MEDICAL BILL REVIEW SERVICES

This solicitation seeks a qualified vendor to provide comprehensive medical bill review services for the State Fiscal Accountability Authority. The contractor will audit, analyze, and validate medical claim submissions to ensure compliance with state regulations, identify overpayments or discrepancies, and recommend corrective actions. The work supports fiscal accountability and cost containment across state‑funded health programs. • Perform detailed audits of medical claims submitted by providers to state‑funded health plans. • Verify coding, eligibility, and service appropriateness against state statutes and payer policies. • Deliver summary reports highlighting overpayment findings, savings opportunities, and compliance recommendations.