7-SHE130921-1 Pricing Schedule.pdf

This pricing schedule is associated with a request for proposal from Salt Lake County, Utah, specifically the Sheriff's Office Jail Health Services Division, for Medicaid claim submission and management services under the 1115 Medicaid Waiver. The contract requires the selected vendor to prepare, submit, and manage eligible Medicaid claims for incarcerated individuals who received Medicaid-covered services or medications during the final 90 days of incarceration. Initial implementation will focus on Medication-Assisted Treatment (MAT) participants, approximately 90 inmates, with eventual expansion to all inmates receiving Medicaid-eligible medical care. The contractor must interface seamlessly with the County's Saphire Health EHR system, comply with County IT standards and security policies, provide staff training on Medicaid-eligible claim identification, and maintain a dedicated Account Manager with additional billing specialists as needed based on claim volume. The contractor is also required to submit monthly reports on claim submissions, reimbursements, and denials; attend quarterly performance review meetings; and provide annual compliance audit summaries with process improvement recommendations.

Bidders must submit pricing as a percentage of the final amount received for each settled claim, with the award going to the lowest responsive and responsible bidder offering the lowest percentage of costs. The pricing submission must include all potential delivery charges and be shipped FOB Destination with freight prepaid. No information regarding set-asides, incumbents, response deadlines, contract term, or renewal options is specified in this pricing schedule document.