Medical Claims Processing System RFI
US IMMIGRATION AND CUSTOMS ENFORCEMENT
Original Solicitation Links
ICE_Medical_Claims_
]ice medical claims
Contact
Submission Instructions
Description
The Department of Homeland Security (DHS), specifically the Immigration and Customs Enforcement (ICE) Health Service Corps (IHSC), is seeking information on potential vendors capable of providing a comprehensive medical claims processing system. This system must support claim adjudication, reimbursement, program integrity, and related functions. The system is expected to handle approximately 300,000 medical claims annually and include features such as auto-approval for emergency department claims and prior authorization of referrals. The RFI seeks to understand vendor capabilities regarding transition timelines, key milestones, best practices for complex transitions, and the technology used for adjudication and reimbursement. Specific areas of interest include support for paper claims, the process for provider enrollment and reimbursement, capabilities for identifying and resolving overpayments, and the potential for contract financing. Vendors are also asked about their system's scalability, integration capabilities with other government systems (like EHR/EMR), interoperability standards (HL7, FEDRAMP), and provider network management. Additionally, the DHS is interested in reporting and dashboard capabilities, customer and business support services, experience with government contracts, and experience within federal cloud environments (GovCloud), including obtaining Authority to Operate (ATO) and Privacy Threshold Analysis (PTA). Experience with AI/ML tools for fraud, waste, and abuse detection, as well as system availability and disaster recovery, are also key areas of inquiry. The government is considering NAICS code 518210 (Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services) for this requirement.
Classification Codes
Smart Codes
Specifications
Documents
| Title | Date Posted |
|---|---|
| RFI_Medical Claims Management.pdf | Jun 16, 2026 12:00 PM |
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