Department of DefenseIssuing agency·Rosslyn, VA·via the SAM.gov Get Opportunities APIWe post new it & software opportunities in Virginia as agencies publish them. Get them in one email — free, and unsubscribe whenever.
Request for Solutions (RFS): Autonomous Coding (AC) and Automated Appeals & Denials Management (ADM)
Opportunity Overview
The Defense Healthcare Management Systems Modernization (DHMSM) Program Management Office (PMO), in conjunction with the Defense Healthcare Management Systems Program Executive Office (DHMS PEO) is seeking innovative, Artificial Intelligence and Machine Learning (AI/ML) enabled solutions to enhance healthcare delivery and strengthen financial recovery operations across the Military Health System (MHS).
Pursuant to 10 U.S.C. § 4022, the Government intends to award one or more prototype Other Transaction Agreements (OTAs) through this competitive Request for Solutions (RFS) process.
Under this RFS, the DHMSM PMO is seeking solutions for two distinct capability areas. Industry partners may submit a solution for either capability individually or for both capabilities:
Capability 1: Autonomous Coding (AC) – A solution that uses advanced, human-like AI/ML computational processes to assign medical billing codes from clinical documentation without human intervention, while maintaining full auditability and explainability.
Capability 2: Automated Appeals & Denials Management (ADM) – A phased, automated solution designed to address backlogged aged Accounts Receivable (A/R), improve first-pass claim success, accelerate documentation release, and automate the generation and submission of appeals to third-party payers.
Important Instructions for Interested Parties
Interested parties are strongly encouraged to review the attached documents in their entirety for complete details regarding this opportunity, including submission requirements and other specific instructions.
The contractor must provide a solution for Autonomous Coding (AC) that uses advanced AI/ML computational processes to assign medical billing codes (ICD-10, CPT, HCPCS) from clinical documentation without human intervention, with full auditability and explainability, across outpatient, inpatient, and ancillary environments. For Automated Appeals & Denials Management (ADM), the contractor must provide a phased, automated solution to address backlogged aged Accounts Receivable (A/R), improve first-pass claim success, accelerate documentation release, and automate the generation and submission of appeals to third-party payers. The solution shall not autonomously write off, adjust, or otherwise financially dispose of any claim; all financial dispositions shall require human approval; and every automated action shall carry a complete, FFMIA-aligned audit trail. The project will be executed via a two-capability, milestone-driven structure with four milestones: Onboarding & Cybersecurity, Testing in Pre-Production Environment, Authority to Operate Approval, and Full Integration with MHS GENESIS in Production Environment.
"22209""ROSSLYN""VA""USA""DEF HC MGT SYS CONTRACT DIV DHMS-CD""1700 NORTH MOORE STREET, SUITE 2300""Request for Solution ACADM.pdf"222760"file"".pdf""1""2026-08-05T19:51:18.202+00:00""b6844979abcd4017bb578d76c99602c8""public""0""public""6a8de22b01494d178672d36aaa8806e7""0"3"0""Draft SOO ACADM.pdf"318831"file"".pdf""1""2026-08-05T19:51:18.202+00:00""efdd6863d9544a0d9759777fcfcb8938""public""0""public""d65d2c6e31fe427a813f20189caafb0e""0"2"0"Source: SAM.gov (notice 0b3185c8044941b1a91f6c6b9e3f0230), retrieved via the SAM.gov Get Opportunities API. View the official posting , always confirm requirements and deadlines with the issuing agency.