Active SLED Opportunity · CALIFORNIA · INLAND EMPIRE HEALTH PLAN

    25-06803 - Clinical Review Services

    Issued by Inland Empire Health Plan
    localRFPInland Empire Health PlanSol. 231342
    Open · 34d remaining
    DAYS TO CLOSE
    34
    due May 27, 2026
    PUBLISHED
    Invalid Date
    Posting date
    JURISDICTION
    Inland Empire
    local
    NAICS CODE
    621111
    AI-classified industry

    AI Summary

    Inland Empire Health Plan seeks a vendor for Clinical Review Services to meet regulatory turnaround times for physician-level review of prior authorizations, grievances, and potential quality incidents. The opportunity includes physician credentialing and quality assurance review services. Deadline for submissions is May 27, 2026.

    Opportunity details

    Solicitation No.
    231342
    Type / RFx
    RFP
    Status
    Open
    Level
    local
    Published Date
    Invalid Date
    Due Date
    May 27, 2026
    NAICS Code
    621111AI guide
    Agency
    Inland Empire Health Plan

    Description

    The primary objective of contracting with a vendor for Clinical Review Services is to ensure that IEHP meets regulatory turnaround times for physician level review of prior authorizations, grievances, and potential quality incidents (PQIs).

    Commodity Codes

    • Commodity Codes: NIGP 91878 Medical Consulting NIGP 92065 System Requirements Quality Assurance Review NIGP 94871 Physician Credentialing Services NIGP 94874 Professional Medical Services: Physicians, Pharmacists, and All Specialties

    Events & Timeline

    StatusEvent NameLocationDescriptionDatesMandatory
    OngoingOpen DateOnline PortalPosting date for the OpportunityApr 15th 2026, 4:30 PM PDTN/A
    UpcomingQuestions Due DateOnline PortalDeadline to submit QuestionsMay 1st 2026, 5:00 PM PDTN/A
    UpcomingClose DateOnline PortalDeadline for SubmissionsMay 27th 2026, 2:00 PM PDTN/A

    Requested Information

    Note: Template files for the items below (BidTables, Questionnaires) are available in the Attachments section of this opportunity.

    NameType# FilesRequirementInstructionsActions
    Principal Certification Binding Bidder's Response (Must complete IEHP-provided document)File Type: PDF (.pdf)MultipleRequired
    Certification of Non-Debarment (Must complete IEHP-provided document)File Type: PDF (.pdf)MultipleRequired
    Non-Collusion Declaration (must submit IEHP-provided document)File Type: PDF (.pdf)MultipleRequired
    Local Preference Affidavit (Must submit IEHP-provided document)File Type: PDF (.pdf)MultipleOptional
    Contractor's Certificate Regarding Workers CompensationFile Type: PDF (.pdf)MultipleRequired
    Acknowledgment of Non-Negotiable Contract Terms (IEHP-Provided form)File Type: PDF (.pdf)MultipleRequired
    Company W-9 Form Listing Company's TINFile Type: Any (.*)MultipleRequired
    Evidence of Insurability (ACORD Certificate of Insurance)File Type: PDF (.pdf)MultipleRequired
    Business License(s)File Type: PDF (.pdf)MultipleRequired
    Proof of Registration: Documentation verifying corporate registration with the California Secretary of State or if not a corporation, proof of tax registration with the California Franchise Tax Board.File Type: PDF (.pdf)MultipleRequired
    Company Hierarchy (President, Vice President, Company Officers, etc.) and an organizational chart. The organizational chart shall clearly identify all staff members that will provide services under this contract.File Type: Any (.*)MultipleRequired
    Credentials/Certifications/LicensesFile Type: PDF (.pdf)MultipleRequired
    Account Management NarrativeFile Type: PDF (.pdf)MultipleRequired
    List of three (3) contracts of similar value awarded to your company in the past three (3) years. Include the year, type of services, dollar amounts, services provided, location, contracting company, contact name, and phone number.File Type: Any (.*)MultipleRequired
    Policy and Procedures document detailing Bidder’s background checking procedures and the name of any external company utilized to perform this service.File Type: PDF (.pdf)MultipleRequired
    Pricing NarrativeFile Type: PDF (.pdf)MultipleRequired
    Redacted Pricing NarrativeFile Type: PDF (.pdf)MultipleRequired
    Financial StatementsFile Type: Any (.*)MultipleRequired
    IEHP Security Risk AssessmentFile Type: Any (.*)MultipleRequired
    Data Sharing AssessmentFile Type: Any (.*)MultipleRequired
    Bidder’s Security DocumentsFile Type: Any (.*)MultipleRequired
    Annual Report for publicly traded companies, or if privately held, details of financial stability.File Type: PDF (.pdf)MultipleRequired
    Bidder’s Standard Agreement Template, including detailed pricing and Scope of Work (for consideration). If not available, include a detailed proposal on Bidder’s letterhead including detailed pricing and Scope of Work (for consideration).File Type: Word (.doc, .docx)MultipleRequired
    Workflow of Credentialing ProcessFile Type: Any (.*)MultipleRequired
    Credentialing Documentation of Physicians providing services to IEHPFile Type: Any (.*)MultipleRequired
    Bidder AttachmentsFile Type: Any (.*)MultipleOptional
    References (Q-25PZ)Questionnaire: Excel (.xlsx)1RequiredYou will need to fill out the provided Response Template for this Questionnaire.Download
    Bidder Cost Proposal (BT-37LS)BidTable: Excel (.xlsx)1RequiredYou will need to fill out the provided Response Template for this BidTable.Download
    Company Profile and Evaluation Criteria (Q-67OZ)Questionnaire: Excel (.xlsx)1RequiredYou will need to fill out the provided Response Template for this Questionnaire.Download
    Bidder's DUNS NumberData Type: NumberN/ARequired
    IEHP is a public agency with a Board of Directors composed of elected officials and public members. The elected officials are restricted from voting on any action concerning a contract whose owners have made a campaign contribution of $250 or more in the previous 12 months. To assist them in their decision-making process, please indicate the owners of the company, and if any contributions were made to the Elected Officials.Data Type: TextN/ARequired
    Bidders must certify that it or any of its subcontractors do not appear on State and Federal exclusionary listsData Type: True/FalseN/ARequired
    Scope of Services - Bidder Response Questions (Q-27FT)Questionnaire: Excel (.xlsx)1RequiredYou will need to fill out the provided Response Template for this Questionnaire.Download

    Attachments

    Key dates

    1. Invalid DatePublished
    2. May 27, 2026Responses Due

    AI classification tags

    Frequently asked questions

    SLED stands for State, Local, and Education. These are solicitations issued by state governments, counties, cities, school districts, utilities, and higher education institutions — as opposed to federal agencies.

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