SOURCES SOUGHT - CLEARINGHOUSE SERVICES FOR OKLAHOMA AREA IHS

The Oklahoma City Area Indian Health Service (IHS) requires a secure software application for electronic transactions and DDE/FISS access across twelve facilities. This Request for Proposal (RFP) seeks a contractor to provide a secure exchange data software solution for processing medical and dental claims from Medicare, Medicaid, VA, and Commercial Payers via a clearinghouse. The solution must not require local software installation, utilize secure FTP, support EDI transactions and telnet sessions, and accommodate multiple users. It must also comply with HIPAA, Privacy Act of 1974, and other federal regulations, including established interconnection and business associate agreements. The contractor will provide technical support, notify the IHS of downtime or disruptions, and offer customer support. Key functionalities include secure internet connectivity, unlimited DDE and PPTN access, automated batch file transfers (837/835, 276/277), real-time eligibility verification, and a flat fee for unlimited transactions. The clearinghouse services must ensure claims submission by the next business day, electronic transmission, defect detection, and rejection of faulty claims with edit reports. Billing will be at a flat rate, and the contractor must provide weekly claims approval and clearinghouse reports. The contract period is one year with four optional extension years.