Healthcare Revenue Cycle Management Services

The vendor is required to provide healthcare revenue cycle management (RCM) services for include:
1. Revenue cycle management
•    Pre-authorization and utilization review: obtaining necessary approvals for procedures and services. 
•    Charge captures and coding: ensuring all services provided are captured, coded appropriately and accurately billed. identify discharged not fully billed (DNFB) and unbilled days claims and improve (DNFB) and unbilled days metric. 
•    Claim submission and processing: submitting insurance claims in a timely manner and following up on any denials or issues. 
•    Accounts receivable (A/R) management: payment processing for patient and insurance, unpaid claims tracking, credit balances, refunds, improve A/R by accelerating revenue from aged accounts. 
•    Denial management: investigating and resolving claim denials to ensure proper and timely reimbursement.
2. Reconciliation and reporting
•    Work within point and click system. 
•    Revenue cycle analysis: analyzing revenue data to identify trends, patterns, and areas for improvement in the RCM process. 
•    Key performance indicator monitoring, tracking and reporting.
•    Monthly reconciliation of revenues including establishing reporting details and schedules.
3. Consultation and training:
•    Assist and provide feedback to provider on procedure code assignments.
•    Medical record review for ongoing training and education for new and existing providers.
- Budget: $80,000 to $265,000 per fiscal year.

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: August 20, 2025