RFP - medi-CAL billing consulting services

The County of San Diego, Department of Behavioral Health Services, is requesting proposals for Medi-Cal Billing Consulting Services under RFP 13201, with proposals due August 19, 2026 at 3:00 p.m., and a pre-proposal conference on July 14 via Microsoft Teams. Small-Local Businesses meeting Board Policy B-53 receive a 15% price preference (up to $150,000 reduction) during evaluation, though contract award is made at the unadjusted price; offerors must complete a Small-Local Business Subcontractor Utilization Plan demonstrating either 3% participation by small-local businesses or good faith effort to meet this goal.

The scope encompasses six primary objectives: development of a project workplan; provision of coder-approved training and technical assistance; development of billing enhancement strategies; delivery of a recommended Revenue Cycle Management staffing model; identification of artificial intelligence opportunities; and provision of ongoing ad hoc assistance in billing and revenue cycle improvement. The County seeks to optimize specialty Mental Health and Substance Use Disorder Medi-Cal billing, standardize best practices, and maximize reimbursement opportunities.

The contract maximum is anticipated at $4.25 million to $5.0 million for the five-year period. The initial term runs October 1, 2026, through September 30, 2027, with four one-year renewal options extending through September 30, 2031, plus up to six additional months in incremental options. Compensation is fixed price based on a detailed Payment Schedule with deliverables aligned to proposed outcomes. Proposals are limited to 40 pages excluding disclosures, financials, and sample reports. All deliverables become the property of the County with unrestricted rights to use, reproduce, modify, and distribute. Written questions are due July 22, 2026 at 5:00 p.m. Evaluation criteria, in order of importance, are program approach, organizational capability and experience, organizational stability and risk, cost reasonableness, and acceptance of County terms and conditions including insurance requirements.