Colorado VSS #RFI-UHAA-2026000042-1

Colorado seeks advanced pre-payment solutions for Medicaid claims processing

This opportunity from the Colorado Department of Health Care Policy and Financing seeks innovative solutions to improve Medicaid fee-for-service claim processing. - Government Buyer: - Colorado Department of Health Care Policy and Financing - Requested Products/Services: - Advanced pre-payment solutions for Medicaid claims - Technologies and approaches include: - Analytics for medical billing claims - Post-payment review - Billing error identification - Pre Pay Artificial Intelligence (AI) - Rules-based analytics - Fraud, waste, and abuse detection - OEMs and Vendors: - No specific OEMs or vendors are mentioned - Unique/Notable Requirements: - Solutions must identify erroneous or improper billing and paid claims - Focus on cutting-edge, innovative technology - Emphasis on fraud, waste, and abuse detection - Place of Performance: - Denver, Colorado (state government office) - No product part numbers or quantities specified - No administrative or procedural requirements highlighted

Description

The Colorado Department of Health Care Policy and Financing is issuing a Request for Information to gather responses from vendors who can provide advanced pre-payment solutions for Medicaid fee-for-service claims. The focus is on technologies such as analytics, post-payment review, billing error identification, Pre Pay Artificial Intelligence, and rules-based analytics for medical billing claims. The solutions sought should be capable of identifying erroneous or improper billing and paid claims, as well as detecting fraud, waste, and abuse. The RFI aims to explore cutting-edge technology or approaches in this domain.

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