Specifications include, but are not limited to: The department is soliciting proposals that will establish a contract for the review of community hospital and provider claims received by the department to validate that each is appropriate and accurate to ensure the department is paying their vendors appropriately. This process is referred to as “scrubbing” or “cleaning” claims. The offeror must have the ability to process 10,000 – 15,000 claims per year for the department. The department will send claims on a regular basis and not on a set schedule. The offeror must be able to accommodate monthly fluctuations. The selected contractor must have PPO network that includes Alaska vendors that the department commonly receives claims. If the contractor establishes discounts, then the discounts shall be applied to the claim during the cleaning process.
