List of Latest Medical Billing & Coding RFPs Posted on RFPMart RFPMart LLC en-us https://www.rfpmart.com/medical-billing-and-coding-rfp-government-contract.html Sat, 20 Jun 2026 11:26:52 -0700 (1) Vendor needs to provide vaccine injury assistance program actuarial review service.• Provide recommendations for adjustments, if necessary, to ensure the framework remains current and sustainable• Assess whether the proposed payment structure is reasonable, equitable, and consistent with actuarial best practices• Forecasting of program costs and liabilities;• Determination of compensation levels and payment structures;• Evaluate Reasonableness: Assess whether the proposed payment structure within the financial framework is actuarially sound, fair to claimants, and aligned with comparable compensation programs• Benchmarking: Compare payment structure against similar national and international injury compensation programs.• Assessment: Identify potential financial risks, sustainability concerns, and long–term implications of the current framework.• Recommendations: Provide clear, evidence–based recommendations on whether adjustments are required to maintain fairness, adequacy, and sustainability Sat, 20 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1133311-canada-ontario-vaccine-injury-assistance-program-actuarial-review-service-rfp.html http://www.rfpmart.com/1133311-canada-ontario-vaccine-injury-assistance-program-actuarial-review-service-rfp.html (1) Vendor needs to provide excess workers compensation insurance services.• Reduce workers' compensation costs by self–insuring a portion of its workers' compensation risk to reduce direct costs and maximize indirect cost savings by capturing the cash flow savings associated with self–insurance.• Establish a stable workers' compensation program and enter into a long–term relationship with a financially strong stop–loss carrier.(2) All question must be submitted no later than June 26, 2026.(3) A contract period will be for one year.  Sat, 20 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1133137-usa-texas-excess-workers-compensation-insurance-services-rfp.html http://www.rfpmart.com/1133137-usa-texas-excess-workers-compensation-insurance-services-rfp.html [B] Scope of Service: (1) Vendor needs to provide medical bill review service. – provide a health care review program in accordance with MCL 418.315 of the Workers’ Disability Compensation Act and Health Care Services (HCS) rules.– The vendor is to have a Professional Program in place for medical bills which include:· In–patient hospital care· Total claim medical payments exceed $20,000.00.· Any cases where it is suspected there is inappropriate care taking place.· Medical bills are reviewed by licensed, registered, or certified health care professionals.· The application by others of criteria developed by licensed, registered, or certified health care professionals.· The licensed health care professionals are to be involved to address reconsideration requests from the medical providers.· Any bills with date of service before the date of injury, the vendor is to contact the appropriate Technician directly to confirm the date of injury to assist in processing the payment timely.(2) All the questions must be submitted no later than June 24, 2026. Sat, 20 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1133107-usa-michigan-medical-bill-review-service-rfp.html http://www.rfpmart.com/1133107-usa-michigan-medical-bill-review-service-rfp.html (1) Vendor needs to provide workers’ compensation administration service to mitigate and manage the costs associated with work–related injuries.– The review of all medical bills for conformance with the workers’ compensation fee schedule and reducing these bills to the proper amount when the fee schedule is exceeded. – Establish and maintain complete claim files (including an electronic file) and supervise all claim litigation for each claim received.– Provide representation at workers’ compensation board panel hearings, with such expense to be treated as a claim file expense.– Prepare self–insured employers workers' compensation forms.– Prepare and file all workers’ compensation claim forms.– Prepare and mail compensation payment drafts or checks to claimants and claimant’s attorneys.• Provide a minimum of the following services:– Supplemental benefits and special funds reimbursement administration.– Mandatory Medicare reporting.– Electronic filing.– Claim management.– Claims administration.– Loss reporting.– Financial reporting.– Cost savings analysis.(2) All the questions must be submitted no later than July 07, 2026.         (3) The contract period will be for three years. Fri, 19 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1132570-usa-new-york-workers-compensation-administration-service-rfp.html http://www.rfpmart.com/1132570-usa-new-york-workers-compensation-administration-service-rfp.html (1) Vendor needs to provide excess reinsurance workers compensation services.– Quote several plan options as long as each option is fully explained.(2) The contract period will be for five years. Fri, 19 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1132533-usa-texas-excess-reinsurance-workers-compensation-services-rfp.html http://www.rfpmart.com/1132533-usa-texas-excess-reinsurance-workers-compensation-services-rfp.html (1) Vendor needs to provide claims audit services to conduct medical claim audit services, prescription drug claim audit services, pharmacy rebate audit services, and clinical validation review services.(2) A pre–proposal conference will be held on June 25,2026.(3) All question must be submitted no later than July 1, 2026.  Thu, 18 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1131930-usa-texas-claims-audit-services-rfp.html http://www.rfpmart.com/1131930-usa-texas-claims-audit-services-rfp.html (1) Vendor needs to provide flexible spending account, health reimbursement account and cobra administration services.• Provide consultative support on plan design• Advise on contribution strategies, eligibility rules, and plan structure• Support alignment with overall benefits strategy• Provide benchmarking against public sector and peer employers• Assist with plan document development and updates• Configure all plan parameters within the administrative platform• Develop and manage implementation timeline• Coordinate with employer systems• Conduct file testing and validation (eligibility, payroll, claims)• Provide training for HR and benefits staff• Support open enrollment setup and readiness• Manage participant elections and contribution tracking• Maintain individual participant account balances• Process and adjudicate claims based on plan design,• Support secure data exchange and file feeds• Generate and distribute COBRA billing statements(2) A pre–proposal conference will be held on June 23,2026.(3) All question must be submitted no later than July 1, 2026.  Wed, 17 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1131258-usa-colorado-flexible-spending-account-health-reimbursement-account-and-cobra-administration-services-rfp.html http://www.rfpmart.com/1131258-usa-colorado-flexible-spending-account-health-reimbursement-account-and-cobra-administration-services-rfp.html (1) Vendor needs to provide third party administrator services.• Provide Third Party Administrator (TPA) services for the County Workers’ Compensation Claims processing• Claims adjuster will work with the managed care nurse manager for management of the County’s on–the–job injuries • Monitor each injury claim with the objective of returning the injured employee to work as soon as medically possible following the injury. • If such injured employee is unfit to work in a full duty capacity, the claims adjuster will work closely with the injured employee’s supervisor and case manager for a limited duty position within the injured employee’s medical restrictions.• The claims adjuster must also be familiar with the requirements of the State Workers’ Compensation Statutes, and keep current and timely all filings required by the State (2) All questions must be submitted no later than June 30, 2026.  Wed, 17 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1131221-usa-nebraska-third-party-administrator-services-rfp.html http://www.rfpmart.com/1131221-usa-nebraska-third-party-administrator-services-rfp.html (1) Vendor needs to provide motor vehicle accident and workers’ compensation billing and collection services.• Support agency Medicine in obtaining reimbursement from Motor Vehicle Accident (MVA) and Workers’ Compensation (Work Comp) payers for both hospital and professional claims.• Medicine does not currently work with an outside party who submits claims, follows up with payers, and appeals denials for MVA or Work Comp, but agency Medicine is interested in learning more about vendors in this space, including how they support other integrated health systems in the state with these particular payers, whether that is a Day 1 outsourcing arrangement or other.(2) All questions must be submitted no later than June 26, 2026.  Tue, 16 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1130596-usa-washington-motor-vehicle-accident-and-workers-compensation-billing-and-collection-services-rfp.html http://www.rfpmart.com/1130596-usa-washington-motor-vehicle-accident-and-workers-compensation-billing-and-collection-services-rfp.html (1) Vendor needs to provide claims adjusting services for the investigation, adjustment, acceptance or denial of claims on behalf of the risk management internal service fund.– Review new loss reports to identify all parties who may have potential claims against the Fund, determining liability regarding claims presented, and identifying incidents with potential salvage or subrogation recoveries– Prepare/print forms necessary for the proper handling of claims and for establishing proof of loss if required– Investigate, adjust, accept or deny claims in accordance with governing rules, regulations and policies.– Prepare a plan of action to include an evaluation of responsibility, applicable law, reserves for property damage and bodily injury and future actions on claim.– Respond to the requests and directions of the risk management department claims staff.– Review and approve invoices for services related to the claim within 24 hours of receipt and give to risk management technicians to process the payment,– Provide the Director or designee a weekly activity report on the time spent on each claim worked.(2) All question must be submitted no later than June 9, 2026.  Tue, 16 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1130538-usa-virginia-claims-adjusting-services-rfp.html http://www.rfpmart.com/1130538-usa-virginia-claims-adjusting-services-rfp.html (1) Vendor needs to provide workers compensation actuarial services and reporting services to produce an annual loss reserve amount for the states workers compensation fund.– Shall provide a range of reserve estimates, which consists of: (1) case reserve on reported claims, (2) additional development on these case reserves,(3) pure “incurred by not reported claims,(4) reopened claims;(5) claims in transit,– Review shall be performed separately by indemnity, medical, and expense loss types.(2) All question must be submitted no later than June 29, 2026.  Tue, 16 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1130537-usa-connecticut-workers-compensation-actuarial-services-and-reporting-services-rfp.html http://www.rfpmart.com/1130537-usa-connecticut-workers-compensation-actuarial-services-and-reporting-services-rfp.html (1) Vendor needs to provide third party administrator medical services. – Provide third party administration of medical benefits.– Responsible for receiving and reviewing all claims and provider billing information generated.– conduct all necessary and timely investigation of all claims and invoices.– Issue appropriate instrument to effect and satisfy claim settlement in a timely manner.– Utilize legal services for any third–party claims.– Responsible for answering all inquiries from claimants and assume responsibility for the adjustment of all claims so that these activities are diverted from personnel.– Provide COBRA administration for all current and future enrollees and employees, including members in their fully insured plan.– Provide plan document and summary plan description to plan administrator upon commencement of contract and upon demand thereafter.– Provide necessary advice and opinion regarding plan provisions and interpretation immediately upon receiving.– Providing the necessary retiree claims cost for the medical plans to actuary.– Administer the flexible spending account program including medical and dependent care accounts.– Provide at least the same level of benefits as are currently provided.(2) The contract period will be for five years. (3) All the questions must be submitted no later than June 29, 2026. Mon, 15 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1130428-usa-new-york-third-party-administrator-services-rfp.html http://www.rfpmart.com/1130428-usa-new-york-third-party-administrator-services-rfp.html (1) Vendor needs to provide third party administrator dental services. – Provide third party administrative services for dental benefits.– Responsible to receive and review all claim and provider billing information generated.– Initiate and conduct all necessary and timely investigation of all claims and invoices.– Evaluate the facts and circumstances of each claim and incident and, based upon such evaluation, achieve a decision on the whether the services provided on the invoice were appropriate and covered under the provisions of the plan.– Utilize legal services for any third–party claims.– Responsible for answering all inquiries from claimants and assume responsibility for the adjustment of all claims so that these activities are diverted from personnel.– Issue appropriate instrument to effect and satisfy claim settlement.– Provide COBRA administration for all current and future enrollees and employees, including members in their fully insured plan.– Required to collect, receive, store claim exposure and other necessary data and will organize such data in reports to provide risk management information.– Providing the necessary retiree claims cost for the dental plans to actuary.– Provide at least the same level of benefits as are currently provided.(2) The contract period will be for five years. (3) All the questions must be submitted no later than June 29, 2026. Mon, 15 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1130427-usa-new-york-third-party-administrator-services-rfp.html http://www.rfpmart.com/1130427-usa-new-york-third-party-administrator-services-rfp.html (1) Vendor needs to provide seniority calculation and reporting, and long–term disability claims administration and reporting solutions.– a Software–as–a–service (SaaS) seniority calculation and reporting solution.– Software–as–a–service (SaaS) long–term disability (LTD) claims administration and reporting solution.– Project delivery services to support the implementation of one or both solutions.– Post–implementation maintenance and support services for the solution.– Services include the provision of the Solution(s) and all activities required to:– Design and configure the solution.– Implement and integrate with systems.– Deploy into production.– Support and maintain the solution.– Provide ongoing operational services.(2) All the questions must be submitted no later than June 26, 2026.(3) The contract period will be for three years. Sat, 13 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1129792-canada-manitoba-seniority-calculation-and-reporting-and-long-term-disability-claims-administration-and-reporting-solutions-rfp.html http://www.rfpmart.com/1129792-canada-manitoba-seniority-calculation-and-reporting-and-long-term-disability-claims-administration-and-reporting-solutions-rfp.html (1) Vendor needs to provide third party liability and coordination of benefits services. • Innovative data mining and matching techniques to identify unreported active commercial insurance, Medicare, and Tricare coverage.• Processes for continuous, real–time (or near real–time) verification of member coverage to minimize the latency between a member obtaining other insurance and the state’s systems being updated.• Capabilities in identifying and recovering funds for claims previously paid by Medicaid where a liable third party existed.• Expertise in managing complex billing and recovery processes with commercial carriers, Medicare.• Use of advanced analytics, artificial intelligence (AI), or machine learning (ML) to predict TPL and streamline workflows.• System architecture that aligns with the Centers for Medicare and Medicaid Services (CMS) and State of Connecticut Medicaid Enterprise Systems.(2) All the questions must be submitted no later than June 18, 2026.  Sat, 13 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1129727-usa-connecticut-rfi-for-third-party-liability-and-coordination-of-benefits-services-rfp.html http://www.rfpmart.com/1129727-usa-connecticut-rfi-for-third-party-liability-and-coordination-of-benefits-services-rfp.html (1) Vendor needs to provide advisory council on workers’ compensation actuarial consulting services.– National council on compensation insurance, inc.’s 2026 annual filing of advisory prospective loss cost and rating values for the voluntary workers’ compensation insurance market (also known as the loss cost filing) and all such subsequent annual loss cost filing during the term of this contract.– Contractor shall evaluate the data selected by the underlying its annual loss cost filing.– This evaluation shall include, but not be limited, to the scope of the data in terms of casesand dollar amount of claims in the data base, possible sources of any bias in the data, thebreadth of coverage of the data, and any data from insurance companies that is excluded fromthe data utilized.– Contractor shall address the data relating to both direct loss costs and loss adjusting expenses separately in the review of any filing and in any written report generated.– provide other actuarial services, ad hoc reports, or oral presentations relative to the workers’ compensation area as deemed needed by the Council and shall be compensated in accordance.(2) All the questions must be submitted no later than June 24, 2026.(3) The contract period will be for five years. (4) Pre–bid meeting will be held on June 18,2026. Sat, 13 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1129663-usa-tennessee-workers-compensation-actuarial-consulting-services-rfp.html http://www.rfpmart.com/1129663-usa-tennessee-workers-compensation-actuarial-consulting-services-rfp.html (1) Vendor needs to provide medical third–party administrator and network services.– Medical TPA and network providers to ensure access to the most competitive pricing and evolving industry trends, while maintaining a comprehensive and sustainable benefits plan for approximately 900 employees and retirees.– Remove systemic barriers to reconcile historic injustices and their continued presence in agency work.(2) This is a brief information; Main RFP Document is not available on our website Sat, 13 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1129583-usa-kansas-medical-third-party-administrator-and-network-services-info-only-rfp-not-included-rfp.html http://www.rfpmart.com/1129583-usa-kansas-medical-third-party-administrator-and-network-services-info-only-rfp-not-included-rfp.html Attachment: Notice of Intent to Sole Source Fri, 12 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1129368-us-fed-comet-package-automated-seqif-stainer-and-imaging-system-for-spatial-multiomics-analysis.html http://www.rfpmart.com/1129368-us-fed-comet-package-automated-seqif-stainer-and-imaging-system-for-spatial-multiomics-analysis.html (1) Vendor needs to provide fully insured, level funded medical benefits service.          • Maintain a fully automated claims adjudication system in compliance with electronic transmission standards and security requirements and all other regulations as required by HIPAA, provide WEB access to plan participants that allows for claim status and offers various customer service functions. • Maintain records and management reports, including claims and accounting information, as required by the contract. Provide a timely response to inquiries from plan participants and providers regarding eligibility and status of claims, correspondence, payment, and any other information requested by such parties in a manner that will limit the County’s involvement in day–to–day inquiries. • In consultation with county Staff, prepare and print summary plan documents, claim forms, and any other communication material. • Employee insurance ID cards shall be provided by Respondent and shall be mailed by Respondent to the employees’ home addresses. • Deliver utilization reports. • Provide online access to additional standard or ad hoc reports as needed by the County. • Meet with representatives of the County as often as deemed necessary by the County. • Attend annual Open Enrollment each year as requested. (2) All questions must be submitted no later than July 2, 2026.(3) The contract period will be one year. Fri, 12 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1128991-usa-texas-fully-insured-level-funded-medical-benefits-service-rfp.html http://www.rfpmart.com/1128991-usa-texas-fully-insured-level-funded-medical-benefits-service-rfp.html (1) Vendor needs to provide medicare claim management and revenue cycle management (RCM) services.– Create an efficient, streamlined process for Medicare claims management verification services.  – Attain comprehensive eligibility information– make eligibility requests to Medicare.– Verify Medicare eligibility in real time and batches– Provide toll free telephone/technical support during normal business hours, 7 AM to 7 PM, Monday thru Friday, except Government holidays.– Perform batch eligibility checks – determine eligibility status for multiple patients at one time.– Better manage workflow with a customizable dashboard that prioritizes and assigns patients, payers and daily task lists– Experience integration between eligibility and claims functions. – Eliminate repetitive tasks with the ability to run multiple payers and patients in one session.– Increase efficiency when checking eligibility – verify a patient’s eligibility status.– Save significant time using batch imports of eligibility data files. – Enhance record–keeping with access to all eligibility transaction history.(2) All questions must be submitted no later than June 15, 2026.(3) The contract period will be for one year.(4) This bid is set aside for Indian Small Business Economic Enterprise Fri, 12 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1128952-usa-montana-medicare-claim-management-and-revenue-cycle-management-rcm-services-rfp.html http://www.rfpmart.com/1128952-usa-montana-medicare-claim-management-and-revenue-cycle-management-rcm-services-rfp.html (1) Vendor needs to provide third–party administration services of family medical leave act.– Respondent must be regular and have at least five (5) continuous years' experience implementing and administering a comprehensive solution for family medical leave act and non–FMLA (leave of absence, disabilities act amendments Actos and care giver), administrative leave (admin leave) and fitness for duty administration services.– Respondent must possess and maintain a valid Third–Party Administration Party (TPA) license.– Provide the following services: which may include but not limited to: – Intake.– Claim Administration (Eligibility, Claim Management, Claim Processing, Intermittent Leave, Recertification, Handling, Escalation, Communication, Tracking, Return to Work, Compliance).– Contractor shall have the capability to administer workability and/or independent medical evaluations and/or a release to return to work, as appropriate.– Provide Dallas County Human Resource staff access to its data in order to track FMLA leave and Non–FMLA Leave.– Contractor shall have the ability to track FMLA leave concurrently with disability claims.– Account management and customer services.– Implementation and transition services.(2) All the questions must be submitted no later than June 30, 2026.(3) The contract period will be for five years. (4) Pre–bid meeting will be held on June 23, 2026. Fri, 12 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1128917-usa-texas-third-party-administration-services-of-family-medical-leave-act-rfp.html http://www.rfpmart.com/1128917-usa-texas-third-party-administration-services-of-family-medical-leave-act-rfp.html (1) Vendor needs to provide third party administrator for workers compensation claims service. (2) This is a brief information; Main RFP Document is not available on our website.     Fri, 12 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1128886-usa-texas-third-party-administrator-for-workers-compensation-claims-service-info-only-rfp-not-included-rfp.html http://www.rfpmart.com/1128886-usa-texas-third-party-administrator-for-workers-compensation-claims-service-info-only-rfp-not-included-rfp.html (1) Vendor needs to provide third party administrator services.• Third Party Claims Adjusting Services for Workers Compensation and Employers Liability.• Prepare, maintain and file all records and reports as may be required by legal authorities (state, local, and federal).• Prepare, maintain and file statistical or other records and reports as required by excess insurers• Prepare, maintain and file payroll and premium audits.• Establish claim and/or loss files for each reported claim and loss. Such files are subject to review and audit by the client at any reasonable time.• Conduct such investigation, as the exercise of professional judgment would deem necessary• Receive and examine on behalf of the Entity reports of employee injury claims.• Prepare and maintain files necessary for legal defense of claims and/or litigation (such as actions for subrogation) or other proceedings.(2) All questions must be submitted no later than July 2, 2026.  Fri, 12 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1128884-usa-florida-third-party-administrator-services-rfp.html http://www.rfpmart.com/1128884-usa-florida-third-party-administrator-services-rfp.html (1) Vendor needs to provide billing and electronic patient care reporting services. – For management and oversight of emergency medical transport billing and collection services.            – To provide training, management, and oversight of the task of processing incident information, invoicing and collecting the fees for transporting Emergency Medical Service (EMS) patients.– Provide relevant background information on your firm, including a brief history, firm ownership, organizational structure, location of headquarters, number and location of offices, especially those performing EMS billing/collection processes.– A complete EMS billing and accounts receivable management system.– HIPAA–compliant security and data management with the capability of establishing personnel access rights and privileges. – Web–based reporting capabilities supporting the management of billing and collection operations, as well as crew documentation management. – Training on the use of the billing technology on processes to the County’s personnel. – Management and oversight of the billing and collection processes, including feedback to the County’s EMS Administration regarding County personnel performance. – Training on proper documentation with regard to improving collections and compliance. – Provide at least quarterly – assessment of revenue with recommendations for improvements. (2) All questions must be submitted no later than June 17, 2026. Fri, 12 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1128864-usa-tennessee-billing-and-electronic-patient-care-reporting-services-rfp.html http://www.rfpmart.com/1128864-usa-tennessee-billing-and-electronic-patient-care-reporting-services-rfp.html (1) Vendor needs to provide workers’ compensation services.• Provide Workers’ Compensation Claims and Cost Containment Services for all claims activities on or after July 1, 2027, for all claims incurred July 1, 1986 and later.• Vendor will oversee and manage employees and subcontractors to provide claims administration services (with specific delegated authorities to be negotiated), program administrative support, Short Term Disability (STD) and Long Term Disability (LTD) Disability Coordinator, paralegal, medical preferred• Provider bill review, utilization review, discount prescription drug, supplies and apparatus program, surveillance, field investigation, two dedicated loss control/safety staff to provide consulting and training services, payroll classification audit, field medical and vocational placement, telephonic nurse consulting, on–line claim reporting intake program proprietary• The contractor will also oversee and manage claims services on an as needed basis for claims prior to this date period for a small quantity of claims• Services include surveillance, payroll classification audit, field investigation, agency, and other special claims or loss control services (i.e. – industrial hygienist services), not identified above may be priced on a per service/per hour/per item basis(2) The contract period will be for three years.(3) All the questions must be submitted no later than June 25, 2026(4) Pre–bid meeting will be held on June 22, 2026  Thu, 11 Jun 2026 00:00:00 -0700 http://www.rfpmart.com/1128635-usa-virginia-workers-compensation-services-rfp.html http://www.rfpmart.com/1128635-usa-virginia-workers-compensation-services-rfp.html