PEO DHMS - CSO, Area of Opportunity (AOI) 6 - Autonomous Coding & Denials Mgmt

The Department of Defense (DoD) Healthcare Management System Modernization (DHMSM) Program Management Office (PMO) is seeking solutions for Autonomous Coding and Denials Management Services. The goal is to improve operational efficiency, coding accuracy, and cost-effectiveness of outpatient and inpatient medical clinics. The solution should utilize modern, human-like, computational processes to assign medical billing codes from clinical documentation without human intervention and have an auditing capability for the results. The solution should also automate the generation and submission of appeals to third-party payers. • The solution should be able to integrate with the MHS GENESIS Electronic Healthcare Record (EHR) system. • The solution should meet and maintain DoW cybersecurity authorizations and obtain FedRAMP authorization at the Medium level, IL4. • The solution should be able to partially integrate in 3 months or less and fully integrate in 12 months or less. • The solution should have an existing commercial solution for Autonomous Coding capability. • The solution should have a phased, automated solution for Automated Appeals and Denials Management Services.