Payer Compliance Tool (PCT) for Community Care Claims

New

Dept. of VA

Location

NJ (Eatontown)

Posted

Aug. 15

Deadline

Aug. 18 Ending soon

Source & Summary

Summary

The VA is seeking vendor input on a software-as-a-service (SaaS) solution for a national Payer Compliance Tool (PCT) to support pre- and post-payment integrity across 837I, 837P, and 837D claims. The system must integrate with VA and external data sources, automate compliance rule checks (e.g., CMS, MAC, VA Fee Schedules), support predictive analytics, and generate auditable insights for FWA detection and claim oversight. The RFI also explores integration capabilities, user training models, dashboards, alerting mechanisms, and security standards. 
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Due: August 18, 2025

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