Medi-Cal Billing Infrastructure Consultant

REQUEST FOR PROPOSALS
Issued: June 2026
Medi-Cal Billing Infrastructure Consultant
Compass Family Services, Compass Behavioral Health Services (CBHS)

The Opportunity
Compass Family Services is a nonprofit organization dedicated to assisting San Francisco families who are homeless or at-risk of homelessness to achieve housing stability, economic self-sufficiency, and overall well-being. One of our thirteen direct service programs, Compass Behavioral Health Services (CBHS), provides a range of behavioral health services, including short- and long-term therapy, individual, couples and family therapy, clinical consulting to frontline staff, therapeutic shadowing, counselor of the day support, children’s play therapy, and support groups. In Fall 2025, Compass received a four-year Hellman Foundation grant to build Medi-Cal billing infrastructure for CBHS. This is a strategic priority for Compass, as Medi-Cal reimbursement presents an opportunity to diversify revenue and create a stronger financial foundation for behavioral health services. Compass is seeking an experienced consultant to guide this infrastructure building process. We are seeking a partner with deep working knowledge of the California Medi-Cal behavioral health system, experience with community-based nonprofit providers, and the ability to work practically and collaboratively with an internal team new to Medi-Cal. This is an initial one-year opportunity with the possibility for continued partnership for an additional two years.

Scope of Work
The full project timeline spans three years. Compass will contract with a selected consultant for an initial Year 1 term. Ongoing partnership beyond Year 1 is contingent upon performance and project progress.

Year 1 (August 2026 – June 2027) — $30,000
The consultant's primary contribution in Year 1 is to conduct a series of analyses and produce key deliverables, including service billing feasibility, billing pathway comparison, and EHR system recommendations, that will directly inform three foundational decisions: A) which services to bill, B) whether to bill Medi-Cal directly or bill through a third-party, and C) which Electronic Health Record system (EHR) to select. Should Year 1 work be completed ahead of schedule, Compass has the option to move forward into Years 2 and 3 with an expedited implementation timeline.

Specific Year 1 deliverables include:

• Feasibility and revenue analysis. Working with our internal team, assess the Medi-Cal eligibility rate among current CBHS clients and map CBHS services to billable Medi-Cal benefit categories, CPT/HCPCS codes, license types, and applicable rates. Produce a revenue model with low, mid, and high scenarios that validates or revises our internal projection of $200,000 or more in first- year billing revenue.
• Billability analysis. Identify which CBHS services are billable under standard outpatient Medi-Cal codes, which require special structuring, and which are not billable. Advise on how non-billable services (e.g., therapeutic shadowing, Counselor of the Day, care coordination, support groups) should be handled in the context of a billing model.
• Billing Process Determination. Assess the financial, administrative, and logistical considerations involved in billing through a third-party entity as compared to billing Medi-Cal directly. Advise Compass on a billing pathway. Should Compass choose to contract a third-party billing partner, assess the landscape of potential partners in San Francisco, including Federally Qualified Health Centers (FQHCs), the county behavioral health department, and established Medi-Cal certified behavioral health providers.
• EHR advisory. Advise on EHR requirements from a Medi-Cal billing and compliance standpoint to inform our internal RFP and vendor evaluation process.
• Internal readiness input. Review findings from our internal readiness audit (covering clinical documentation practices, supervision structure, and license mix) and advise on the gaps most critical to address before billing begins.

Year 2 (July 2027 – June 2028) — $100,000
The consultant’s primary contribution in Year 2 is to help Compass build the infrastructure determined in Year 1.

Specific Year 2 deliverables include:

• Billing Setup. Should Compass choose to contract a third-party billing partner, participate in contract negotiation and advise Compass on the following considerations: administrative fee structures, data access rights, clinical autonomy, off-ramp terms, and IP ownership. Should
• Compass choose to bill Medi-Cal directly, advise on the specific certification pathway for direct Medi-Cal provider status, and on what is required for setup.
• Billing operations support. Advise on denial pattern analysis, documentation improvement, and workflow optimization as billing begins.
• Compliance infrastructure. Support development of billing compliance policies, utilization review processes, audit readiness procedures, and privacy protocols to Medi-Cal standards.

Year 3 (July 2028 – June 2029) — $50,000
The consultant’s primary contribution in Year 3 is to help Compass complete certification requirements, refine internal systems, and develop training for staff.

Specific Year 3 deliverables include:

• Certification application support. If relevant, provide direct support in preparing and submitting the certification application to the county MHP or applicable health system, including required documentation, readiness evidence, and responses to any review or site visit requirements.
• Internal systems. Advise Compass on how to integrate our internal Salesforce database (called CoDa), used for client clinical case notes, with a new EHR.
• Training. Assist Compass in preparing and administering staff training.

Organizational Context
Additional programmatic information relevant for this partnership:

• CBHS is low-barrier and clients do not need a clinical diagnosis to receive services. A billing model will require a diagnostic pathway for clients entering the billable track, and Compass seeks a consultant who understands the clinical and mission implications of this shift.
• CBHS therapists currently have a mix of licenses, including LCSW, LMFT, ASW, AMFT, as well as clinical interns. Compass seeks a consultant who can advise on how this mix may affect billing capacity.
• CBHS currently receives City of San Francisco contract funding for services, some of which may not be Medi-Cal billable. Compass seeks a consultant comfortable working with a model where Medi-Cal and government funding co-exist.

Application Requirements
Please submit the following, in PDF form, by 5:00 PM PST on Friday, July 3, 2026.

• Resume
• Narrative description of your relevant content experience. If applicable, include specific experience with any of the following:
  • California Medi-Cal
  • Behavioral health billing
  • Nonprofit community-based providers
  • San Francisco county landscape
• Narrative description of your relevant consulting or partnership experience, including:
  • A brief description of a past project(s) and your role
  • What your work entailed
  • What the client achieved
• Proposal for Year 1 scope of work, including:
  • How you would structure the work
  • What you would need from Compass to be effective
  • Your availability and capacity
• Your proposed fee structure for Year 1. Please note: Compass has a proposed budget of $30,000 for Year 1. If your approach to the scope would require more, tell us.

Selection Criteria
Compass will evaluate proposals on the following basis, roughly in order of priority:

• Depth of content experience (e.g. California Medi-Cal behavioral health experience, county MHP contracting, familiarity with San Francisco behavioral health landscape etc.)
• Experience with nonprofit community-based organizations serving similar populations.
• Practical orientation — evidence that the consultant can work effectively with the Compass team.
• Fit within the Year 1 budget.

Timeline

• Proposals due: Friday, July 3, 2026.
• Interviews (if needed): Monday, July 6 – Wednesday, July 15, 2026
• Selection decision: Friday, July 17, 2026
• Contract start: August 2026

To Submit or Ask Questions
Please send final proposals or questions to Ben Hice, Senior Director of Support Services, at bhice[at]compass-sf.org. Proposals can also be submitted by clicking the Apply link here and uploading your pdf document. We are happy to answer questions before the submission deadline and encourage you to reach out if anything about the scope is unclear.