Jail/Juvenile Hall Medical Billing

The County of Napa (hereinafter referred to as “the County”) is inviting proposals from qualified firms (hereafter referred to as "Proposer", “Bidder”, “Bidders”, “Vendor” or “Vendors”) to administer forensic billing services for the Napa County Health and Human Services Agency (HHSA), Department of Corrections (NCDC), and Probation Department (Probation). Bidders are responsible for all requirements and responsibilities outlined in the Scope of Work and specifications. Bidders must provide a Cost Proposal breakdown for all areas as listed in this RFP. It is the intent of this RFP to locate qualified Bidders who are interested and able to provide and coordinate comprehensive forensic billing services for physical health, mental health, substance use treatment, pharmacy, durable medical equipment, CalAIM pre-release services, and other Medi-Cal covered benefits. The selected Vendor shall work cooperatively with NCDC, Probation, and the Napa County Health and Human Services Agency (HHSA), local hospitals and any behavioral health providers. The County intends to award a t hree (3) year contract (with two (2) year annual options to renew) t o the bidder selected as most qualified in providing the forensic billing services to meet the needs of the County’s incarcerated adults and juveniles. The primary goal of the County in requesting these services is to purchase forensic billing and revenue cycle management services in an efficient and effective manner at a cost that is reasonable to the County. Each respondent to the RFP shall be evaluated as to its achievements and compliance with the following stated objectives: To deliver high quality comprehensive billing and revenue cycle management services (including coding, claims administration, denials, appeals, credentialing, reporting) that can be audited against established standards. To maintain an open and cooperative relationship with the administration and staff of the Napa County HHSA, Department of Corrections, and Probation Department. To maintain complete and accurate records of care and to collect and analyze billing and revenue statistics on a regular periodic basis. To provide for a fair and objective proposal that will result in a mutually satisfactory contract between the successful Bidder and Napa County. Objectives of the RFP Vendors shall meet the general obligations, standards, and objectives for the delivery of comprehensive Medi-Cal billing and revenue cycle management services. Provide information regarding the background, expertise, qualifications, and philosophy of your organization. Vendors are encouraged to demonstrate how best practices and lessons learned are integrated into a reliable service model to maximize earned revenues. Vendor shall fulfill the following objectives. Submit a pricing proposal for forensic billing and revenue cycle management services, demonstrating experience and qualification for processing Medi-Cal outpatient, pharmacy, and other Medi-Cal covered benefits and services. Ensure the billing and revenue cycle management services are operated in a professional, ethical, efficient, and cost-effective manner with full reporting and accountability to County. Ensure that the health care services operate at full staffing. Implement a utilization review program. Implement a consistent, accurate, complete, and timely claims adjudication process. Ensure that Federal, State, and County requirements are met.