Payment Integrity Services and Solution
Overview
Fit Score
Settle Intelligence
Settle helps teams find, evaluate, and respond to public RFPs. We continuously surface new opportunities, score them against your company strengths, and draft proposal responses so you can focus on the work that wins business.
SUMMARY
DESCRIPTION
The issuing organization is seeking a vendor to provide payment integrity services and a modern, scalable solution that supports both pre-payment and post-payment review activities. The solution is expected to use data mining capabilities to improve operational efficiency and help prevent improper payments before they occur.
The proposed platform must integrate with the claims system through an API to verify claims accuracy, regulatory compliance, and medical necessity in real time. Evaluation will consider proposer qualifications, relevant experience, capabilities, past performance, references, staffing approach, availability of key personnel, service location, responsiveness, and diversity outreach efforts.
An intent to propose notification is due by May 6, 2026, and questions must be submitted by May 11, 2026. The anticipated contract term is three years.
Source attribution
This Settle analysis is based on the issuing organization’s public RFP listing.