Description
CareOregon is seeking a software solution for a Second Pass Claims Editing System to provide payment accuracy and integrity solutions and services. The system should ensure claims are coded and processed correctly. Services are to begin in June 2026 and continue through May 31, 2027, with the option for two additional one-year renewal terms thereafter. The proposal should include the firm's general background and qualifications, scope of work, equity, diversity, and inclusion efforts, fees, and references.
• The system should be fully integrated with QNXT.
• The proposal should include a detailed implementation document with a timeline.
• The proposal should include information on data security and governance policies and processes.
• The proposal should include information on the firm's experience with similar services to non-profit entities, preferably Medicaid carriers.
• The proposal should include information on the firm's ability to meet the requirements in Section 3.