Third Party Liability Fund Recovery and Cost Avoidance Services

The Missouri Department of Social Services is seeking vendors to provide Third Party Liability Fund Recovery and Cost Avoidance Services for the Medicaid and Children's Health Insurance Program (CHIP). The one-year contract will require the selected vendor to recover funds and avoid costs for Medicaid and CHIP claims. Key services include fund recovery based on revenue thresholds, cost avoidance services based on membership volumes, and additional services such as credit balance audits, Medicare buy-in, and targeted clinical bill audits. Vendors will be compensated through firm, fixed percentage rates for fund recovery and firm, fixed per member per month rates for cost avoidance. Proposals are due by July 7, 2016 at 3:00 PM CDT.

The solicitation does not mention any set-aside designations or restrictions on the types of organizations that can respond. Additionally, it does not list any incumbent vendors or current contractors, nor does it specify any existing infrastructure or technology that requires integration. The solicitation also does not provide any information on possible award values or budget ranges.