Description: The primary objective of contracting with a vendor for Clinical Review Services is to ensure that IEHP meets regulatory turnaround times for physician level review of prior authorizations, grievances, and potential quality incidents (PQIs). Project closes Jun 10, 2026 2:00 PM PDT.
Description: REQUEST FOR INFORMATION (RFI): IEHP’s Finance – Provider Resolution & Recovery Department is seeking information from qualified vendors on Payment Integrity capabilities spanning Pre-Pay and Post-Pay domains. IEHP seeks solutions that reduce improper payments before adjudication, recover overpayments retrospectively, detect fraud, and improve overall payment accuracy across Medi-Cal, Medicare Advantage (D-SNP), and Covered California claims operations. Vendors may offer capabilities in one or more of the areas described in this RFI. Project closes Jun 15, 2026 2:00 PM PDT.
