Dental Authorization Review Services

The Washington State Health Care Authority (HCA) is issuing a Request for Qualifications and Quotations (RFQQ) to solicit bids from Washington State licensed dentists to provide Dental Authorization Review Services. The selected bidder will be responsible for conducting dental authorization adjudications for the Apple Health fee-for-service dental program, providing expert testimony at dental hearings and peer-to-peer meetings, and assisting other HCA units as a subject matter expert. Bidders must have at least 5 years of experience as a practicing clinical dentist, experience with Washington State Medicaid dental programs, a valid Washington State dental license, and the ability to enter utilization review decisions into an electronic records system. The contract will be awarded based on an evaluation of the bidder's qualifications, quotation, and other scored criteria. The initial contract term is from July 1, 2024 to June 30, 2026, with the possibility of extensions through June 30, 2029. Bids are due by April 3, 2024.

The RFQQ does not specify any set-aside designations or restrictions on the types of organizations that can respond. The amendment identifies CVF Dental Consulting, LLC as an interested subcontractor, but does not indicate if there are any incumbent vendors or contractors. The HCA has budgeted up to $311,120 for the two-year contract term, and bidders must provide a not-to-exceed hourly rate for the dental authorization review services, which will be negotiated during contract award.