Health Claims Audit Service
Overview
Fit Score
Settle Intelligence
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SUMMARY
KEY REQUIREMENTS
BUDGET
EstimateCONTRACT DURATION
TIMELINE
RFP issued on March 6, 2026.
Pre-Proposal Conference on March 12, 2026, at 11:00 A.M.
Proposals due by April 2, 2026, at 5:00 P.M.
Interviews (if required) tentatively held the last week of April.
Issuing Agency
Chatham County
Organization overview and procurement intelligence available on paid plans.
DESCRIPTION
A government authority in Savannah, Georgia is seeking a vendor to provide health claims audit services related to healthcare and pharmacy benefit administration, as well as financial settlements. The primary objectives include identifying potential claim subrogation opportunities due to overpayments, calculating the impact of errors, and evaluating associated statistics on sample findings.
The audit aims to assess the adequacy and effectiveness of United Healthcare’s internal controls for processing medical and prescription drug claims. Tasks include ensuring provider submissions contain necessary supporting documentation, verifying compliance with contractual provisions and appropriate application of discounts, and validating the coordination of benefits, including Medicare and third-party liability. The selected vendor must also corroborate that payments are made to the correct parties as required.
A pre-bid meeting is scheduled for March 12, 2026. All questions related to the RFP must be submitted no later than March 18, 2026. The contract period is for one year.
Source attribution
This Settle analysis is based on the issuing organization’s public RFP listing.