Claims Audit Services

The Teacher Retirement System of Texas is seeking vendors to conduct medical claim audit, prescription drug claim audit, pharmacy rebate audit, and clinical validation review services.

Texas SmartBuy Member 323


General
Open (posted)
TRS000646
Jul 17, 2026 08:00 PM
Jun 17, 2026 12:00 PM
3 years 4 months base + 2 × 2 years options
Request for Proposal (RFP)
State
Original Solicitation Links
Contact
Alvaro Copa
+15125426154
4655 Mueller Boulevard, Austin, TX, USA
Submission Instructions
Description

The Teacher Retirement System of Texas (TRS) is requesting proposals for comprehensive claims audit services. This includes medical claim audits, prescription drug claim audits, pharmacy rebate audits, and clinical validation reviews. These services are crucial for TRS to ensure the accuracy, contractual compliance, and financial integrity of its healthcare programs for Texas public education employees and retirees.

Classification Codes
NAICS524291Claims Adjusting
PSCQ601Medical Coding and Auditing
Smart Codes
medical claim auditpharmacy rebate auditclinical validation review
Specifications
Service Only
Requirements
Required
  • Workers' Compensation Insurance
  • Employer's Liability Insurance — $1,000,000.00
  • Commercial General Liability Insurance — $1,000,000.00
  • Professional Liability Insurance — $5,000,000.00
  • Security and Privacy (Cyber) Liability — $10,000,000.00
  • Crime/Fidelity Bond — $1,000,000.00
Required
  • Minimum 1 reference
  • Within the last 5 years
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