Insurance Medical Claims

Background
The Cabinet for Health and Family Services (CHFS) is seeking a Vendor to provide Insurance Medical Claims (IMC) services. The goal of this contract is to perform claim processing and eligibility inquiry services for Medicaid Managed Care Organizations (MCOs) contracted with CHFS, as well as private third-party insurance carriers.

The Vendor is expected to deliver a cloud-hosted, configurable Software as a Service (SaaS) solution that complies with HIPAA regulations.

Work Details
The Vendor will be responsible for the following minimum contract deliverables:

1. Planning Phase (5% payment):
- Initial Project Assessment
- Project Work Plan
- Communications Management Plan
- Risk and Issue Management Plan
- Change Management Plan
- Release Management Plan

2. Requirement/Design/Build/Configuration Phase (5% payment):
- Design Document and Requirements Traceability Matrix
- Security Plan and Privacy Impact Assessment
- System Capacity Plan
- Configuration Management Plan
- Operations Procedures Solution

3. Testing Phase (10% payment):
- Test Management Plan
- Integration/System Test Results
- User Acceptance Testing Results
- Performance Test Results

4. Data Conversion Phase (20% payment):
- Data Migration/Conversion Plan
- Migration/Conversion Test Results

5. Training Phase (20% payment):
- End-User Training Plan
- Training Materials
- System Operations Manual

6. Implementation Phase (25% payment):
- Implementation Plan
- Disaster Recovery and Business Continuity Plan

7. Operations and Maintenance Phase (15% payment):
- Operational Readiness Report
- Operations and Maintenance Plan
- Final Updated Design Document.

Period of Performance
The contract will be performed over a series of phases, with specific deliverables due at various intervals based on the completion of each phase, typically within business days from the contract effective date or design approval.

Place of Performance
The services will be performed in compliance with the requirements set forth by CHFS, ensuring that all data resides within the continental United States.