Crow Service Unit Clearinghouse and Eligibility Verification Services,

MOD 1 This modification reflects the following updates to RFQ-CSU-21-021-JJP. 1. Page 1 Section 1 part D. "already established" has been removed. 2. Page 2 Section 2 (B)(iii)(1)(a) claims per month has been corrected to 7400. 3. The Basis for Award Technical Proposal has been expanded to 25 pages. 4. Statement of Work Page 2 Section 1(a) claims per month has been corrected to 7400. 5. Deadline is now 10/01/2021. End of modification The CSU is seeking a well-established Medical Claims Clearinghouse service provider whose proposed solution is the most advantageous in meeting the CSU’s needs. The CSU process up to 88,800 claims per year, approximately 7,400 per monthly billing cycle. The medical claims clearinghouse will work directly with CSU to securely and electronically transmit medical claims to insurance companies and to electronically verify patient eligibility. The proposed solution will have the ability to be integrated into the existing health information system (RPMS) billing software and automatically in processing exported claims to third party payers; Medicare, Veterans Affairs, and Private Insurance electronic claims. The CSU is also seeking a solution that is able to setup third party payer accounts with minimal transition from the existing clearinghouse. The proposed solution should be able to review and filter claims against established edits to identify any errors. As well as provide a means to correct the claim before the claim is submitted to the insurance company. The service shall enable CSU/payer data exchanges approved by the Indian Health Service Office of Information Technology. See attatched documents for full details.