4-USBE-CC26314-RFP - Technical Criteria.pdf

Technical Criteria

USBE-CC26314-RFP

Medicaid Billing Services

Instructions:

Responses to ALL Technical Criteria are required. For ease of evaluation, proposals must provide a clear, complete, point-by-point response to each criterion identified in this RFP. Each response must address the applicable requirements and issues described in this RFP.

Offerors may attach additional materials in the vendor submission files section of this RFP, if necessary, to provide supplemental information to the evaluation committee. However, submission of attachments does not replace the requirement to fully respond to each criterion.

Failure to fully respond to any Technical Criterion in a point-by-point manner may result in a determination that the proposal is non-responsive.

The Technical Criteria are not intended to limit proposal content or exclude relevant information. Offerors are encouraged to include additional details, as appropriate, to demonstrate their capability to provide USDB with the proposed solution.

1. Ability to meet scope of work: Describe your ability to provide a comprehensive, integrated Medicaid claim and documentation system that meets all functional, technical, and service requirements described in the Scope of Work. Include a description of how your solution supports claim activities, documentation, validation, billing, reporting, and ongoing support.

2. PowerSchool integration: Describe your experience integrating with PowerSchool, including secure API connectivity, bi-directional data exchange, data accuracy, and synchronization frequency. Include details on how your solution will integrate with USDB’s PowerSchool environment. Please note offeror’s ability to integrate with PowerSchool must be current and active.

3. Experience with School-based Medicaid Programs: Describe your experience providing Medicaid documentation and claiming solutions for school-based health services, including work with Utah school districts or comparable K-12 or special education environments.

4. System usability and workflow design: Describe the usability and workflow design of your system, including how it supports efficient documentation, validation, and billing workflows for service providers and program administrators.

5. Customization: Describe how your solution can be customized: In your response, explain what parts of the system can be adjusted or set up differently for USDB, such as workflows, forms, user roles, reports, and settings. Indicate whether these changes are made through system configuration or require vendor development.

6. Customer Service and issue resolution: Describe your customer service model, including support availability, issue resolution processes, response times, escalation procedures, and ongoing system support.

7. Implementation: Describe your proposed implementation approach and timeline, including onboarding, configuration, staff training, and transition support to ensure the system is fully operational by July 1, 2026.

8. System Architecture and software capabilities: Describe the system architecture and software capabilities of your proposed solution, including hosting environment, system availability, scalability, browser and device compatibility, accessibility compliance, and any technical dependencies required for implementation and ongoing use.

9. Compliance, security, and data protection: Describe how your solution ensures compliance with applicable state and federal requirements regarding data protection, system security, user access controls, data backup, and disaster recovery.

10. Operational Risk Management: Describe the key project and operational risks associated with implementing and operating your solution and explain how your organization manages and mitigates those risks.

11. Project team qualifications and experience: Provide resumes and describe the qualifications, experience, and roles of key project team members who will be assigned to this project, including experience with Medicaid billing systems and K-12 or special education environments.