Inland Empire Health Plan Bonfire #25-06803

Clinical Review Services Solicitation for Inland Empire Health Plan (IEHP)

This opportunity seeks vendors to provide clinical review services for the Inland Empire Health Plan (IEHP), a public health agency in California. - Government Buyer: - Inland Empire Health Plan (IEHP), a public health agency in California - Products/Services Requested: - Clinical review services, including: - Physician-level review of prior authorizations, grievances, and potential quality incidents - Medical consulting - System requirements quality assurance review - Physician credentialing - Professional medical services across all specialties - OEMs and Vendors: - No specific Original Equipment Manufacturers (OEMs) or vendors are named in the solicitation - Notable Requirements: - Vendors must provide extensive documentation, including: - Certifications, financial statements, security risk assessments, data sharing assessments - Proof of insurability, business licenses, company hierarchy, credentials - Detailed pricing proposals - Compliance with non-negotiable contract terms - Evidence of not being on exclusionary lists - Disclosure of campaign contributions by company owners - Classification Codes: - NIGP 91878 (Medical Consulting) - NIGP 92065 (System Requirements Quality Assurance Review) - NIGP 94871 (Physician Credentialing Services) - NIGP 94874 (Professional Medical Services: Physicians, Pharmacists, and All Specialties)

Description

This solicitation seeks a vendor to provide Clinical Review Services to ensure compliance with regulatory turnaround times for physician-level review of prior authorizations, grievances, and potential quality incidents. The scope includes medical consulting, quality assurance review, physician credentialing, and professional medical services across various specialties. Bidders are required to submit extensive documentation including certifications, financial statements, security assessments, and detailed proposals. The procurement is managed by Inland Empire Health Plan (IEHP) in California.

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