CONSULTING SERVICES FOR EXCLUSIVE CARE EDI IMPLEMENTATION PROJECT

The County of Riverside is soliciting quotations for consulting services to implement Electronic Data Interchange (EDI) for their Exclusive Care health plan. The plan currently provides coverage for approximately 14,000 members and processes 2,500 claims per week. The County desires to improve operational workflow of claims processing by implementing electronic transaction management elements. The consultant will be responsible for developing project plans, completing transaction testing, and providing staff training. The contract is for a fixed fee of $215,000. • The project includes completion of a project plan and initial assessment report • Transaction testing for EDI 835, 837, 270/271, 276/277 • Completion of staff training • Complete documentation of EDI processes • Testing and EDI implementation • Post-implementation audits and CAQH Core certification