AI-1183 - USA (Virginia) - AI/ML-Enabled Autonomous Coding, Automated Appeals and Denials Management Solution - Deadline August 19,2026

(1) Vendor needs to provide AI/ML–enabled autonomous coding, automated appeals and denials management solution. • Requires an artificial intelligence/machine learning (AI/ML)–enabled solution capable of adapting and improving dynamically based on data patterns in order to autonomously code clinical encounters; prioritize and resolve denied claims; and prevent denials before claim submission.• Autonomous Coding (AC): Provide an AI/ML capability to automatically assign medical billing codes without human intervention.• Appeals and Denials Management (ADM): Use AI/ML to automate the generation of appeals, reduce future claim denials, assess payer performance, and provide auditing for financial impacts.• Comprehensive Reporting Dashboards: Vendors will provide unified reporting dashboards that consolidate data and analytics from both vendors’ systems, presenting a cohesive view of the complete solution performance and outcomes.• Interdependent Algorithm Learning: The vendors will implement interdependent machine learning algorithms that operate across both the Autonomous Coding (AC) and Appeals and Denials Management (ADM) systems.