Request for Solutions (RFS): Autonomous Coding (AC) and Automated Appeals & Denials Management (ADM)

August 21, 2026: Responses to submitted questions are now available in the attached document, 'ACADM Phase 1 QA 082126'. This document also specifies which questions will receive responses at a later date.

August 17, 2026: Revision 2, RFS has been extended to 8/28/2026 to allow the government additional time to respond to questions. Question period has not been extended.

August 5, 2025: Revision 1, to correct the SAM.gov solicitation close date to 8/19/2026

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...