Medical Bill Review Services

Pre-Bid/Proposal Conference: April 30th, 2026

Questions Due: May 1st, 2026

Submission Deadline: June 3rd, 2026

Award Posting: July 22nd, 2026

Contract Start: August 11th, 2026

The selected vendor will provide comprehensive medical bill review services as part of workers' compensation coverage and administration for all South Carolina state agencies and local governmental entities. The goal is to deliver these services at reasonable prices while ensuring reliable insurance coverage that safeguards state workers.

Responsibilities include maintaining a process for reviewing all medical and expense bills related to medical services, applying appropriate workers’ compensation medical services provider manuals, and implementing network discounts for all claims. The vendor must offer an online portal for agency review and approval, provide responses to bill review inquiries within forty-eight business hours, and support the addition of alternative fee schedules or negotiated rates with medical providers at any time during the contract period.

The provider must also be capable of applying fee schedules and network savings, issuing written notifications for rejected or ineligible bills, receiving and reviewing bills from providers unable to submit electronically, and allowing for electronic transmission of bills for seamless input into Claims Management Systems. Additionally, the contractor must supply high-resolution, up-to-date scanners to support agencies in accurately scanning and transmitting bills into the bill processing system. The contract duration is five years.