Request for Proposals Hospital & Clinic Billing and Revenue Cycle Management Services

Summary

Rural Health Enterprise (RHE), in collaboration with 24 rural hospitals in Washington, is soliciting proposals from qualified vendors to provide comprehensive hospital and clinic billing and revenue cycle management (RCM) services. The selected partner will work closely with hospital finance teams and RHE, aiming to improve billing accuracy, optimize reimbursement, enhance regulatory compliance, and support financial performance for rural hospitals. Services may include patient access/front-end, medical coding, claims management, follow-up, denial management, payment posting, data reconciliation, reporting, and performance analytics. RHE emphasizes transparent and scalable solutions, requiring vendors to present detailed and separate pricing (including performance-based incentives and penalties), sample reports, clear SLAs and performance guarantees, and a robust implementation/transition plan. Vendors should demonstrate experience with Critical Access Hospitals (CAH) and Rural Health Clinics (RHC), especially in Washington State. Collaboration under a master services agreement and hospital data-based pricing is expected.

Eligibility

Qualified and experienced vendors with specific and demonstrable experience providing comprehensive hospital and/or clinic billing and RCM services, particularly to Critical Access Hospitals (CAH) and Rural Health Clinics (RHC) in Washington State. Minimum three CAH client references required.

Requirements Checklist

• Provide company overview and organizational financial stability; demonstrate experience with CAH and RHC clients, listing at least three references; describe technology capabilities and compliance with healthcare security standards (including HIPAA BAA); detail staffing model and support procedures; submit a comprehensive implementation and transition plan; provide a transparent pricing proposal for required and optional services using supplied hospital data workbooks; include clearly defined SLAs, performance guarantees, and reporting mechanisms aligned with stated metrics; attach sample reports. All proposals must indicate acceptance of terms outlined in the RFP and willingness to execute RHE’s master services agreement.