NIGP 95327: Claims Processing Services

NIGP 95327 Claims Processing Services, an Item code, covers third-party administration of workers' compensation claims, medical bill review and repricing services, assigned claims processing for noncomplying employers, and related administrative functions that state and local governments buy to manage workplace injury claims and associated cost containment. Recent solicitations show cities, counties, school districts, and special districts across Arizona, California, Florida, Georgia, Oregon, Texas, and Utah actively procuring these services, with city and county risk management departments and large school districts representing the primary buyer categories alongside state agencies and transit authorities.

Representative recent opportunities include the City of Phoenix RFP for worker's compensation third-party administration claims management services for approximately 14,000 benefit-eligible employees (sealed offers due July 31, 2026, under a five-year agreement commencing July 1, 2027), Forsyth County, Georgia's solicitation for Workers' Compensation Third Party Claims Administration Services covering a self-insured program of approximately 2,681 employees with proposals due October 15, 2026, Salt Lake City Corporation's Request for Information SLCI27041 on workers compensation third-party administrator services with responses due November 9, 2026, and the City of Orlando's Request for Proposal 26-0265 for Third-Party Administration of Firefighters' Worker Compensation Claims with a three-year initial term plus optional extensions. Northside Independent School District (San Antonio, Texas) issued RFP2026128 for Workers' Compensation Third-Party Administration and Related Services with proposals due October 22, 2026, replacing an expiring contract. The State of Oregon Department of Consumer and Business Services, Workers' Compensation Division is requesting proposals for assigned claims and claims processing agent services covering noncomplying employers, defaulted self-insureds, and decertified employer groups under RFP S-44000-00017296, with proposals due July 30, 2026, for a five-year initial term with renewal options up to ten years total and an estimated total contract value of $70 million. Geographic activity clusters in the Southwest (Arizona, Texas), Southeast (Florida, Georgia), and Mountain West (Utah, Colorado), with Oregon and California activity supporting nationwide spread. Typical scopes include claims intake and file management, compensability determinations, medical and indemnity benefit processing, subrogation recovery, pharmacy benefit management, preferred provider network services, utilization review, Medicare Secondary Payer compliance, return-to-work coordination, and system access for government users, with pricing structured as fixed fees, per-claim administrative charges, or bundled service arrangements.