Healthcare Revenue Cycle Management

Background
Western Washington University (WWU) is a state-funded, four-year institution of higher education in Washington state. The university operates on a September-to-June academic year and aims to support the health and wellbeing of its college student population through its Student Health Center (SHC). WWU is seeking to contract with a Healthcare Revenue Cycle Management provider to implement health insurance billing, beginning in January 2026. This will be a new contracted service for WWU, with an anticipated spend ranging from $80,000 to $265,000 per fiscal year.

Work Details
The contractor will provide comprehensive Healthcare Revenue Cycle Management (RCM) services, including:

1. Pre-Authorization and Utilization Review: Obtaining necessary approvals for procedures and services.

2. Charge Capture and Coding: Ensuring all services are captured and coded accurately, identifying unbilled claims.

3. Claim Submission and Processing: Timely submission of insurance claims and follow-up on denials.

4. Accounts Receivable (A/R) Management: Payment processing for patients and insurance, tracking unpaid claims, and improving A/R metrics.

5. Denial Management: Investigating claim denials for timely reimbursement.

6. Reconciliation and Reporting: Working within the Point and Click system for revenue cycle analysis and KPI monitoring.

7. Consultation and Training: Assisting providers with procedure code assignments and ongoing training.

Period of Performance
The initial contract term will be up to three years, starting from October 15, 2025, with the possibility of extending for an additional three years or longer at WWU’s discretion.

Place of Performance
Services will be performed at Western Washington University’s campus in Bellingham, Washington.

Bidder Requirements
Respondents must have at least five years of experience in RCM services. Preference will be given to those with experience providing RCM services to higher education institutions or government organizations in Washington state, as well as familiarity with the Point and Click Electronic Medical Record system.