Medicare Billing Services

The Idaho Division of Purchasing, on behalf of the Idaho Division of Veterans Services, is requesting proposals for comprehensive Medicare Part A and Part B Consolidated Billing services for four State Veterans Homes, with proposals due October 12, 2026 and a pre-proposal conference on September 16.

The scope encompasses billing, accounts receivable management, denial resolution, and reporting for skilled long-term nursing care at facilities in Boise, Lewiston, Pocatello, and Post Falls. The contractor must submit claims timely, achieve a 95 percent first-pass acceptance rate, maintain a 5 percent or lower denial rate, and provide monthly reporting and support quarterly monitoring by IDVS. The contractor must supply all necessary equipment and resources and maintain a Data Recovery Project Plan. Estimated effort is approximately 100 hours monthly for professional billing consultation and 65 hours monthly for billing data entry and clerical processing across all four homes (evaluation purposes only, not guaranteed).

The contract is firm fixed-fee, indefinite-quantity, with fully-burdened hourly rates for actual authorized units of service. The initial term is two years, with potential renewal options for up to two additional two-year terms, resulting in an anticipated total term of six years. The anticipated contract start date is November 1, 2026. The contractor must not be federally debarred or appear on the Idaho Medicaid Exclusion List.

Proposals are scored on a 1,200-point scale: qualifications and experience (325 points), approach (275 points), obstacles, challenges, and risks (100 points), cost proposal (300 points), and key personnel interviews (200 points). Award will be made to the single responsive and responsible offeror with the highest normalized score. Questions are due September 23, 2026 at 11:59 p.m. MT. The proposal closing date is October 13, 2026 at 10:30 a.m. MT with public opening.