Georgia Procurement Registry Sciquest #41900-eRFP-001835-2027

Georgia DCH Seeks SaaS Medicaid Claims Processing Solution via NASPO ValuePoint

The Georgia Department of Community Health is seeking a comprehensive SaaS solution for Medicaid claims processing and management through the NASPO ValuePoint cooperative contract. - Government Buyer: - State of Georgia, Department of Community Health - Procurement Scope: - Core requirement: Claims Processing and Management Services Module (SaaS) - Adjudicates, edits, prices, and determines reimbursement for Medicaid healthcare claims - Optional services requested: - Financial Management and Financial Reporting - Call Center services for members and providers - Federal Reporting - OEMs and Vendors: - No specific OEMs or vendors named; only NASPO ValuePoint awarded suppliers are eligible - Notable Requirements: - Single supplier to provide all core and optional services - Solution must be SaaS-based and support Medicaid claims processing at scale - Participation limited to vendors with a current NASPO ValuePoint MMIS Claims contract

Description

The State of Georgia, through the Department of Community Health, is seeking to procure a Claims Processing and Management Services Module via a cooperative competitive down-select process from the NASPO Medicaid Management Info System (MMIS) Claims RFP. 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 (Member and Provider Call Center), and Federal Reporting. The goal is to obtain these services from a single supplier under a Participating Addendum with a NASPO ValuePoint awarded supplier.

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