Financial Management Services

The vendor is required to provide financial management services (FMS) duties include but are not limited to:
- Managing all provider tasks associated with state cares fund including contracting creating pre-authorizations, processing claims, and remitting payment for services rendered.
•    FMS contractor will contract and pay provider(s) for the following service, but WCF may add additional services if needed to achieve provider network adequacy goals. 
•    Medical provider types registered with state cares that do not accept Medicaid and do not wish to enroll as a Medicaid provider, which would include but not limited to:
o    Dementia and behavioral supports,
o    Home safety evaluations,
o    Education and consultation (as a medical provider type), and
o    Professional nursing services. (Skilled nursing services only)
•    Must have a system that can process claims that:
o    Maintains a record of every payment made to every transaction per beneficiary. 
o    Utilizes the conventional rounding method to the nearest penny (e.g., two decimal points); and
o    Automatically detect duplicate claims.
•    Causes an error resulting in inaccurate, delayed, or erroneously issued, or erroneously omitted payments, they are responsible for resolving the error as soon as possible, but no more than five business days after a payment error is identified.
•    The state cares billing guide and other resources when billing for services and utilizing the provider one system.
- Purchasing goods and services on behalf of the beneficiary in accordance with WCF policy.
•    Adaptive equipment and technology
o    Durable medical equipment
o    Non-medical equipment and supplies
o    Assistive technology
•    Environmental modifications items, for self-installation only, and
•    Transportation
o    The FMS may not purchase goods from consumer-to-consumer (c2c) online classified marketplaces such as but not limited to:
1.    Offer up,
2.    CRAGISLIST,
3.    Facebook marketplace,
4.    EBAY classifieds, and
5.    Etsy.

- Contract Period/Term: 3 years
- Pre-Bid Conference Date: October 14, 2025
- Questions/Inquires Deadline: October 21, 2025