1-SF26011 Medicaid Billing Services for Incarcerated Individuals - RFI.pdf

REQUEST FOR INFORMATION

FOR SALT LAKE COUNTY

Title: Medicaid Billing Services for Incarcerated Individuals Under the 11-15 Waiver

Solicitation #: SF26011

Comments Due Date/Time: Thursday, February 19, 2026, before 1:00pm Mountain Standard Time

Salt Lake County is seeking information from vendors/suppliers that are interested and able to provide Medicaid billing services for incarcerated individuals, specifically related to requirements under the Section 11-15 Medicaid Waiver.

Following the evaluation of the information submitted from this Request for Information, a formal Request for Proposal process will likely be initiated.

Proposers are encouraged to submit their contact information and written response in no more than three (3) pages to Salt Lake County Contracts and Procurement via email to memery@saltlakecounty.gov on or before the due date and time listed. Please include the solicitation number and due date. Questions may be submitted to memery@saltlakecounty.gov as well.

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Materials Provided to Salt Lake County The County is a governmental entity subject to the Utah Governmental Records and Access Management Act (GRAMA), Utah Code Section 63G-2-101 et seq. All documents submitted in response to this RFI will be treated as protected records under GRAMA Section 63G-2-305(7). Please be advised that documents submitted in response to this RFI will become public records upon execution of a contract directly relating to the subject of this request or in the event the County does not enter into a contract which directly relates to the subject matter upon the expiration of two years from the date of issue of this RFI. Trade secrets and commercial information will not be disclosed provided that you have properly compiled with Utah Code Section 63G-2-305 and Utah Code Section 63G-2-309.

Background Salt Lake County Sheriff’s Office operates a correctional facility with an average daily population of approximately 1,937 inmates. Under the state’s implementation of the 11-

15 Medicaid Waiver, the facility will be required to submit Medicaid claims for eligible off‑site medical services provided to incarcerated individuals.

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Due to the facility’s size and operational constraints, Medicaid billing cannot be performed in-house. The County is therefore exploring third‑party vendors capable of managing Medicaid eligibility verification, claim preparation, submission, denial management, and reporting

Expectations Salt Lake County Sheriff’s Office (County) is seeking information from qualified vendors regarding Medicaid billing services for incarcerated individuals, specifically related to requirements under the Section 11-15 Medicaid Waiver.

Scope of Information Requested

Vendors are asked to provide detailed information regarding their capabilities in the following areas:

A. Medicaid Billing Services

• Eligibility verification for incarcerated individuals

• Claim preparation, coding, and submission

• Coordination with hospitals, clinics, and specialty providers

• Management of claim denials, appeals, and resubmissions

• Tracking and reporting claim status and reimbursements

B. Technical Capabilities

• Software platforms used

• Integration with jail medical records or EHR systems

• Data security standards (HIPAA, CJIS, etc.)

• Audit support and compliance reporting

• Data exchange formats and interface requirements

C. Operational Requirements

• Staffing model (e.g., dedicated account manager, billing specialists)

• Expected responsibilities of the County

• Required data inputs and documentation

• Turnaround times for claim submission and follow-up

• Customer support structure

D. Vendor Qualifications

• Company background and years in operation

• Experience with correctional facilities

• Experience with Medicaid billing under 11-15 waivers

• Current or past government clients

• References

E. Pricing Information Vendors should provide general pricing models, including but not limited to:

• Per‑claim fee

• Percentage of collections

• Monthly or annual subscription

• Hybrid models Detailed pricing is not required at this stage but should be sufficient to inform budget planning.

F. Implementation & Transition

• Estimated implementation timeline

• Training requirements

• Data migration needs

• Onboarding process

RFI Response Format To ensure consistency, vendors are asked to structure their responses as follows:

1. Cover Letter

2. Company Overview

3. Detailed Responses to Sections A–F

4. Additional Information (optional)

5. Contact Information

Responses should be clear, concise, and limited to no more than 10 pages.