RFP 2025-02 Laboratory Claims Management Services
Closed State & local contract opportunity Posted
- Solicitation number
- S-X26083-00013738
- State
- Oregon
- Responses due
Opportunity facts
- Jurisdiction
- NIGP codes
- 91869 Insurance Consulting
- 94610 Accounting And Billing Services (Including Payroll Services, 3Rd Party Reimbursement For Medicare, Medicaid, Private Insurance, Etc)
- 94807 Administration Services, Health
- 953 Insurance And Insurance Services, All Types
- 95327 Claims Processing Services
- 95352 Insurance And Insurance Services (Not Otherwise Classified)
- 96116 Claims Processing Services
- UNSPSC codes
- 71161611 Technical consultant services for claim management
- 78142101 Claim management
- 64121504 Commercial multiple peril policy
- 64122202 Group dental insurance policy
- 84131520 Insurance broking fees and commission
- 84111500 Accounting services
- 85101704 Health economics
- 71161612 Technical consultant services for asset integrity information and data control
- 64120000 Insurable interest contracts
- 64122007 Modified guaranteed annuity policy
Show all 43
- 64122006 Fixed annuity policy
- 64121514 Warranty policy
- 64121505 Farm owners multiple peril policy
- 84131513 Erection all risks insurance
- 84131905 Employment practice liability insurance services
- 81162309 Payroll process as a service
- 84111507 Inventory accounting service
- 85101703 Health service planning
- 84131613 Claims payment processing or administration
- 84131900 Insurance services for casualty lines
- 64122102 Group health insurance policy
- 64122201 Individual dental insurance policy
- 64122101 Individual health insurance policy
- 81162310 Procurement process as a service
- 84130000 Insurance and retirement services
- 81162301 Accounts payable process as a service
- 84111505 Payroll accounting services
- 93151606 Government accounting services
- 85101700 Health administration services
- 85101701 Health policy
- 85101702 Health legislation or regulations
- 85101705 Public health administration
- 85101706 Traditional healthcare services
- 85101707 Health system evaluation services
- 64122100 Health insurance contracts
- 64122200 Dental insurance contracts
- 64121502 Boiler and machinery policy
- 64121507 Fraternal benefit society insurance policy
- 64121508 Homeowners insurance policy
- 64121509 Inland marine insurance policy
- 64121511 Ocean marine insurance policy
- 64121512 Surety policy
- 84131518 Bicycle insurance
- Point of contact
-
- Lee Reinholtz reinholtzl@careoregon.org (503) 416-1797
Opportunity details come from oregonbuys.gov. Updated .
About this opportunity
CareOregon, Inc., on behalf of Health Share of Oregon and Health Plan of CareOregon (CareOregon Advantage), is seeking one or more contractors to provide a comprehensive laboratory claims management services through RFP 2025-02. The procurement focuses on establishing a payment integrity program with cost containment services specifically targeting laboratory benefit management for approximately 575,000 Medicaid and 17,205 Medicare members. Contractors will be responsible for optimizing test utilization, reducing healthcare costs, preventing testing barriers, and managing laboratory service payments for the nearly 990,000 lab claims generated in 2024. The proposal evaluation will be conducted using a 100-point scale, with points distributed across general background and qualifications (30 points), scope of work (35 points), equity and diversity efforts (10 points), and fees (25 points). Proposals are due by June 2, 2025, at 2:00 PM Pacific Time and must be submitted via email to vendorservices@careoregon.org, with contract work anticipated to commence in the second half of 2025 for an initial one-year term with options for four additional one-year renewals.
CareOregon explicitly encourages proposals from minority, women, service-disabled veteran, and emerging small businesses, signaling a commitment to diverse vendor participation. While specific budget ranges were not explicitly detailed in the procurement documents, the scope suggests a substantial contract value given the extensive laboratory claims management requirements. The procurement does not appear to reference existing incumbent vendors or mandate specific technological integration requirements. Potential respondents should demonstrate robust capabilities in laboratory claims management, healthcare cost containment, and a proven track record of delivering efficient payment integrity services. The multi-year contract structure with potential renewals indicates CareOregon's intent to establish a long-term partnership with a qualified vendor that can consistently deliver high-quality laboratory claims management services.
Opportunity text
CareOregon, along with its subsidiaries and affiliated entities, Health Share of Oregon and Health Plan of CareOregon (CareOregon Advantage), is seeking one or more Contractors to provide a payment integrity program that offers cost containment services to include laboratory benefit management. Work is to begin approximately second half of 2025, and continue for one year with the option for four (4) additional one (1) year renewals thereafter.
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