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Payment Integrity Services and Solution

Overview


Healthcare Services, Wellness & Biotech
Camarillo, California, United StatesPosted 3 days agoDeadline: May 22nd, 2026

Fit Score


Settle Intelligence

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SUMMARY


Seeking a vendor to deliver a payment integrity solution with pre-payment and post-payment review, data mining, and real-time API integration with a claims system. The resulting contract is expected to run for three years.

KEY REQUIREMENTS


BUDGET

Estimate

$250,000 – $750,000

CONTRACT DURATION


36 months

TIMELINE


RFP Released: May 1st, 2026

Intent to Propose Notification Due By: May 6th, 2026

Questions Due: May 11th, 2026

Questions Answered: May 15th, 2026

Proposal Due Date: May 22nd, 2026

QUESTION DEADLINE


May 11th, 2026

Issuing Agency


Gold Coast Health Plan

Organization overview and procurement intelligence available on paid plans.

DESCRIPTION


The issuing organization is seeking a vendor to provide payment integrity services and a modern, scalable solution that supports both pre-payment and post-payment review activities. The solution is expected to use data mining capabilities to improve operational efficiency and help prevent improper payments before they occur.

The proposed platform must integrate with the claims system through an API to verify claims accuracy, regulatory compliance, and medical necessity in real time. Evaluation will consider proposer qualifications, relevant experience, capabilities, past performance, references, staffing approach, availability of key personnel, service location, responsiveness, and diversity outreach efforts.

An intent to propose notification is due by May 6, 2026, and questions must be submitted by May 11, 2026. The anticipated contract term is three years.

Source attribution

This Settle analysis is based on the issuing organization’s public RFP listing.

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