Claims Processing and Management Services Module

The Georgia Department of Community Health is executing a Notice of Intent to Utilize Cooperative Purchasing Agreement under the NASPO ValuePoint Medicaid Management Information System (MMIS) Claims contract, with a Participating Addendum deadline of August 17, 2026. DCH is pursuing a Claims Processing and Management Services Module leveraging the Master Agreement executed by the State of Montana on January 4, 2021, under RFP No. DPHHS-RFP-2020-0254T.

The procurement is structured as a cooperative purchase from an existing NASPO ValuePoint awarded supplier, eliminating the need for a new competitive solicitation. The scope includes the Core Service—a Software-as-a-Service solution that adjudicates, edits, prices, and determines reimbursement amounts for Medicaid healthcare claims—plus all three optional service modules: Financial Management and Financial Reporting (Option A), Member and Provider Call Center services (Option B), and Federal Reporting (Option C). DCH intends to procure the complete bundled solution from a single supplier.

As a cooperative purchasing vehicle, the terms and pricing are governed by the existing Master Agreement rather than newly negotiated rates. Eligible suppliers are those already awarded under the NASPO ValuePoint MMIS Claims contract with the State of Montana. Interested vendors must submit a Participating Addendum response by August 17, 2026 to formalize Georgia's participation and establish service terms.