Medical Bill Review, Repricing and Utilization Review Services

The buyer requires a vendor to provide medical bill review, repricing, and utilization review services for workers' compensation claims. The selected vendor must audit all workers' compensation bills, verify procedural codes, reprice bills against state fee schedules and preferred provider organization (PPO) contracts, and transfer reviewed bills to the county contracted PPO daily. Additionally, the vendor must prepare explanation of payment letters, accept electronic and paper bills, and daily scan paper bills and reports into a digital format. The buyer limits eligibility to USA organizations for onshore performance, and the vendor must perform all work offsite at its own office premises. Bidders must submit all questions no later than October 2, 2026. The buyer seeks proposals to determine the budget and provides no specific evaluation criteria in the text.