Converged Eligibility, Enrolment System and Appeals Management System

The buyer requires a vendor to provide a Converged Eligibility, Enrolment System, and Appeals Management System. The system must deliver a centralized platform for managing benefit recovery cases, track statuses, maintain audit trails, and create business partner roles. It must use open interfaces and web services, generate enrolment notifications, apply coverage date rules, and feature an Issuer management engine for certification, disallowance, and disenrollment. Only onshore USA organizations are eligible to bid, and the work will be performed offsite. Vendors must submit all questions no later than December 21, 2026. Proposals can be submitted digitally through email or online, and the buyer is currently seeking budget proposals.