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, 04 Apr 2026 12:26:52 -0700 (1) Vendor needs to provide property, liability insurance and workers compensation excess insurance service. (2) Main RFP document not available at here, only detail information at here, specification may be obtained by email. Sat, 04 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1095582-usa-texas-property-liability-insurance-and-workers-compensation-excess-insurance-service-info-only-rfp-not-included-rfp.html http://www.rfpmart.com/1095582-usa-texas-property-liability-insurance-and-workers-compensation-excess-insurance-service-info-only-rfp-not-included-rfp.html (1) Vendor needs to provide workers’ compensation third party administrator service. • Provide a comprehensive range of workers’ compensation administration services, focused on a Total Cost of Risk philosophy and high–transparency reporting• Review and process all workers’ compensation claims. Conduct necessary investigations in consultation with the District and maintain appropriately documented files• Admit or deny claims with prior District approval, in accordance with statutory guidelines and medical analyses.• Pay disability benefits on admitted cases in a timely manner. Confirm medical verification of continuing disability before payment.• Obtain medical reports and pay bills as required by statute. Monitor treatment for appropriateness and cost–effectiveness.• anage all statutory filings including, but not limited to, forms WCI, WC2, WC4, WC12, and WC115.• Provide full transparency of all fees (Monthly/Annual, Per Claim, Special Project, and File Conversion).• Provide monthly performance/experience reporting with trend analysis, annual benchmarking, and data for experience modification factor calculations.• Provide District staff with real–time access for claim entry, viewing claim information, and reviewing adjuster notes• Investigate and refer files for subrogation where appropriate.(2) All the questions must be submitted no later than April 8, 2026.  Sat, 04 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1095178-usa-colorado-workers-compensation-third-party-administrator-service-rfp.html http://www.rfpmart.com/1095178-usa-colorado-workers-compensation-third-party-administrator-service-rfp.html (1) Vendor needs to provide third party claims administrator service. • Administering the following types of claims for governmental entities: workers compensation claims, governmental immunity act claims, property claims, general liability claims, automobile claims, and federal claims applicable to municipal utilities• Create accurate files and set monetary reserves within two (2) working days from receipt of the initial report. • Audit medical bills to determine if there is a causal relationship to the injury and if such bills are reasonable. • Annually review medical maintenance for closure and make note of such cases• Review medical–only claims for possible closure no less than every thirty (30) days.• Maintain a close liaison with treating providers to assure that claimants receive proper care and are not over–treated. • Be medically knowledgeable in accordance with industry standards.• Monitor a claimant’s treatment program to ensure that it is related to the compensable injury or illness(2) All the questions must be submitted no later than April 22, 2026.  Sat, 04 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1095177-usa-colorado-third-party-claims-administrator-service-rfp.html http://www.rfpmart.com/1095177-usa-colorado-third-party-claims-administrator-service-rfp.html (1) Vendor needs to provide workers compensation insurance program services.– Workers’ compensation insurance program that will provide the broadest coverage at the most competitive price available.(2) All the questions must be submitted no later than April 28, 2026.(3) The contract period will be for one year. Fri, 03 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1094643-usa-texas-workers-compensation-insurance-program-services-rfp.html http://www.rfpmart.com/1094643-usa-texas-workers-compensation-insurance-program-services-rfp.html (1) Vendor needs to provide spending accounts and HAS service.– Provide a quality account management team with experience working with higher education employers.– Provide a single debit card solution that supports both FSA and HSA accounts, allowing all eligible funds and products to be accessed and used through one card.– Must be able to accept electronic claim file feeds from the medical and pharmacy carrier and use them for automated claim adjudication and payment from spending accounts.– Provides a dedicated, strong experienced large market account management team.– Provide a bundled spending account (FSA/DCFSA) and health savings account solution.     – Providing spending accounts and HSA services administered at a high service level.(2) Intent to Bid must be submitted no later than April 10, 2026. Fri, 03 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1094447-usa-oklahoma-spending-accounts-and-has-service-rfp.html http://www.rfpmart.com/1094447-usa-oklahoma-spending-accounts-and-has-service-rfp.html Vendor needs to provide workers compensation insurance services.– Provide workers' compensation coverage, claim processing and risk management services– Providing coverage for active employees in all classification codes related to municipal government and authorized volunteers of the City– Prompt and accurate processing and payments för claims– Timely communications to injured workers and the City Human Resources department– Accurate and up–to–date information provided to the City regarding the status and capacity of injured workers– Appropriate efforts to settle claims when determined to be in the best interest of the city– Identify trends/concerns and suggestions for next steps when necessary Fri, 03 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1094378-usa-montana-workers-compensation-insurance-services-rfp.html http://www.rfpmart.com/1094378-usa-montana-workers-compensation-insurance-services-rfp.html (1) Vendor needs to provide comprehensive billing, reimbursement, collection and administrative services for emergency medical services.– Provides emergency ambulance service and its surrounding communities and is currently operated at the advanced life support level.–Identify efficiencies in billing, clinical care, and operations and to implement best management practices to gain efficiencies and improve care to the public we serve.– Emergency medical services (EMS) administrative services is to utilize national best practice techniques and improve clinical sophistication in order to provide the best EMS services available.– Billing, Collection and Reporting– EMS Billing and Collection Consulting– EMS Patient Satisfaction Data Collection and Reporting– Cardiac Arrest Data Collection, Database Management and Reporting– Hosted Electronic Patient Care Reporting (ePCR)– FirstWatch for situational awareness and early event notification– EMS billing, collections and reimbursement reporting services  Fri, 03 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1094284-usa-massachusetts-comprehensive-billing-reimbursement-collection-and-administrative-services-for-emergency-medical-services-rfp.html http://www.rfpmart.com/1094284-usa-massachusetts-comprehensive-billing-reimbursement-collection-and-administrative-services-for-emergency-medical-services-rfp.html (1) Vendor needs to provide family medical leave administration administrative services.– Claim Processing: Offerors shall provide their process for obtaining additional claim information if needed, timeframes for certifying a leave claim once all information is in hand, determination of an employee’s claim as a Family Medical Leave Administration (FMLA) qualified event and respond to the other claim processing requirements as noted in this section of the questionnaire.– Initial Claim Intake: Offerors shall clearly identify the methods by which they accept FMLA claims, hours for claim intake, call centre services and call handling experience and capability.(2) Pre–bid meeting will be held on April 07, 2026.(3) All the questions must be submitted no later than April 9, 2026. Thu, 02 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1093965-usa-virginia-family-medical-leave-administration-administrative-services-rfp.html http://www.rfpmart.com/1093965-usa-virginia-family-medical-leave-administration-administrative-services-rfp.html (1) Vendor needs to provide flexible spending account administrator service. – Ensure efficient, compliant, and user–friendly administration of these accounts for our employees.– Provide regular reports on account activity, claims processing, and fund utilization.– A mobile application for account management and claim submission.– Standard service electronic statements, available online are acceptable. – Training sessions for hr staff and employees on how to use the platform and submit claims. – Provide a secure online portal for employees to manage their accounts, submit claims, and access account information.– Load plan specifications, enrolment data, elections and paid claims.– Process claims, issue pending and denial letters and issue reimbursements to employees on at least a weekly basis.(2) All the questions must be submitted no later than April 8, 2026. Wed, 01 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1093534-usa-ohio-flexible-spending-account-administrator-service-rfp.html http://www.rfpmart.com/1093534-usa-ohio-flexible-spending-account-administrator-service-rfp.html (1) Vendor needs to provide medical terminology and coding training service. – Requires medical terminology and coding training for government employees and supervisors processing medical claims.– Provide a fundamental understanding of the various medical terminology and medical codes.– Effectively apply to government employees and supervisors with little or no previous experience with medical terminology and medical coding.– Be set in a culture designed to promote innovative ways to develop employees’ understanding of basic medical terminology requirements.– Promote knowledge retention and include innovative strategies for effective learning and continuous application, accounting for human memory, learning processes, and adult learning styles.– Maintain and develop a government employee and supervisor workforce capable of effectively processing customers’ medical claims.(2) This bid is set aside for service–disabled veteran owned small business. Wed, 01 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1093519-usa-maryland-rfi-for-medical-terminology-and-coding-training-service-rfp.html http://www.rfpmart.com/1093519-usa-maryland-rfi-for-medical-terminology-and-coding-training-service-rfp.html (1) Vendor needs to provide health claims development and promotion services. • Develop a document that compiles and evaluates relevant research on soy human health claims that would stand up to peer review.• Ensure the document is structured to support regulatory applications in a variety of international marketplaces.• Work with on the application health claims in one selected country and provide assistance for applications in two additional countries.• Target countries may include Colombia, Vietnam, India, UK, EU, Malaysia, Thailand, and the Philippines, Latin America, with potential for additional markets.• Engage with stakeholders, including scientific and regulatory communities, to advocate for soy health claims.• Present findings at international conferences to build stakeholder support.(2) All question must be submitted no later than April 7, 2026.(3) A contract term will be for one year. Wed, 01 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1093496-usa-missouri-global-health-claims-development-and-promotion-services-rfp.html http://www.rfpmart.com/1093496-usa-missouri-global-health-claims-development-and-promotion-services-rfp.html (1) Vendor needs to provide health savings account services.– Setup, Implementation, and Administration of Health Savings Account (New Benefit with new HDHP Health Plan Offering). Wed, 01 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1093485-usa-ohio-health-savings-account-services-rfp.html http://www.rfpmart.com/1093485-usa-ohio-health-savings-account-services-rfp.html (1) Vendor needs to provide cobra administration and compliance services. – Initial Notification by first class mail with proof of mailing to employees who first become eligible under the covered benefit plans on or after the plan year begin date.– Qualifying event notification by first class mail with proof of mailing certification.– Qualified beneficiaries for qualifying events occurring after the effective date of the agreement.– Update notifications by first class mail to covered employees, cobra participants, and qualified beneficiaries as may be required by amendments to the acts and the regulations, or changes to covered benefit plans.– Termination notification upon non–payment of premium or end of cobra term.– Billing, premium collection, and remittance to the plan sponsor, TPA will retain any administrative fees added to premiums charged by the insurer.– Maintain computer and physical records of all notices.– Maintain a database of qualified beneficiaries to whom any notifications have been sent.– Data will include all pertinent information reported by the plan sponsor.– Provide the plan sponsor with confirmation reports of all activities. Wed, 01 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1093481-usa-ohio-cobra-administration-and-compliance-services-rfp.html http://www.rfpmart.com/1093481-usa-ohio-cobra-administration-and-compliance-services-rfp.html (1) Vendor needs to provide flexible spending account services.– Setup, implementation, and administration of flexible benefits cafeteria plan (current benefit).– Flexible benefits cafeteria plan design and document services including:– plan document development.– Flexible benefits cafeteria plan installation and implementation services.– Benefits cafeteria enrolment services:– Includes group meetings.– Benefits fair.– Enrolment materials.– Flexible benefits cafeteria plan administration services including the following:– issuing of reimbursements.– online account access.– payment by check or direct deposit processing.– on demand reporting for sponsor.– debit card program.– annual close–out reporting.– annual non–discrimination testing. Wed, 01 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1093477-usa-ohio-flexible-spending-account-services-rfp.html http://www.rfpmart.com/1093477-usa-ohio-flexible-spending-account-services-rfp.html (1) Vendor needs to provide self–funded health benefits program services including health and welfare benefits to its active, benefits–eligible employees, retirees, survivors, COBRA participants, direct–billed continuation participants, and eligible dependents, including spouses, domestic partners, and children.a) Medical Administrative Servicesb) Pharmacy Benefit Management Servicesc) Dental Administrative Servicesd) Vision Administrative Servicese) Spending Account Services – Health Savings Accounts (“HSA”)f) Spending Account Services – Flexible Spending Accounts (“FSA”)g) COBRA / Dependent to Age 30 Direct Billing Administration Services(2) A pre–proposal meeting will be held on April 2, 2026.(3) All question must be submitted no later than April 6, 2026. Wed, 01 Apr 2026 00:00:00 -0700 http://www.rfpmart.com/1093324-usa-new-jersey-self-funded-health-benefits-program-services-rfp.html http://www.rfpmart.com/1093324-usa-new-jersey-self-funded-health-benefits-program-services-rfp.html (1) Vendor needs to provide medical third–party administration service. – Provide self–funded medical Third–Party Administrator (TPA) services, and will entertain fully insured HMO, as well as Colorado based purchasing coalitions or multi–employer trusts. – Proposer will also need to include a detailed provider disruption and claims re–price analysis.– Medical claims adjudication.– Medical network access fees.– Utilization management.– Disease management.– Maternity management.– HIPAA services.– COBRA services. (2) All the questions must be submitted no later than April 13, 2026. (3) The contract period will be for three years. Tue, 31 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1093082-usa-colorado-medical-third-party-administration-service-rfp.html http://www.rfpmart.com/1093082-usa-colorado-medical-third-party-administration-service-rfp.html (1) Vendor needs to provide flexible spending, health savings account and cobra administration services.– Provide healthcare and dependent care flexible spending account plan to the county’s employees.– The current Healthcare FSA plan includes a carryover provision.– Perform all required non–discrimination testing of plan at least annually.– Provide administration and banking services for health savings accounts for county employees who elect the county’s high–deductible health plan and choose to contribute to a health savings account.– At this time, the County does not contribute to employee accounts but reserves the right to initiate contributions and would expect employer contributions to be included in the scope of services.– Provide full cobra administration for county’s medical or RX, dental, vision, EAP, and healthcare flexible spending accounts.– Administration to a new vendor, payment of run–out claims submitted for the 2025–2026 plan year will be administered by the incumbent vendor.– Offeror is required to provide Quarterly and Annual utilization and activity reports.– Offeror shall attend our annual benefit meetings to be held in May or June upon request.(2) The contract period will be for one year. Tue, 31 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1093042-usa-new-mexico-flexible-spending-health-savings-account-and-cobra-administration-services-rfp.html http://www.rfpmart.com/1093042-usa-new-mexico-flexible-spending-health-savings-account-and-cobra-administration-services-rfp.html (1) Vendor needs to provide third–party administrator services for disability programs.– Provide (1) third–party administrator (TPA) services for the agency long–term disability (LTD) plan.– Medical consulting services and advise–to–pay services.– Provides disability benefits to active plan participants (members) and other eligible Kansas public employees.– The plan includes long–term disability and group life waiver of premium coverage and administration (life claim payments) for non–work–related and work–related claims for qualified full– and part–time employees of agency–affiliated employers.– Retirement system also administers disability benefits under the agency police and fireretirement system and the retirement system for judges.– Provide medical consulting and advise–to–pay services only.(2) All the questions must be submitted no later than April 7, 2026. Tue, 31 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1093033-usa-kansas-third-party-administrator-services-for-disability-programs-rfp.html http://www.rfpmart.com/1093033-usa-kansas-third-party-administrator-services-for-disability-programs-rfp.html (1) Vendor needs to provide workers compensation utilization review services.– To provide an effective workers’ compensation utilization management program– Workers’ Compensation to ensure that medical treatment provided to injured workers is appropriate, evidence–based, timely, and cost–effective, while still prioritizing recovery and return to work.– At the discretion of the county, the proposer will schedule occasional on–site visits– Medical records and referrals will be forwarded electronically to contracted vendor– Proposer shall use nationally accepted treatment guidelines to review and assess medical reports for each patient– Send an e–mail confirmation of UR receipt and UR determination– Proposer must respond within 24 hours from receipt of telephone or e–mail inquiries regarding UR referrals, timelines, review determinations, appeals, billings, level of service– Standard monthly reports– Utilization Review reports with itemized service description and fee date.– Regular and comprehensive statistical reporting is the only method that the County may measure the value of the utilization review program.– Digital Media and Correspondence(2) All questions must be submitted no later than April 20, 2026.(3) The contract period will be for five years. Tue, 31 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1092997-usa-california-workers-compensation-utilization-review-services-rfp.html http://www.rfpmart.com/1092997-usa-california-workers-compensation-utilization-review-services-rfp.html Vendor needs to provide long–term disability claims management and claims payment services.– This bid is researched and provided for information purposes only, and RFP/RFI/Bid document has not been included. Additional Payment of will be required to pay to obtain the Main RFP document (Apart from RFPMart charges). This notice only refers to contact details of contracting authority. Tue, 31 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1092970-canada-new-brunswick-long-term-disability-claims-management-and-claims-payment-services-info-only-rfp-not-included-rfp.html http://www.rfpmart.com/1092970-canada-new-brunswick-long-term-disability-claims-management-and-claims-payment-services-info-only-rfp-not-included-rfp.html (1) Vendor needs to provide medical plan administration services.  Tue, 31 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1092829-usa-maryland-medical-plan-administration-services-rfp.html http://www.rfpmart.com/1092829-usa-maryland-medical-plan-administration-services-rfp.html (1) Vendor needs to provide health system pharmacy program partner services to the government authority located in Cleveland, OH.–  Development of a private label and modular pharmacy benefit administrator model. – Claims processing.– Member services call center (24/7/365), including member and provider communications support and member engagement tools (mobile/online portal, real –time pharmacy benefit check technology)– Account management.– Full–scale reporting and analytics support, including online access to reporting tools and eligibility portal.– Integration with agency’s point solutions.– Clinical support (formulary management, utilization management, prior authorization review, etc.)– Implementation support.(2) All questions must be submitted no later than April 14,2026.(3) The contract period will be for three years. Tue, 31 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1092827-usa-cleveland-ohio-health-system-pharmacy-program-partner-services-rfp.html http://www.rfpmart.com/1092827-usa-cleveland-ohio-health-system-pharmacy-program-partner-services-rfp.html This is a Request for Information (RFI) only. This is NOT a solicitation for proposals, proposed abstracts, or quotations, and it does not commit the Centers for Medicare and Medicaid Services (CMS) to award a contract now or in the future. Likewise, responding to this RFI does not guarantee participation in or award under any future procurement.CMS seeks information regarding consumer–reported verification data sources and services to support state Medicaid agencies in meeting federal eligibility determination requirements. CMS is developing the EMMY (Eligibility Made Easy) platform, a centralized, API–based data exchange infrastructure designed to provide participating state Medicaid agencies with standardized access to trusted third–party data sources for eligibility verification. CMS has an operational need for authoritative payroll and employment verification data to support Medicaid eligibility determinations and to prepare for community engagement verification requirements established under the Working Families Tax Cut Act (WFTCA), subject to implementing guidance. CMS is also gathering market intelligence on industry capabilities across other verification data domains relevant to Medicaid eligibility and benefits program compliance, including but not limited to educational enrollment verification, asset and financial verification, and identity verification. This RFI does not signal a single consolidated procurement across all data domains described. Vendors are encouraged to respond to the areas most relevant to their capabilities.Please see Attachment. Sun, 29 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1092605-us-fed-consumer-reported-verification-data-sources-for-state-medicaid-eligibility-determination.html http://www.rfpmart.com/1092605-us-fed-consumer-reported-verification-data-sources-for-state-medicaid-eligibility-determination.html (1) Vendor needs to provide emergency medical billing services.• Provide vendor to administer the task of processing, invoicing and collecting costs, including collections for past due invoices for Emergency Medical Services (EMS)• The agency will award one Contract for a Vendor to provide all services necessary to receive and process patient billing and collections.• Provide all labor, materials and technology to obtain missing patient information from all available sources prior to issuing insurance claims or direct patient billing• Provide a Customer Service Representative to assist patients and/or other third–party payers in all billing inquiries• Electronically file insurance claims, and mail direct patient billing upon verification of run ticket information no later than two (2) business days after receipt of run ticket• Provide regular updates and annual on–going training to the agency of any changes to billing requirements, best practices based on industry standards or requirements applicable to health care laws and regulations• The Contractor shall conduct annual training sessions for agency staff focused on clinical documentation, billing compliance, and industry best practices to ensure adherence to current requirements and promote continuous improvement in compliance performance. (2) The contract period will be for five years. Sat, 28 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1092306-usa-maryland-emergency-medical-billing-services-rfp.html http://www.rfpmart.com/1092306-usa-maryland-emergency-medical-billing-services-rfp.html (1) Vendor needs to provide medicaid recovery audit contractor services.– Meet and fulfill all federally mandated and state required actions regarding recovery audit contractors– Minimize Provider abrasion by developing Provider–friendly tools that allow them to transmit documents for review and implementing regular outreach and training efforts to promote compliant billing practices– Develop necessary technology, including a document management system and data warehouse, to maintain line level detail of claims and encounters and information associated with Provider audits– Approving all audit protocols, methodologies, procedures, and Provider communications to be used for Overpayment recovery activities as well as for the identification of Underpayments– Project Management– Project Kickoff– Project Documentation Management– Project Management Plans(2) A pre–proposal conference will be held on April 17, 2026.(3) All questions must be submitted no later than April 21, 2026.  Sat, 28 Mar 2026 00:00:00 -0700 http://www.rfpmart.com/1092175-usa-south-carolina-medicaid-recovery-audit-contractor-services-rfp.html http://www.rfpmart.com/1092175-usa-south-carolina-medicaid-recovery-audit-contractor-services-rfp.html