The Maricopa County Department of Public Health, hereinafter referred to as “MCDPH,” seeks proposals from qualified firms, hereinafter referred to as the “Contractor,” to provide billing services in accordance with the terms, conditions, and specifications contained in this Request for Proposal (RFP). It is the intent of MCDPH to establish a contract with an established billing services provider for the purpose of collecting fees from patient insurance carriers, both commercial and Medicaid, for select medical and programmatic services provided by MCDPH. In addition, the Contractor shall be responsible for ensuring any necessary provider credentialing required for billing is completed. The Contractor shall be responsible for either establishing and holding the health insurance contracts, or assisting MCDPH in establishing and maintaining such contracts, as well as negotiating rates with insurance carriers on behalf of MCDPH. Contractor shall retain a percentage of monies collected for all costs associated with providing services under this contract. This includes any ancillary or “value-added” services that may be requested by MCDPH.
MCDPH currently provides a myriad of services to the community including clinical services such as testing for sexually transmitted infections (STI) and tuberculosis (TB), pharmacy services (340B), lab services and community services such as a community doula program. However, currently MCDPH is only billing for Immunizations and Refugee services, which will be consolidated under this initial contract. It is estimated that in consultation with the Contractor, MCDPH will slowly begin adding other billable services such as STI, TB, pharmacy and laboratory. MCDPH also intends to expand its programs and services and when done, these additional programs may be added to the resulting contract.
MCDPH currently estimates billing patient insurance carriers (primarily AHCCCS) for approximately $500,000 annually for its clinical services. MCDPH clinics are using an electronic medical record, eClinicalWorks (ECW), for patient charting and creation of claims. There are no delinquent accounts and there is no requirement for collection of payments from a patient.
The awarded Contractor shall have successfully completed services similar to those specified in Section 2.0 Scope of Work, and be licensed, insured, and HIPAA compliant in the State of Arizona.
