Victims of Crime - Medical Billing and Claims Management

The Nevada Department of Health and Human Services (DHHS), specifically the Division of Child and Family Services (DCFS), is seeking a vendor to provide comprehensive medical expense and claims management services for the Nevada Victims of Crime Program (VOCP). The solicitation, Reference Number 40DHHS-S3392, was released on August 14, 2025, with proposals due by September 11, 2025, at 2:00 pm Pacific Time. The primary objective is to modernize the claims processing system for victims of violent crimes, replacing legacy paper-based processes with a fully electronic, paperless platform that supports case management, document imaging, audit trails, and robust reporting. The selected vendor will be responsible for receiving and reviewing victim applications, processing claims, negotiating medical bills, issuing payments, managing communications, and providing comprehensive reporting capabilities. The procurement will involve a comprehensive evaluation process with multiple technical factors weighted at 30 points each, and a cost factor weighted at 10 points, focusing on the vendor's ability to maximize funding, provide high-user experience software, support efficient workflows, demonstrate a collaborative approach, and showcase expertise in claims management.

The solicitation does not specify explicit set-aside designations or restrictions on responding organizations, but it does require vendors to have a Nevada business license and active SAM.gov registration. Vendors must agree to specific contract terms, including data encryption, maintaining data within the United States, and not engaging in a boycott of Israel. The anticipated contract term is four years, subject to Board of Examiners approval, with estimated start dates of October 14, 2025, May 1, 2026, or July 1, 2026. The project is estimated at $1,048,604 for fiscal year 26 and $1.4 million for each subsequent year, with funding sources including 62% General Fund, 23% Other, 10% Federal Fees, and 5% State Fees. The technology investment aims to create a scalable, secure, and user-friendly software platform that can handle personally identifiable information (PII) while complying with federal and state regulatory requirements. Optional services may include mobile apps, a managed care provider panel, and tax document management. The State reserves the right to request best and final offers and may invite higher-scoring vendors to provide 30-minute presentations to an evaluation committee.