OhioMHAS Utilization Review and Billing Consultant

Location: Ohio
Posted: Apr 18, 2025
Due: Apr 21, 2025
Agency: State Government of Ohio
Type of Government: State & Local
Category:
  • Q - Medical Services
  • R - Professional, Administrative and Management Support Services
Solicitation No: SRC0000029322
Publication URL: To access bid details, please log in.
Solicitation ID: SRC0000029322
Solicitation Name: OhioMHAS Utilization Review and Billing Consultant
Original Begin Date: 4/3/2025 2:35:41 PM
Begin Date: 4/18/2025 2:18:42 PM
End Date: 4/21/2025 2:00:00 PM
Inquiry End Date: 4/18/2025 5:00:00 PM
Commodity: Project administration or planning
MBE Set Aside: MBE Set Aside
Agency: DMH104209 FINANCIAL MGMT - HCM ONLY JRST11
Solicitation Status: Open for Bidding
Solicitation Type: Request For Proposal (RFP) (Double Envelope)

Solicitation General Information
In an MBE set-aside solicitation, only those bidders/suppliers with an active MBE certification at the time the solicitation closes can submit a response
Solicitation ID
SRC0000029322
Solicitation Name
OhioMHAS Utilization Review and Billing Consultant
RFx Type
Request For Proposal (RFP) (Double Envelope)
Lot #
1
Solicitation Status
Open for Bidding
Round #
2
MBE Set Aside
Begin Date
4/18/2025 2:18:42 PM (ET)
Amendment?
End Date
4/21/2025 2:00:00 PM (ET)
Inquiry End Date
4/18/2025 5:00:00 PM
Summary
  1. MISSION & GUIDING PRINCIPLES
The mission of the Ohio Department of Mental Health and Addiction Services (OhioMHAS) is to provide statewide leadership of a high-quality mental health and addiction prevention, treatment and recovery system that is effective and valued by all Ohioans. OhioMHAS strives to be a national leader in implementing a comprehensive, accessible, and quality-focused system of addiction and mental health care and wellness for all Ohio citizens.
  1. PURPOSE
The Ohio Department of Mental Health and Addiction Services ( Ohio MHAS) is seeking proposals from qualified contractors to provide a thorough evaluation and consultation of the structure and processes surrounding utilization review and billing to provide timelier filings and error resolution to improve internal processes and capture rate of billing
  1. BACKGROUND
The agency has recently adopted an Epic electronic health record and from that, many processes and job roles have switched with regards to UR and billing. There have been areas of opportunity identified in the structure and delineation of duties with the new EHR which would be augmented with an external review and modernization of the UR and billing processes.
  1. SCOPE OF WORK AND DELIVERABLES
The awarded vendor will need to complete the following:
  1. MINIMUM QUALIFICATIONS OF CONTRACTOR


Contractor shall not be subject to an “unresolved” finding for recovery under Section 9.24 of Ohio Revised Code.

Process

EVALUATION PROCESS
MHAS’s evaluation process of responses submitted to this request may consist of up to four distinct phases:
1. MHAS’s initial review of all proposals for timely submission;
2. An evaluation committee review of the proposals for defects and scoring;
3. MHAS’s request for more information (clarifications, interviews, presentations, and/or demonstrations); and,
4. Negotiations or best offer requests.

At its sole discretion, MHAS will determine whether phases three and/or four are necessary under this RFP, reserving for itself the ability to eliminate or add phases three or four at any time during the evaluation process. MHAS may add or remove sub-phases to phases 2 through 4 at any time if MHAS believes doing so will improve the evaluation process.

PROPOSAL EVALUATION CRITERIA
In the proposal evaluation phase, MHAS staff or reviewers selected by MHAS (the committee) will rate the proposals submitted in response to this RFP based on the following criteria and weight assigned to each criterion.

Evaluation Criteria Weight Rating Extended Score
Previous experience in healthcare billing and utilization review 40
Previous experience in psychiatric healthcare settings 40
Previous experience consulting for hospital systems 10
Previous experience working with electronic healthcare records 10
Proposer has submitted a cost proposal that is complete, and the quality of the proposal demonstrates proposer’s ability to successfully complete all deliverables within a budget considered reasonable. 10
Total: _____/550






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DMH104209 FINANCIAL MGMT - HCM ONLY JRST11
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