Medical Billing Outsourcing Services

The Vendor is required to provide an established billing services provider for the purpose of collecting fees from patient insurance carriers, both commercial and medicaid, for select medical and programmatic services provided by department.
- Responsible for ensuring any necessary provider credentialing required for billing is completed.
- Provides a myriad of services to the community including clinical services such as testing for sexually transmitted infections (STI) and tuberculosis (TB), pharmacy services (340B), lab services and community services such as a community doula program.
- Provide comprehensive third-party billing and collection services on behalf of agency. 
- Services shall include, but are not limited to, claim preparation and submission, payment posting, denial management, reporting, training, and full compliance with all applicable federal, state, and local laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA).
- Provide the Contractor limited access to the electronic medical record system (eClinicalWorks) to obtain patient and encounter information necessary for claims generation.
- Review each claim for accuracy of billing codes and services documented; one-to-one alignment between patients seen and claims generated; presence of required documentation to support charges; and correct use of act codes based on treatment and diagnosis.
- Conduct timely follow-up on all unpaid, denied, or rejected claims using appropriate communication methods (telephone, email, fax, mail).

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: November 17, 2025