Medical Claim and Billing Clearinghouse Services

The City of Tucson is issuing this solicitation to establish a contract with a qualified clearinghouse service provider for medical claims management services in support of Tucson Fire Department's (TFD) EMS billing program. The selected provider will be responsible for transmitting electronic medical claims, ensuring correctness and resolving discrepancies, monitoring rejections, and providing related reporting functions. The intent is to secure a vendor that is compatible with TFD’s existing billing system, improve claims accuracy, and promote timely reimbursement for emergency medical services provided to the community.

The Tucson Fire Department (TFD) provides prehospital emergency medical services to residents and visitors within the City of Tucson. As part of its EMS operations, TFD submits medical claims to Medicare, Medicaid, and commercial insurance payers to recover allowable reimbursement for services rendered. To support these efforts, TFD relies on the secure and efficient exchange of electronic health care transaction data. TFD must adhere to all applicable HIPAA regulations, Arizona state requirements, and City information security standards for data handling and transmission.