DRA-10988 - USA (Grand Prairie, Texas) - RFI for Historical Medical Claims Data Analysis Services - Deadline July 2,2026

Vendor needs to provide professional analytical support services to evaluate approximately 2,000,000 historical medical claims to the government authority located in Grand Prairie, TX.– The analysis will be used to examine the data for fraud, waste, and abuse; as well as to identify trends within the claims data such as over–use or over–billing including duplicate charges.The analysis deliverables shall include:• Duplicate claims• Inappropriate procedure code based on included diagnostic code• Outliers (overuse) of specific procedure codes by specific providers and/or sites• Comparison of billed rates to Medicare rates, reported as a percentage of Medicare rates• Ranking of providers by amount billed• Ranking of patients by amount billed• Ranking of sites (facilities) by amount billed• Ranking of procedure codes by amount billed• Ranking of providers by procedure code– Commercial Artificial Intelligence (AI)The Government is interested in commercially available AI–enabled capabilities that could improve the efficiency, quality, and timeliness of the required analyses. The Government is not seeking development of a custom AI model.