Clearinghouse/Electronic Claims and Print Mail Services

Louisville Jefferson County Metro Government is seeking proposals for a comprehensive Clearinghouse/Electronic Claims and Print Mail Services contract for its Emergency Medical Services and Public Health and Wellness billing division. The procurement aims to secure a web-based platform capable of processing approximately 85,000 annual ambulance service claims and 36,500 total annual mailings, including medical claims and non-medical documents. Key technical requirements include HIPAA compliance, electronic claim transmission, print mail services, address validation, CASS certification, NCOA processing, and USPS presorting capabilities. Vendors must provide a solution with claim scrubbing, payer directory integration, electronic transaction processing, and comprehensive reporting functionalities. The evaluation process will score proposals across five categories totaling 100 points, with submissions due by 3:00 p.m. EST on December 2, 2025, through a digital portal. A question period is scheduled from November 11-25, 2025, with technical support available through Euna Procurement for system-related inquiries.

The procurement strongly encourages participation from certified minority, female, and handicapped-owned businesses, establishing minimum utilization goals of 15% for minority-owned, 5% for female-owned, and 0.5% for handicapped-owned businesses. Vendors must complete a comprehensive Good Faith Efforts (GFE) form documenting subcontractor engagement and provide an IT Risk Assessment Questionnaire demonstrating robust information security protocols. Additional compliance requirements include adherence to the Louisville Metro Codified Ordinance's "Ban the Box" hiring policy and certification of minimum wage standards. While no specific incumbent vendor is mentioned, the contract will be awarded based on the most advantageous proposal, considering technical capabilities, customer support, electronic transaction handling, operational capabilities, integration potential, and overall pricing structure. Although a specific contract value is not disclosed, the extensive claims processing requirements and multi-departmental scope suggest a potentially significant contract opportunity for the selected vendor.