NIGP 95078: Swcap Reimbursement to Gr

NIGP 95078 Swcap Reimbursement To Gr, an Item code, encompasses Medicaid reimbursement management services for state and local entities, particularly school districts administering school-based Medicaid programs. The work involves Fee-for-Service billing administration for medically necessary direct services such as speech-language pathology, occupational therapy, physical therapy, and nursing; Administrative Claiming for Education reimbursement support; compliance monitoring and documentation review; staff training and audit assistance; and revenue maximization consulting. Vendors operate on a contingency fee basis, receiving a percentage of actual Medicaid reimbursements received by the buying entity rather than flat fees. School districts are the primary issuing bodies under this code, drawn from the public K–12 sector.

The Dougherty County School System in Georgia posted the most recent and sole visible opportunity under this code: an RFP for comprehensive Medicaid reimbursement management services with a response deadline of June 25, 2026. The solicitation targets vendors with demonstrated experience in Georgia school-based Medicaid programs and Children's Intervention School Services program administration. The contract term runs July 1, 2026 through June 30, 2027, with evaluation weighted heavily toward experience and qualifications in Georgia school-based Medicaid (35 points), quality and completeness of proposed services (30 points), cost structure (20 points), and past performance and references (15 points). Compensation is contingency-based; all Medicaid payments flow directly to the district, and the contractor invoices only after reimbursement is received. The contracting office requires sealed proposals with one print copy and one digital copy, along with vendor information forms, debarment certifications, and references, submitted to the Dougherty County School System Logistical Services Department in Albany, Georgia.