Claims processing management

The Ohio Department of Administrative Services (DAS) has established a Competitive Selection Indefinite Delivery Vehicle (IDV) for Claims Processing Management Services under contract CSP018879. This IDV provides specialized claims processing solutions specifically for the Ohio Department of Rehabilitation and Correction and the Department of Youth Services. The contract enables electronic data interchange (EDI) claim submissions, secure file transfer protocol (SFTP) data exchanges, and patient eligibility verification services, with a standardized per-claim processing fee of $17.00 for offenders that is only charged for processed claims.

CorrectCare-Integrated Health, located in Lexington, Kentucky, is the prime contractor for this IDV, which was awarded following RFP No. SRC0000011937. The contract has a performance period from January 1, 2024, to June 30, 2026, with statewide coverage in Ohio. The contract requires the contractor to maintain professional liability insurance with $3,000,000 per occurrence and $5,000,000 aggregate limits, and includes Net 30 payment terms. While the state makes no guarantee of purchase volume, the IDV provides a structured mechanism for claims processing management with comprehensive technical and operational requirements.