AHCCCS Medicaid School-Based Claiming Third Party Administrator RFP YH27-0002 - 2026
Arizona Health Care Cost Containment System (AHCCCS) | State of ArizonaState · Phoenix, AZ- Due
- Oct 20, 2026
- Deadline passed
- Posted
- Sep 4, 2026
- Contract term
- 3 years
- Primary contact
- Cynthia Smolens
- (555) 555-5555
The 30-second brief
The Arizona Health Care Cost Containment System (AHCCCS) is soliciting proposals from qualified organizations with third party administration experience to act as a third party administrator for the Medicaid School-Based Claiming (MSBC) program. The work encompasses program promotion and contracting, education, training, technical assistance, program handbook production, claim disputes management, compliance reviews, and pre-payment review processes. The contractor will manage claims processing and reimbursement for both the Direct Service Claiming (DSC) and Medicaid Administrative Claiming (MAC) programs, conduct Random Moment Time Studies (RMTS), and handle cost-based reconciliation and reporting for participating Local Education Agencies (LEAs) statewide across Arizona. The submission deadline for proposals is October 20, 2026, at 3:00 PM Arizona Time, with questions due by September 24, 2026, and an intent to bid due by October 15, 2026. The initial contract term is for three years with two one-year options to extend.
Third party administration services, Claims processing, Direct Service Claiming (DSC) program administration, Medicaid Administrative Claiming (MAC) program administration, Training and technical assistance, Random Moment Time Studies (RMTS), Cost-based reimbursement methodology and reconciliation, Compliance reviews
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Summary
The Arizona Health Care Cost Containment System (AHCCCS) is soliciting proposals from qualified organizations with third party administration experience to act as a third party administrator for the Medicaid School-Based Claiming (MSBC) program.
The work encompasses program promotion and contracting, education, training, technical assistance, program handbook production, claim disputes management, compliance reviews, and pre-payment review processes. The contractor will manage claims processing and reimbursement for both the Direct Service Claiming (DSC) and Medicaid Administrative Claiming (MAC) programs, conduct Random Moment Time Studies (RMTS), and handle cost-based reconciliation and reporting for participating Local Education Agencies (LEAs) statewide across Arizona. The submission deadline for proposals is October 20, 2026, at 3:00 PM Arizona Time, with questions due by September 24, 2026, and an intent to bid due by October 15, 2026. The initial contract term is for three years with two one-year options to extend.
REQUIRED DELIVERABLES
8- Third party administration services
- Claims processing
- Direct Service Claiming (DSC) program administration
- Medicaid Administrative Claiming (MAC) program administration
- Training and technical assistance
- Random Moment Time Studies (RMTS)
- Cost-based reimbursement methodology and reconciliation
- Compliance reviews
REQUIRED ATTACHMENTS
4- Attachment 1 – Intent to Bid
- Attachment 2 – Offer and Acceptance Page
- Attachment 3 – Pricing Proposal
- Attachment 4 – Questionnaire
- Submit to
- https://www.azahcccs.gov/Resources/OversightOfHealthPlans/SolicitationsAndContracts/open.html
- Duration
- 60 months
- Scope location
- Phoenix, AZ
- Reported agency
- Arizona Health Care Cost Containment System
Questions about this RFP
How do I respond to this RFP from Arizona Health Care Cost Containment System (AHCCCS) | State of Arizona?
Review the full solicitation document for submission requirements, evaluation criteria, and deadlines. The submission deadline is October 20, 2026. The solicitation specifies required deliverables that must be addressed in your response. Be sure to include all required attachments as outlined in the solicitation. Submissions should be delivered to: https://www.azahcccs.gov/Resources/OversightOfHealthPlans/SolicitationsAndContracts/open.html. For questions, contact Cynthia Smolens.
Can small businesses or minority-owned firms bid on this RFP?
Most government agencies, including Arizona Health Care Cost Containment System (AHCCCS) | State of Arizona in AZ, encourage participation from small businesses, minority-owned, women-owned, and disadvantaged business enterprises (MBE/WBE/DBE). Check the full solicitation for any small business participation goals.
What happens after the RFP submission deadline?
After the deadline, the issuing agency reviews all submissions against the stated evaluation criteria. This typically includes a compliance check, technical evaluation, cost analysis, and may involve oral presentations with shortlisted vendors.
Can I ask questions about this solicitation before submitting?
Yes, most solicitations allow vendors to submit questions during a designated period. The primary contact is Cynthia Smolens at (555) 555-5555. Questions and answers are typically shared with all prospective bidders.
What are the key deliverables?
The solicitation specifies the following deliverables: Third party administration services, Claims processing, Direct Service Claiming (DSC) program administration, Medicaid Administrative Claiming (MAC) program administration, Training and technical assistance, Random Moment Time Studies (RMTS), Cost-based reimbursement methodology and reconciliation,. Proposals should clearly address how each deliverable will be met.
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Where can I find more RFPs from Arizona Health Care Cost Containment System (AHCCCS) | State of Arizona?
All active and historical solicitations from Arizona Health Care Cost Containment System (AHCCCS) | State of Arizona are tracked and searchable. As a state agency, Arizona Health Care Cost Containment System (AHCCCS) | State of Arizona regularly publishes solicitations. Visit the agency profile to see current open bids, past contracts, vendor relationships, and decision-maker contacts.
What is the contract term for this solicitation?
The anticipated contract term is 3 years. Contract terms may include renewal options.
What documents are required to bid on this RFP?
Requirements vary by solicitation, but common documents include a technical proposal, cost/price proposal, proof of insurance, relevant certifications, past performance references, and any forms specified in the solicitation. This solicitation specifically requires the following attachments: Attachment 1 – Intent to Bid, Attachment 2 – Offer and Acceptance Page, Attachment 3 – Pricing Proposal, Attachment 4 – Questionnaire. Review the full document from Arizona Health Care Cost Containment System (AHCCCS) | State of Arizona for the complete list.
What is the scope of this project?
This solicitation defines a specific project scope. The scope covers the following locations: Phoenix, AZ. Review the full solicitation for detailed scope requirements.