Request For Letters of Interest (LOI) PRI/037 Mangement Services Organization/ Administrative Services Organization
| Agency: | Sacramento County |
|---|---|
| State: | California |
| Type of Government: | State & Local |
| NAICS Category: |
|
| Posted Date: | Dec 15, 2025 |
| Due Date: | Dec 29, 2025 |
| Original Source: | Please Login to View Page |
| Contact information: | Please Login to View Page |
| Bid Documents: | Please Login to View Page |
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SACRAMENTO COUNTY
DEPARTMENT OF HEALTH SERVICES
PRIMARY HEALTH SERVICES DIVISION
REQUEST FOR LETTERS OF INTEREST (LOI) #PRI/037
MANAGEMENT SERVICES ORGANIZATION / ADMINISTRATIVE SERVICES
ORGANIZATION
RELEASE DATE: DECEMBER 12, 2025
Sacramento County, Department of Health Services, Primary Health Services is seeking Letters
of Interest (LOI) from Medi-Cal Managed Care Health Plans (MCP), Independent Provider
Organizations (IPO), or Management Services Organizations (MSO) (also may be referred to as
an Administrative Service Organization (ASO)) to operate and manage an Administrative
Services Organization. This is for the Healthy Partners Program but may include additional
health services at a later date.
This agreement for the Healthy Partners Program will manage a $2,000,000 program that
provides limited scope specialty medical care for approximately 4,000 lives, the organization will
receive an administrative fee for an approximated minimum of 4,000 claims processed annually.
Scope of Work Overview:
1. Manage and administer the Healthy Partners Program:
a. Development and management of a network of Participating Providers under
contract including front-line Provider Relations to support provider engagement,
onboarding, and issue resolution.
b. Healthcare claims administration.
c. Claims processing and verification.
2. Healthcare service consultation:
a. Provide subject matter expertise and consultation for healthcare services for low-
income adults.
b. Advise regarding usual and customary medical provider reimbursement rates.
3. Specialist claim adjudication and payment:
a. If necessary, perform as fiscal intermediary on behalf of the County of
Sacramento.
b. Maintain an electronic, HIPAA compliant portal for providers’ submission of claims.
c. Receive and adjudicate specialty electronic and paper claims according to
generally accepted medical claiming guidelines for government payors.
d. Print checks or Electronic Fund Transfers (EFT) to compensate and/or reimburse
contracted providers for medical services rendered.
e. Include appeals and exception management processes, and escalate unresolved
issues to the County as appropriate.
4. Electronic benefits management system:
a. Provide and maintain an electronic benefits management system that is consistent
with healthcare and managed care industry standards and is HIPAA and HI-TECH
Act compliant.
5. Contract and Network Development:
a. Develop and maintain a provider network for diagnostic and specialty care services
for the Healthy Partners Program.
b. Secure provider contracts or undertake securing the execution of contracts with
each specialty provider to serve Healthy Partners members.
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SACRAMENTO COUNTY
DEPARTMENT OF HEALTH SERVICES
PRIMARY HEALTH SERVICES DIVISION
REQUEST FOR LETTERS OF INTEREST (LOI) #PRI/037
MANAGEMENT SERVICES ORGANIZATION / ADMINISTRATIVE SERVICES
ORGANIZATION
RELEASE DATE: DECEMBER 12, 2025
6. Authorization/referral software:
a. Create and maintain an electronic authorization/referral system that is consistent
with healthcare and managed care industry standards and is HIPAA and HI-TECH
Act compliant.
7. Care Coordination:
a. Manage referrals and provide care coordination services.
8. Ongoing Reporting:
a. Provide regular reporting to the County on program performance, claims activity,
provider network status, appeals and exceptions, and other key operational
metrics as requested.
Minimum Qualifications:
1. Possess a minimum of ten (10) years of experience managing a healthcare program
serving low-income or uninsured populations, with subject matter expertise in healthcare
services for these populations in Sacramento County and/or surrounding areas.
2. Possess a minimum of ten (10) years of experience in healthcare claims processing and
verification, including adjudication of specialty claims, in compliance with HIPAA and
government payor standards.
3. Currently maintains and manages an electronic benefits management system that
complies with HIPAA and the HI-TECH Act and aligns with healthcare and managed care
industry standards.
4. Currently maintains and manages an electronic authorization/referral system consistent
with managed care industry standards and is compliant with HIPAA and the HI-TECH Act.
5. Ability to process payments (via checks or EFT) to compensate and/or reimburse
contracted providers for medical services rendered, including appeals and exception
management.
6. Have the capacity to add or alter MSO or ASO services as needed by the County.
7. Ability to receive and adjudicate specialty electronic and paper claims according to
generally accepted medical claiming guidelines for government payors and maintain a
HIPAA-compliant portal for provider submissions.
8. Currently maintain a wide network of diagnostic and specialty care providers to ensure
access to care and have the ability to secure additional contracts to serve Healthy
Partners members.
9. Be physically located within Sacramento County or have a designated regional
coordinator based within Sacramento County.
10. A minimum of ten (10) years of experience in managing referrals and providing care
coordination services for underserved or uninsured populations.
11. Will provide regular reporting to the County on program performance, claims activity,
provider network status, appeals, exceptions, and other key operational metrics.
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SACRAMENTO COUNTY
DEPARTMENT OF HEALTH SERVICES
PRIMARY HEALTH SERVICES DIVISION
REQUEST FOR LETTERS OF INTEREST (LOI) #PRI/037
MANAGEMENT SERVICES ORGANIZATION / ADMINISTRATIVE SERVICES
ORGANIZATION
RELEASE DATE: DECEMBER 12, 2025
Instructions:
1. LOI documents must be submitted in accordance with all the instructions in this notice.
2. Fully complete and submit the LOI Form below.
3. The LOI must be submitted on the required form, at the end of this document.
4. The completed LOI must be submitted via email to the Primary Health Division no later
than 5:00 PM PST on December 29, 2025, to:
Bryan Buonocore, Administrative Services Officer
buonocoreb@saccounty.gov
5. The following will not be accepted:
a. Responses submitted to any other email address than the one listed above.
b. Faxed, mailed or hand-delivered submissions will not be accepted.
c. Submissions received after 5:00 PM PST on December 29, 2025.
d. Incomplete LOI submissions.
e. LOI not demonstrating that the minimum requirements are met.
The County of Sacramento reserves the right to:
1. Reject any or all responses to this request for LOI if the respondents do not meet the
submission criteria.
2. Cancel this LOI or any part of it.
3. If cancelled, reissue this LOI.
4. Select one or more organizations.
5. Determine the amount of resources allocated to respondent(s).
6. Issue a Request for Proposals (RFP) if there is more than one qualified respondent.
7. Only those organizations that have successfully responded to this request for LOI will be
considered eligible to participate in a future RFP process if necessary.
8. If issued, this LOI Public Notice will be the only advertisement for the RFP.
9. The LOI is non-binding.
3
SACRAMENTO COUNTY
DEPARTMENT OF HEALTH SERVICES
PRIMARY HEALTH SERVICES DIVISION
REQUEST FOR LETTERS OF INTEREST (LOI) #PRI/037
MANAGEMENT SERVICES ORGANIZATION / ADMINISTRATIVE SERVICES
ORGANIZATION
RELEASE DATE: DECEMBER 12, 2025
IMPORTANT:
Letter of Interest Form must be submitted in accordance with all instructions.
LETTER OF INTEREST (LOI)
#PRI/037
Management Services Organization / Administrative Services Organization
Legal Entity Name
Name of authorized
contracting official and title
Address
Telephone
Email Address
Primary Contact Information (if different from above)
Contact Person/title
Address
Telephone
Email Address
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SACRAMENTO COUNTY
DEPARTMENT OF HEALTH SERVICES
PRIMARY HEALTH SERVICES DIVISION
REQUEST FOR LETTERS OF INTEREST (LOI) #PRI/037
MANAGEMENT SERVICES ORGANIZATION / ADMINISTRATIVE SERVICES
ORGANIZATION
RELEASE DATE: DECEMBER 12, 2025
Please indicate whether your agency meets each of the following minimum qualifications:
MINIMUIM QUALIFICATIONS FOR LOI #PRI/037
1. Your agency has a minimum of ten (10) years of experience
managing a healthcare program serving low-income or uninsured
populations, with subject matter expertise in healthcare services for
these populations in Sacramento County and/or surrounding areas.
2. Your agency has a minimum of ten (10) years of experience in
healthcare claims processing and verification, including adjudication
of specialty claims, in compliance with HIPAA and government
payor standards.
3. Your agency currently manages and maintains an electronic
benefits management system that complies with HIPAA and the HI-
TECH Act, and aligns with healthcare and managed care industry
standards.
4. Your agency currently manages and maintains an electronic
authorization/referral system consistent with managed care industry
standards and compliant with HIPAA and the HI-TECH Act.
5. Your agency can process payments (via checks or EFT) to
compensate and/or reimburse contracted providers for medical
services rendered, including appeals and exception management.
6. Your agency has the capacity to add or alter Management Services
Organization (MSO) or Administrative Services Organization (ASO)
services as needed by the County.
7. Your agency can receive and adjudicate specialty electronic and
paper claims according to generally accepted medical claiming
guidelines for government payors and maintain a HIPAA-compliant
portal for provider submissions.
8. Your agency currently maintains wide network of diagnostic and
specialty care providers to ensure access to care and have the
ability to secure additional contracts to serve Healthy Partners
members.
9. Your agency is located within Sacramento County or have a
designated regional coordinator based within Sacramento County.
10. Your agency has a minimum of ten (10) years of experience in
managing referrals and providing care coordination services for
underserved or uninsured populations.
11. Your agency can provide regular reporting to the County on
program performance, claims activity, provider network status,
appeals, exceptions, and other key operational metrics.
Yes ☐
Yes ☐
Yes ☐
Yes ☐
Yes ☐
Yes ☐
Yes ☐
Yes ☐
Yes ☐
Yes ☐
Yes ☐
No ☐
No ☐
No ☐
No ☐
No ☐
No ☐
No ☐
No ☐
No ☐
No ☐
No ☐
5
This page summarizes the opportunity, including an overview and a preview of the attached documents.
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