OMS Coding and Billing Services

The University of Texas Health Science Center at San Antonio (UTHSCSA) issued Request for Proposal 745-26-P14 on February 3, 2026, seeking qualified vendors to provide comprehensive revenue cycle services for the Oral Maxillofacial Services (OMS) department in Bexar County, Texas. The procurement encompasses both medical and dental coding, billing, collections, claim scrubbing and submission, denial research and appeals, payment posting, statement mailing, and monthly reporting and meetings with UTHSCSA staff. Proposers must demonstrate a minimum of five years of experience providing OMS coding and billing services and must be located within the United States with all patient and UTHSCSA data remaining within U.S. borders. Key deliverables include achieving over 97% net collections rates, maintaining accounts receivable over 90 days at 20% or less, following up on 95% of claims monthly, maintaining 99.99% uptime if providing managed software-as-a-service, and integrating with EPIC EHR and Axium systems. The RFP will be evaluated based on cost (30 points), reputation (15 points), quality of services (20 points), extent to which services meet university needs (20 points), past relationship with UTHSCSA (10 points), and exceptions to terms and conditions (5 points). Proposers must submit detailed hourly rate pricing applicable throughout the initial one-year term and up to four additional one-year renewal terms. The question deadline was February 24, 2026, and the proposal submission deadline is March 11, 2026, at 3:00 PM Central Prevailing Time.

Proposers must submit a completed Historically Underutilized Businesses (HUB) Subcontracting Plan as a mandatory component to advance in the evaluation process, reflecting Texas's commitment to minority and women-owned business enterprise participation. All proposers must obtain TX-RAMP Level II Certification from the Texas Department of Information Resources prior to contract execution and comply with a Business Associate Agreement addressing HIPAA, HITECH Act, and Texas Medical Records Privacy Act requirements. Vendors must maintain comprehensive insurance coverage with minimum limits of $1,000,000 for general and professional liability and $10,000,000 for cyber liability, complete a Policy Driven Adoption for Accessibility self-assessment, and submit an extensive risk assessment addressing information security standards aligned with ISO 27005:2011 and NIST frameworks, including AI and machine learning disclosure requirements. The RFP indicates no guarantee of volume, minimum, or maximum compensation; based on operational data, the OMS department currently processes approximately 1,234 encounters monthly with FY2024 net collections of approximately $5.27 million on $15.71 million in gross charges and FY2025 collections reaching approximately $4.34 million on $14.92 million in gross charges, providing context for potential contract value. The initial contract term is four years with one optional one-year renewal, and payment terms are net thirty days in accordance with the Texas Prompt Payment Act, with UTHSCSA exempt from Texas Sales and Use Tax.