Inmate Medical Claims and Pharmacy Cost Administration Services

Inmate Medical Claims and Pharmacy Cost Administration Services

The Clear Creek County Sheriff’s Office is seeking written proposals for outside inmate medical claims administration and inmate pharmacy cost-management services.

The selected vendor would be expected to:

• Review outside medical bills for billing and coding accuracy
• Identify duplicate, improper, or ineligible charges
• Reprice or negotiate outside medical claims when appropriate
• Coordinate provider payments and resolve billing questions
• Review medication and pharmacy invoices for accuracy and potential savings
• Provide medication repricing, pharmacy purchasing, or other pharmacy cost-management services, if available
• Provide itemized invoices and reports showing billed charges, provider payments, pharmacy costs, vendor fees, and County savings
• Securely handle protected health information and execute an appropriate Business Associate Agreement

The anticipated agreement would be for one year with no automatic renewal.

For reference, the County paid approximately $25,324.52 for outside inmate medical services in 2025. This amount does not include the County’s medication and pharmacy costs and is provided for estimating purposes only. It does not guarantee future claim volume or spending.

Please include the following in your response:

• A brief description of your company and experience working with jails or other public entities
• An explanation of your medical claims review and payment process
• A description of the medication and pharmacy services you can provide, including whether those services are performed directly or through another company
• Your complete fee structure, including fees for medical claims and pharmacy services
• A good-faith estimate of the total annual fees your company would likely receive based on the available information
• Any minimum fees, additional charges, per-claim caps, annual caps, or other cost protections
• Contact information for three comparable client references
• Any requested exceptions to the County’s standard professional services agreement

Please identify any additional pharmacy invoices or expenditure information you would need from the County to prepare an accurate proposal.

The County will consider qualifications, anticipated cost, administrative support, reporting, references, and overall value. The County is not required to select the lowest-cost response and reserves the right to reject any or all responses.

Please email your written response to