Medical Claims Payment Integrity Services

The State of Tennessee, Department of Finance and Administration, Division of Benefits Administration has issued a Request for Information (RFI) for Medical Claims Payment Integrity Services. The State manages benefits for three self-insured risk pools serving state, higher education, local education, and local education employees, retirees, and their dependents, covering over 290,000 members. The RFI aims to gather information on best practices for ongoing medical claim payment integrity services and the companies that provide these services. The State is seeking information on strategies to detect and correct issues such as billing errors, waste, and inefficiencies in the healthcare system. The RFI is not a competition or a promise of future business, but rather a market research initiative to enhance existing processes and ensure payment integrity. Responses are due by 2 p.m. on June 24, 2024, with potential webinar meetings scheduled for July 31 - August 2, 2024.

The RFI does not specify any set-aside designations or restrictions on the types of organizations that can respond. The State is not requesting specific pricing but rather price ranges and structures for these types of services to determine approximate costs. The RFI does not list any incumbent vendors or current contractors, nor does it mention any existing infrastructure or technology that requires integration. The RFI also does not provide any information on possible award values or budget ranges.