RFP #26-09 Billing Services for Niles Family Services

The Village of Niles is seeking a qualified vendor to provide comprehensive billing, claims administration, and credentialing services for Niles Family Services. The scope includes handling existing accounts receivable, processing new claims, managing insurance reimbursements, generating patient statements, reconciling payments, and supporting credentialing of current and future clinical providers. The vendor must integrate with the Village’s existing electronic health record (Bonterra/Apricot) and clearinghouses (Waystar, NGS, Availity), maintain HIPAA compliance, and submit regular reporting. The contract is expected to start no later than January 1 2027, with implementation beginning immediately after award. Evaluation will weigh technical approach, experience, past performance, compliance, technology, and cost. • Required services: claim entry, billing, payment posting, patient statements, follow‑up, and credentialing. • Existing volume: ~13 000 USD in claims per month, ~7‑8 000 USD collected, ~80‑90 insurance payments reconciled monthly. • Anticipated growth: 25 % increase in claim volume over 12 months; possible addition of providers (LCSW, LPCP). • Pricing flexibility: fixed fee or percentage of collections; billing and credentialing to be priced separately. • Contract term: implementation by Jan 1 2027; duration not explicitly stated but typical professional‑services contracts run 1‑3 years. • Mandatory U.S.–based vendor; all subcontractors must also be U.S.‑based and HIPAA‑compliant.