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County to seek sole‑source waiver to expand Epic health record billing module for Medicaid reimbursement
Summary
Clallam County staff asked the board to approve a waiver of competitive bidding and a letter of intent so the county can expand its existing Epic electronic health record to include a billing module needed for Medicaid claims processing; staff said a prompt letter is required to get in the vendor's build queue.
County Health and Human Services requested a waiver of competitive bidding and authorization to submit a letter of intent to Tegria (Epic manager) so the county can expand its existing Epic electronic health record with a billing module needed to begin Medicaid billing for program services.
Staff said the county currently uses Epic for records but not for billing. The vendor quote for the expansion was initially under $50,000 but staff warned an IT scope review indicated the total cost will likely exceed that threshold. HHS reported it has $80,000 budgeted from the Health Care Authority grant, not counting juvenile services' planned module expansion.
Why it matters: using an integrated Epic billing module is intended to let the county bill Medicaid and other payers for eligible services and to avoid being placed in Tegria's build queue beyond the current year. Staff said missing the June 1 letter of intent would delay build work into the following year and prolong the county's inability to bill for services already being provided.
Board members indicated support for a sole‑source waiver and the letter of intent; staff will prepare the formal waiver and related documents for the board to sign. HHS staff said they will continue to evaluate whether to maintain specialized behavioral‑health records (ReliaTrax) in parallel or convert behavioral health workflows into Epic while protecting privacy and avoiding duplicate entry.
