IHS Sources Sought: Healthcare Clearinghouse Services for Bemidji Area

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Notice ID: IHS-BEM-SS-2023

Description

Bemidji Area Indian Health Service provides service and support to 34 Federally-recognized Tribes and 4 Urban Indian Health programs located in Illinois, Indiana, Michigan, Minnesota and Wisconsin. Tribal Health services are provided through 11 P.L. 93-638 Title V compacts and 23 Title I contracts. Urban Indian Health programs are located in Chicago, IL; Detroit, MI; Milwaukee, WI; and Minneapolis, MN. Tribes in the Bemidji Area include Ojibwe (Chippewa), Ho-Chunk, Menominee, Mohican, Oneida, Odawa, Potawatomi, and Sioux…

The BAO seeks to establish a centralized healthcare revenue cycle management solution that that offers an intuitive and unified user experience using available Electronic Data Interchange (EDI) technology to conduct patient third-party eligibility checks, prior authorizations, claims management (including clearinghouse, scrub claims, transmit claims, denial management, accept remittance advice, produce reports), facilitate payer enrollments, and patient payment processing. Patient and Claim information must be securely exchanged with outside insurance payers; assuming all electronic transactions and Direct Data Entry (DDE)/Florida Information Shared System (FISS), which includes CMS Section 1011 billing, access with confidentiality, authentication, integrity, and nonrepudiation for the Bemidji Area Indian Health Service Office…

Clearinghouse Services will provide patient eligibility checking, initial scrubbing of all electronic third-party claims produced by Resource Patient Management System (RPMS) data system, provide efficient denial management work queues to track and process work-loads, EFT and ERA capabilities, and credit card payment processing capacity. RPMS is an integrated solution for the management of clinical, business practice, and administrative information in healthcare facilities of various sizes. Flexible hardware configurations, over 50 software applications, and appropriate network communication components combine to provide a comprehensive clinical, financial, and administrative solution…

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