PEO DHMS - CSO, Area of Opportunity (AOI) 6 - Autonomous Coding & Denials Mgmt
Overview
Buyer
Place of Performance
NAICS
PSC
Set Aside
Original Source
Timeline
Qualification Details
Fit reasons
- NAICS alignment with historical contract wins in similar service areas.
- Scope strongly matches core technical capabilities and delivery model.
Risks
- Past performance thresholds may require one additional teaming partner.
- Potential clarification needed on staffing minimums before bid/no-bid.
Next steps
Validate eligibility requirements, assign capture owner, and schedule partner outreach to confirm teaming strategy before submission planning.
Quick Summary
The Defense Health Agency (DHA), specifically the PEO DHMS, has issued a Commercial Solutions Opening (CSO) for Area of Interest (AOI) #6: Autonomous Coding & Denials Management Services. This initiative seeks prototype other transaction agreement(s) under 10 U.S.C. § 4022 to enhance medical billing efficiency and fund recovery. White papers are due by March 9, 2026, at 1:00 PM ET.
Scope of Work
The government is seeking solutions to address two key problem statements:
- Autonomous Coding Services: Utilize modern, human-like computational processes to assign medical billing codes (ICD-10, CPT, HCPCS) from clinical documentation with high accuracy and auditing capabilities.
- Automated Appeals & Denials Management Services: Automate the process of filing appeals to third-party payers, improve first-pass claim success, accelerate documentation release, and enhance the management of aged accounts receivable to reduce future denials and increase recoupment.
Solutions must ensure bi-directional interoperability with the MHS GENESIS EHR system (HL7 FHIR, HL7 v2.x) and comply with DoD Cybersecurity (RMF), FedRAMP (high level, IL5/IL6), CMMC 2.0, and HIPAA requirements. Existing commercially available solutions are preferred, with partial integration expected within 3 months and full integration within 12 months.
Contract Details
- Type: Prototype Other Transaction Agreement (OTA).
- Award Intent: Initial prototype agreement by March 31, 2026.
- Follow-on: Successful prototypes may lead to a production agreement and/or contract.
- Set-Aside: No specific set-aside is mentioned, though the document references "non-traditional defense contractor" and "non-profit research institution."
Submission & Evaluation
Interested companies must submit a white paper via email to Dominique Brown (dominique.u.brown.civ@health.mil) and Elizabeth Holten (elizabeth.l.holten.civ@health.mil). The white paper should be clearly titled "AOI #6." If the submission exceeds 25MB, notify the Government POCs by March 5, 2026, and request Bidscale access.
- White Paper Due: March 9, 2026, 1:00 PM ET.
- Bidscale Access Request (if applicable): March 5, 2026, 5:00 PM ET.
- Review: Rolling basis from March 2, 2026, to March 9, 2026.
- Evaluation Focus: Solutions that realistically meet regulatory, security, and cybersecurity requirements. Companies may be invited for Q&A sessions or live demonstrations.
Key Terms & Notes
- The "Government Rider" document outlines non-negotiable terms, including U.S. federal law as governing law, prohibition of unilateral vendor termination, and the government's non-indemnification policy.
- Comptroller General access is required for prototype OTs exceeding $5 million.
- Authorized users for software include the Defense Health Agency and MHS GENESIS partners for worldwide use.
- Offerors are encouraged to provide video demonstrations and collaborate with Leidos, the MHS GENESIS system integrator.
- The government will not pay for submission or demonstration costs.