Historical Medical Claims Data Analysis

This document is a federal Request for Quote (RFQ) issued by the Department of Justice, Federal Bureau of Prisons Field Acquisition Office in Grand Prairie, Texas. Under solicitation number 15BCMS26Q70000005, the government is seeking quotes for "Historical Medical Claims Data Analysis" services. This acquisition is a 100% small business set-aside under NAICS code 541611, which has a $25 million size standard. The selected contractor will perform a firm-fixed-price analysis of historical medical claims data in accordance with the Statement of Work. All deliverables must be submitted electronically in searchable PDF or editable Microsoft formats within 60 calendar days of receiving the complete claims dataset. Notably, the solicitation states that funding is not yet available, and no award will be made until funds are secured. Special contract requirements govern the use of artificial intelligence, allowing commercial AI tools if identified in the quote, but prohibiting the use of government data to train or improve commercial models. Additionally, all AI-assisted conclusions require human review prior to submission. The solicitation incorporates various standard Federal Acquisition Regulation (FAR) and Department of Justice (DOJ) clauses, including strict guidelines on information security, subcontractor limitations, whistleblower information distribution, and prohibitions on specific foreign-sourced telecommunications and unmanned aircraft systems. Quotes are due by July 23, 2026, at 11:00 AM ET, and all technical inquiries must be directed in writing to the designated contracting officers.

This document contains healthcare claim billing data associated with an institutional medical claim for services rendered at West Virginia University (WVU) Hospitals. The patient, an individual associated with FCI McDowell (a federal correctional institution in Welch, West Virginia), received outpatient services on January 10, 2020. The claim features two primary service lines under authorization number VB230081. The first line detail covers a hospital outpatient clinic visit for patient assessment and management (Revenue Code 510, HCPCS Code G0463) with a charge of $73. The second line detail covers fundus photography with interpretation and report (Revenue Code 920, CPT Code 92250) with a charge of $532. Primary diagnostic codes recorded on the claim include D57.1 (Sickle-cell disease without crisis), H36 (Retinal disorders in diseases classified elsewhere), H43.11 (Vitreous hemorrhage), H53.002 (Unspecified amblyopia, left eye), and Z87.891 (Personal history of nicotine dependence). The billing provider and facility are identified as WVU Hospitals, and the document contains redacted personal identifiers alongside standard medical billing codes (such as bill type 131 for an outpatient hospital claim) to maintain patient privacy under federal regulations. This data represents typical medical services billing integrated within federal agency procurement or reimbursement records for inmate healthcare.