Medical Claims Audit Service
Overview
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SUMMARY
DESCRIPTION
A government authority in Portland, Oregon is seeking a vendor to conduct comprehensive medical claims audits for self-funded health plans, including prescription and dental claims audits. The selected contractor will perform independent audits at the authority’s discretion over a five-year contract period.
The contractor must implement robust quality assurance processes, including internal review protocols and error-checking methodologies, to ensure audit accuracy. The scope also includes a knowledge transfer plan for County staff, such as training on key findings, documentation of audit methodologies, and guidance on corrective action plan monitoring processes.
A pre-proposal meeting is scheduled for September 2, 2026.
Similar RFPs
Frequently asked questions
- When is the submission deadline?
- Submissions are due September 23, 2026.
- Who is a good fit for this opportunity?
- Healthcare claims auditing firm with expertise in medical, prescription, and dental claims
- Experience auditing self-funded employer or government health plans
- Established quality assurance and claims error-detection methodologies
- Ability to provide staff training and document audit and corrective action monitoring processes
- Capacity to support independent audits over a five-year contract
Analysis generated by Settle AI from the source RFP.
RFP Hunter shows what is open. Settle shows what is forming.
Settle pieces together buyer signals, budgets, contract activity, and the sources your team already monitors. See why an opportunity fits and what to do before the RFP posts.