. The buyer accepts digital submission responses through email or online platforms.