Maryland Department of Health

Buyer seeks a contractor to administer provider enrollment, revalidation, reenrollment, and update activities for the Maryland Medicaid Program. The contractor will process applications, operate a call center, verify provider credentials, and train providers on system usage. Services include managing approximately 22,000 new enrollments, 70,000 application updates, and 30,000 revalidations annually. The contractor must maintain staffing to handle an estimated monthly call volume of 4,000 calls while meeting all federal and state regulations.

• 5/6/2025 - RFP Issue Date
• 5/13/2025 - Pre-Proposal Conference
• 6/12/2025 - Questions Due
• 6/23/2025 - Proposal Due Date

• 5 consecutive years operating multilevel healthcare call center with 3,500+ monthly calls
• 3 consecutive years enrolling providers for insurance plan covering 750,000+ individuals
• 3+ years as prime contractor operating Medicaid provider enrollment activities
• 3+ years experience in provider management, credentialing, and maintenance

• Process new Provider Enrollment applications
• Process Revalidation applications for active providers
• Process Update applications for active providers
• Operate Maryland Provider Enrollment and Revalidation Call Center
• Train providers on Enrollment system usage
• Prepare and implement contingency plans for staffing
• Develop succession plans for key operational areas
• Monitor and respond to application processing SLAs
• Verify provider credentials and licensing information
• Implement HIPAA-compliant security protocols for sensitive data