Georgia Procurement Registry #41900-eRFP-001835-2027

Georgia Medicaid MMIS SaaS Claims Processing and Management Services Procurement

The Georgia Department of Community Health (DCH) is seeking a comprehensive Software-as-a-Service (SaaS) solution for Medicaid claims processing and management through the NASPO ValuePoint MMIS Claims contract. - Government Buyer: - Georgia Department of Community Health (DCH) - OEMs and Vendors: - Opportunity is open to NASPO ValuePoint awarded suppliers; specific OEMs not named, but must be original contract holders under RFP No. DPHHS-RFP-2020-0254T (State of Montana) - Products/Services Requested: - SaaS Claims Processing and Management Services Module - Adjudication, editing, pricing, and reimbursement determination for Medicaid healthcare claims - Additional Options: - Financial Management and Financial Reporting - Call Center Services (for both members and providers) - Federal Reporting - Unique/Notable Requirements: - All services must be provided by a single supplier - Supplier must be a NASPO ValuePoint awarded vendor under the referenced RFP - Solution must cover the full suite of claims processing, financial, call center, and federal reporting functions - Quantities and part numbers are not specified; the procurement is for a full-service SaaS solution and associated services

Description

The State of Georgia intends to utilize the NASPO ValuePoint Medicaid Management Information System (MMIS) Claims contract through a Participating Addendum with a NASPO ValuePoint awarded supplier. The procurement includes a SaaS solution for adjudicating, editing, pricing, and determining reimbursement amounts for Medicaid healthcare claims. Additionally, the procurement covers three options: Financial Management and Financial Reporting, Call Center services, and Federal Reporting. The Department of Community Health seeks to procure all these services from a single supplier.

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