L.A. Care Health Plan

The buyer is seeking proposals for claims management solutions services. This includes mailroom services, paper-to-electronic data capture for claims and EOBs, and generation of electronic claims files. The services will cover the buyer's Commercial, Medicare, and Medicaid lines of business. The buyer is the nation's largest publicly operated health plan, serving over 2.3 million members in Los Angeles County.

• 1/13/2025 - RFP Release
• 1/21/2025 - Preliminary RFP Required Documents Due
• 1/28/2025 - Q&A Document Released to Bidders
• 2/11/2025 - Proposal Due Date
• 2/19/2025 - Semi-finalist(s) Selected
• 2/26/2025 - Semi-finalist Presentation(s)

• Provide complete mailroom services
• Perform paper-to-electronic data capture of claims
• Capture Explanation of Benefits (EOB) data
• Generate electronic claims files
• Process claims for Commercial, Medicare, and Medicaid lines of business
• Coordinate with L.A. Care's existing systems and processes
• Ensure compliance with healthcare regulations and standards
• Implement secure data handling and storage solutions
• Provide scalable solutions to handle large volume of claims
• Offer ongoing support and maintenance for the claims management system