Latest US Claims Processing Contracts & Bids

This is a competitive requirement for a contract to provide health insurance benefit administration services, including Medicare claims processing and payment services, for the traditional Medicare program in Jurisdiction FJF, encompassing several US states. The contract type is not fixed price due to ongoing changes in Medicare program requirements and performance uncertainties.

Proposals are sought for medical claims management services for Arrowhead Regional Medical Center. All correspondence, including proposals and questions, must be submitted electronically through the county electronic procurement network (epro). Proposers must register with epro prior to the proposal submission deadline. A mandatory presentation/demonstration is required the week of September 22, 2025 via Microsoft Teams. The contract period will be for a maximum of five years. The county reserves the right to issue amendments or addendums to this RFP. Proposals must be signed by an authorized individual. Proposals shall remain open, valid and subject to acceptance anytime within nine months after the proposal submission. The county is not obligated to pay any costs incurred by the proposer in the preparation of a proposal. The final authority to award a contract rests solely with the county board of supervisors. Proposers should carefully review the RFP for defects and questionable or objectionable material. Comments must be submitted in writing to the RFP contact prior to the deadline for submission of questions or at least ten calendar days before the deadline for proposals. Protests based on any omission or error, or on the content of this RFP, may be disallowed if not submitted in writing to the attention of the RFP contact, prior to the deadline for submission of questions or at least ten 10 calendar days before the deadline for proposals whichever occurs last. The county reserves the right to reject any or all proposals if it is in the best interest of the county to do so. The county also reserves the right to terminate this RFP process at any time. All proposals and other material submitted become the property of the county and are subject to release according to the California Public Records Act. Information must be provided in attachment g regarding former county administrative officials who are employed by or represent the proposer. The county reserves the right to request information from the proposer selected for contract award. Failure to provide the information may result in disqualification from the selection process and no award of contract to the proposer. The county also reserves the right to obtain the requested information by way of a background check performed by an investigative firm. The selected proposer may also be asked to provide information to clarify initial responses. Negative information provided or discovered may result in disqualification from the selection process and no award of contract. The county may reject as nonresponsive any proposal that does not comply with all the material and substantial terms, conditions, and performance requirements of the RFP. Further, the county may reject a proposal from any entity that is a parent, affiliate, or subsidiary, or that is under common ownership, control, or management with any other entity submitting a proposal in response to this RFP. A proposer may not qualify the proposal nor restrict the rights of the county. If proposer does so, the proposal may be determined to be a nonresponsive counteroffer and the proposal may be rejected. No proposal shall be rejected, however, if it contains a minor irregularity, defect or variation. If the irregularity, defect or variation is considered by the county to be immaterial or inconsequential, the county may choose to accept the proposal. Minor irregularities may be waived by the purchasing agent when they are any of the following: 1. do not affect responsiveness 2. are merely a matter of form or format 3. do not change the relative standing or otherwise prejudice other offers 4. do not change the meaning or scope of the rfp 5. are trivial, negligible, or immaterial in nature 6. do not reflect a material change in the work or 7. do not constitute a substantial reservation against a requirement or provision. In such cases the proposer will be notified of the deficiency in the proposal and given an opportunity