County of Marin Health and Human Services

Third Party Administrator (TPA) to Bill State Medicaid for Correctional Healthcare Services

RFP Files: 

RFP Description: 

Third Party Administrator for billing, collection and revenue cycle management services related to the CalAIM JI Reentry Initiative.

Control Number: 

2025-05

Proposal Close Date: 

Wednesday, April 30, 2025 - 3:00pm

Open Questions Period: 

Friday, March 28, 2025 - 3:00pm to Thursday, April 10, 2025 - 3:00pm

Proposal Contact: 

Questions and Answers: 

Question:  Would the scope of CalAim related work be limited to only the Justice Involved group or all CalAim related work for Marin HHS?

Answer:  The scope is limited to the Justice-Involved Reentry population.

Question:  For the reporting requirements, would these be internal reports or report submission to Partnership Health Plan?

Answer:  The Third-Party Administrator (TPA) will be required to provide internal Reporting and Analytics to the HHS Office of Finance, including claim submissions rates, denial rates, and payment trends at specified intervals.

Question:  Would Marin HHS consider a proposal for the CalAim support where we would identify/recommend other resources for non-CalAim related  billing/reporting?

Answer:  Marin HHS will only consider services outlined in the RFI and relevant to the Justice-Involved Reentry Initiative, though vendors may provide supplemental information regarding service capabilities.

Question:  Please lets us know approximately how many claims and approximate revenue received in 2024.

Answer:  Currently, Marin HHS lacks the infrastructure to initiate CalAim Justice-Involved service claims. This RFI seeks a TPA to directly bill for Justice-Involved healthcare and pharmacy services on behalf of the County.

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