Revenue Review and Audit Services

Overview

Financial, Legal, HR & Staffing

San Jose, California, United StatesPosted about 1 month agoDeadline: May 27th, 2026

Fit Score

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SUMMARY

Santa Clara seeks a one-year contract for revenue review, audit, benchmarking, and clinical appeal writing services to ensure compliance and optimize billing practices.

KEY REQUIREMENTS

Must submit proposals electronically through the County's E-sourcing system
Must provide at least three external references from clients who have completed similar programs in the last three years
Must provide independently audited financial statements for the most recent year and the preceding three years
Must comply with the Levine Act regarding campaign contribution disclosures
Must comply with County wage and hour laws and pay equity laws
Must be a lawful business with a physical address and production capability if claiming Local Business preference

BUDGET

Estimate

$100,000 – $500,000

CONTRACT DURATION

60 months

TIMELINE

Release of Solicitation: March 23rd, 2026

Deadline to Submit Written Questions: April 10th, 2026

Response to Written Questions: April 22nd, 2026

Submission of Proposals: May 27th, 2026

Proposal Evaluation: May 28th, 2026 – June 26th, 2026

Negotiations: June 27th, 2026 – August 13th, 2026

Notice of Intent to Award: August 14th, 2026

Anticipated Commencement of Contract: October 2026

QUESTION DEADLINE

April 10th, 2026

Issuing Agency

County Of Santa Clara

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DESCRIPTION

The government authority located in Santa Clara, California is seeking a vendor to provide comprehensive revenue review and audit services. This includes conducting a detailed review and audit of the agency’s Charge Description Master (CDM) to ensure accurate and comprehensive billing practices in accordance with Medicare coding and billing guidelines. The selected vendor will make recommendations based on these guidelines to ensure regulatory compliance.

The scope also encompasses custom benchmarking services to compare the agency’s gross charges with those of other hospitals in similar geographic and demographic markets. In addition, the vendor will perform a comprehensive review of the supply CDM and item master, covering up to 28,000 active line-items, to further ensure billing accuracy. Clinical appeal writing services are also required, which involve documentation gathering, development of clinical or medical necessity justifications, and the drafting of appeal letters.

Vendors must provide a detailed cost estimate that includes all costs anticipated under the contractual arrangement to ensure all service level standards are met. Questions regarding the RFP must be submitted by April 10, 2026. The initial contract period will be for one year.

Source attribution

This Settle analysis is based on the issuing organization’s public RFP listing.