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Payment Integrity Second Pass Retrospective Data Mining RFP


L.A. Care is issuing this Request for Proposals (“RFP”) to solicit proposals for providing Payment Integrity Second Pass Retrospective Data Mining.

Interested Bidders may submit a proposal (“Proposal”) containing the information requested in this RFP. L.A. Care will select one Bidder to be contracted at L.A. Care's discretion to perform the required services. The Bidder will provide services as set forth in Appendix A (Master Services Agreement) and Exhibit A-1 (Statement of Work) pursuant to a contract to be entered into with L.A. Care. L.A. Care is under no obligation to order any work pursuant to this RFP.


The following terms and conditions apply to the submission of proposals.

2.1 Letter of Intent and W-9

The Letter of Intent (“LOI”) and W-9 form are required prior to submission of an RFP response, along with questions using the Appendix F, Q&A template provided. The LOI, W-9 and Appendix F (Questions – if any) must be submitted to L.A. Care Health Plan no later than 5:00 pm PST on March 6, 2020.
Please submit the signed LOI and W-9, and Appendix F (Questions) via e-mail to:

Attention: Procurement Department
Email Address: RFP@lacare.org

Letter of Intent must contain the following:

  • Name of the vendor, address, and phone number
  • Name, address, phone and fax number, and e-mail address of the person responsible/contact for the RFP response
  • Brief description of the qualifications and experience of the vendor.
  • The LOI may be in the form of an email as well as an attached letter.

W-9 must contain the following:

  • Attach a copy of your Company’s W-9. The W-9 must be signed within the last 12 months.

Questions about this RFP. Bidders may submit written questions regarding this RFP by email to RFP@lacare.org. All questions must be received by 5:00 pm PST on March 13, 2020. All questions, without identifying the submitting company, may be compiled with the appropriate answers and released to participating Bidders in accordance with the schedule below.

When submitting questions please use the form provided, “Appendix F, Questions and Answers” and specify the RFP section or document section number, paragraph number, and page number, and quote the language that prompted the question. This will ensure that the subject of the question can be quickly found in the RFP. L.A. Care reserves the right to group similar questions when providing answers.

2.2 Proposal timetable. The timetable for this RFP is as follows:

Activity Date

Release of Request For Proposal


Letter of Intent (LOI), W-9, and Written Questions Due


Questions and Answers Released


RFP Proposals Due by 5:00 pm PDT (No Exceptions)


Semi - Finalist Selections


Semi - Finalist Presentations* 05/11//2020  – 05/15/2020

Finalist Selected


*NOTE: Please keep the following dates available on your calendar for potential on-site presentations, if selected as a semi-finalist: May 11 through May 15, 2020. 

Preparation and submission of a Proposal by interested Bidders will be at no cost or obligation to L.A. Care. L.A. Care reserves the right to terminate its efforts to contract for said services without obligation. Proposals and other materials submitted will become the property of L.A. Care and will not be returned. Your proposal must not be marked proprietary or confidential. Please note that L.A. Care is subject to the California Public Records Act.

2.3 Submission of proposals. 

Proposals shall be submitted to L.A. Care, as follows. 
An electronic copy** shall be submitted to:

**NOTE: Please do not email your proposal in a 3rd party secured email requiring separate log-in or sign-in. Please email proposal documents in one or more email attachments (as may be required due to file sizes) directly to RFP@lacare.org.

Each RFP document must be kept as separate documents/files with your RFP response. Do not combine forms/documents into one single pdf.

A complete version of the RFP is available as a PDF document under Resources.