DDS RFI 25-70008 Medicare Part D Claims Services

Background
The Department of Developmental Services (DDS) is seeking to identify solution alternatives to replace the existing drug claims billing solution. This initiative aims to enhance the efficiency and effectiveness of Medicare Part D claims processing, ensuring better service delivery for beneficiaries.

Work Details
The contractor will be responsible for implementing a new drug claims billing solution that adheres to the NCPDP Telecommunication Standard Format. This includes:
- Ensuring consistent implementation of the standard across all transactions.
- Providing detailed guidelines for eligibility verification, including Medicare Part D eligibility transactions between pharmacies and facilitators.
- Developing and maintaining transaction segments such as Transaction Header, Insurance Segment, Patient Segment, Pharmacy Provider Segment, and Prescriber Segment.
- Facilitating claim billing or encounter information processing, including various response segments for accepted or rejected transactions.

Period of Performance
The contract will be performed over a period extending until November 20, 2025.

Place of Performance
The services will be performed at locations specified by the Department of Developmental Services, potentially including various healthcare facilities and pharmacies across the state.

Bidder Requirements
Bidders must demonstrate compliance with relevant federal and state regulations regarding confidentiality and proprietary information. They should also have experience in implementing healthcare billing solutions that align with NCPDP standards.