(1) Vendor needs to provide medical billing services.
- Provide claims management software that allows for charge entry, claims submission, payment posting and account follow up.
- Create medical claims using the patient data, including but not limited to patient demographics, insurance information, procedure and diagnosis codes provided by the Agency.
- Validate Provider is enrolled with insurance and services are allowable under the designated provider type.
- Comply with all Federal and State regulations regarding Health Insurance Portability and Accountability Act, Medicare and Medicaid.
- Review and track all contracted insurance fee schedules and allowable services electronically to determine payer and patient liability.
- Adhere to insurance timely filing and appeal requirements.
- Bill patients for patient liability.
(2) All questions must be submitted no later than May 11, 2023.
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