Federal and Postal Employee Health Benefit Independent Medical Review 24322625Q0020HI
Summary
AI-generated · Aug 25, 2025Provide independent medical and dental health benefits reviews of disputed claims and preservice requests (prior approval, prior authorization, or precertification), along with consultation services and support for special projects for federal and postal employee health plans. The contractor will review available case documentation for disputed services and deliver a typewritten review analysis to the Government, plus a paper or electronic copy of all references cited in support of the analyses.
OPM will determine the medical specialist category for each disputed claim, and the contractor will assign a medical specialist (Coding Specialist, M.D., D.O., D.D.S., or D.M.D.) appropriate for the claim. Deliverables include the typewritten analysis resulting from the evaluation and copies of all cited references in paper or electronic form. No changes are indicated across the notices; requirements appear identical.
The contractor will provide medical and dental health benefits reviews of disputed claims and preservice requests (prior approval, prior authorization or precertification), consultation services, and special projects. The Office of Personnel Management (OPM) will determine the medical specialist category for each disputed claim and the Contractor will assign a medical specialist (Coding Specialist, M.D., D.O., D.D.S., or D.M.D.) appropriate for each disputed claim. The medical specialist will review the available case documentation for different categories of disputed medical services and will provide the Government a typewritten review analyses resulting from the evaluation of the case file in addition to a paper or electronic copy of all references cited in support of the analyses.
From Solicitation posted on Jun 10, 2025The contractor will provide medical and dental health benefits reviews of disputed claims and preservice requests (prior approval, prior authorization or precertification), consultation services, and special projects. The Office of Personnel Management (OPM) will determine the medical specialist category for each disputed claim and the Contractor will assign a medical specialist (Coding Specialist, M.D., D.O., D.D.S., or D.M.D.) appropriate for each disputed claim. The medical specialist will review the available case documentation for different categories of disputed medical services and will provide the Government a typewritten review analyses resulting from the evaluation of the case file in addition to a paper or electronic copy of all references cited in support of the analyses.
From Solicitation posted on Jul 01, 2025The contractor will provide medical and dental health benefits reviews of disputed claims and preservice requests (prior approval, prior authorization or precertification), consultation services, and special projects. The Office of Personnel Management (OPM) will determine the medical specialist category for each disputed claim and the Contractor will assign a medical specialist (Coding Specialist, M.D., D.O., D.D.S., or D.M.D.) appropriate for each disputed claim. The medical specialist will review the available case documentation for different categories of disputed medical services and will provide the Government a typewritten review analyses resulting from the evaluation of the case file in addition to a paper or electronic copy of all references cited in support of the analyses.
From Solicitation posted on Jul 02, 2025Notice history
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Solicitation Posted Jul 01, 2025No changes from previous notice
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Solicitation LATEST Posted Jul 02, 2025View changes (1)
- Response Deadline: Jul 10, 2025 → Jul 15, 2025
Details
Award Information
Not yet awarded
Contacts
Agency
Place of Performance
USA