CHARGEMASTER SERVICE
Added: Mar 06, 2017 6:54 pm This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice. This procurement is conducted under Simplified Acquisition procedures pursuant to the authority of Federal Acquisition Regulation (FAR) Subpart 13.5, Test Program for Certain Commercial Items (41 U.S.C. 3305, 3306, and Chapter 37); FAR Part 12, Acquisition of Commercial Items (41 U.S.C. 1906 and 1907)); and FAR 37.101, Non Personal Service Contract. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. The solicitation is issued on an unrestricted basis. The solicitation documents and incorporated provisions and clauses are those in effect tough Federal Acquisition Circular 2005-92. The associated North American Industry Classification System code is 541611 and the small business size standard is $15.0 million. The Indian Health Service intends to award a fixed-price commercial item contract in response to Request for Quotation (RFQ)-10-17-026-REL.PRICE SCHEDULE: CHARGEMASTER SERVICESCHEDULE A: BASE YEAR1. Blackfeet Service Unit 12 months @ $___________ per month = $______________2. Crow Service Unit 12 months @ $___________ per month = $______________3. Ft. Belknap Service Unit 12 months @ $___________ per month = $______________4. Ft. Peck Service Unit 12 months @ $___________ per month = $______________5. N Cheyenne Service Unit 12 months @ $___________ per month = $______________6. Wind River Service Unit 12 months @ $___________ per month = $______________Total: $______________SCHEDULE B: OPTION YEAR ONE (1)1. Blackfeet Service Unit 12 months @ $___________ per month = $______________2. Crow Service Unit 12 months @ $___________ per month = $______________3. Ft. Belknap Service Unit 12 months @ $___________ per month = $______________4. Ft. Peck Service Unit 12 months @ $___________ per month = $______________5. N Cheyenne Service Unit 12 months @ $___________ per month = $______________6. Wind River Service Unit 12 months @ $___________ per month = $______________Total: $______________SCHEDULE C: OPTION YEAR TWO (2)1. Blackfeet Service Unit 12 months @ $___________ per month = $______________2. Crow Service Unit 12 months @ $___________ per month = $______________3. Ft. Belknap Service Unit 12 months @ $___________ per month = $______________4. Ft. Peck Service Unit 12 months @ $___________ per month = $______________5. N Cheyenne Service Unit 12 months @ $___________ per month = $______________6. Wind River Service Unit 12 months @ $___________ per month = $______________Total: $______________SCHEDULE D: OPTION YEAR THREE (3)1. Blackfeet Service Unit 12 months @ $___________ per month = $______________2. Crow Service Unit 12 months @ $___________ per month = $______________3. Ft. Belknap Service Unit 12 months @ $___________ per month = $______________4. Ft. Peck Service Unit 12 months @ $___________ per month = $______________5. N Cheyenne Service Unit 12 months @ $___________ per month = $______________6. Wind River Service Unit 12 months @ $___________ per month = $______________Total: $______________SCHEDULE E: OPTION YEAR FOUR (4)1. Blackfeet Service Unit 12 months @ $___________ per month = $______________2. Crow Service Unit 12 months @ $___________ per month = $______________3. Ft. Belknap Service Unit 12 months @ $___________ per month = $______________4. Ft. Peck Service Unit 12 months @ $___________ per month = $______________5. N Cheyenne Service Unit 12 months @ $___________ per month = $______________6. Wind River Service Unit 12 months @ $___________ per month = $______________Total: $______________GRAND TOTAL: $______________PERIOD OF PERFORMANCE: The performance of this contract shall be for 12 months with four 12-month options.BACKGROUND: Tough a point-of-care resource, providers gain immediate access to peer-reviewed recent extractions of information and are assisted in delivering high quality, evidence based, and current medical care for our patients. PURPOSE: To acquire Chargemaster Services for the Indian Health Service (IHS) Hospitals and Hospital based clinics in the Billings Area (Montana and Wyoming). The facilities include: Blackfeet Service Unit, PHS Indian Hospital, Browning, Montana; Crow Service Unit, PHS Indian Hospital, Crow Agency, Montana; Fort Belknap Service Unit, PHS Indian Hospital, Harlem, Montana; Fort Peck Service Unit, PHS Indian Health Centers, Poplar and Wolf Point, Montana; Northern Cheyenne Service Unit, PHS Indian Health Center, Lame Deer, Montana; and Wind River Service Unit, PHS Indian Health Center, Fort Washakie, Wyoming.STATEMENT OF WORK: Vendor shall provide Chargemaster updates/maintenance and support including the following:1. Refresher training2. Training for new employees 3. Quarterly coding and billing audits to ensure optimal reimbursement 4. Assure accuracy and improve quality of data submitted to third party payers 5. Ensure coding and billing procedures are in compliance with Medicare guidelines Vendor must have a minimum of five (5) years of experience with the Resource and Patient Management System (RPMS) and Electronic Health Record (EHR) used toughout Indian Health Service.Vendor will provide chargemaster services for inpatient and outpatient services. Including but not limited to: Pediatrics, Podiatry, Physical Therapy, Pharmacy, Dental, Family Practice, Internal Medicine, Radiology, Laboratory, Emergency Department, Urgent Care, Obstetrical/Gynecology, Public Health Nursing, Nursing, Wound Care, Diabetes, Optometry, Ophthalmology, Audiology, Behavioral Health, Observation, Surgery, Tele-ED, Tele-Health, Specialty Clinics - Rheumatoid Artitis (RA) Hypertension (HTN), Ears Nose and Toat (ENT), Dermatology, Dietician, Cardiology, et cetera.Task 1: Charge Master Development and Implementation for the Billings Area Hospitals and Hospital Based ClinicsImplementation Approach:• Conduct onsite departmental interviews to develop a site-specific trancode table• Form a chargemaster team and define the site's charge capture process prior to implementation• Conduct offsite work on the development of transaction codes, charge capture tools, training materials, supply code list and download file • Conduct onsite departmental training• Conduct onsite validation of charge capture process• Review claims processing• Review of Management ReportsPhase One:Vendor will conduct onsite departmental interviews to identify the costs of the services provided to a patient by department within the service unit. This shall be done as a part of the chargemaster with the use of Indian Health Service cost information for the last 3-5 years.Once the information is gathered; develop and provide the tools necessary to capture and report all facility and professional services.Phase Two:Chargemaster Implementation:Chargemaster implementation will be conducted onsite by the vendor. During the onsite visit, vendor will provide chargemaster training to each department. Vendor will also provide the staff with the knowledge and tools needed to capture and bill for hospital (facility) services. All training materials will be provided including training manuals and copies of presentations.This process will include:• Initial on site visit to gather information, conduct staff interviews and conduct a process review• Offsite time to develop the transaction code list, review supply management list to determine billable vs. non billable supplies and develop training materials• Offsite time for systems support and to enter and validate transaction codes • On site visit to implement chargemaster, conduct a record review and provide extensive chargemaster training to individual departments.• Following implementation, provide on-going chargemaster support via e-mail, fax or phone (to be determined when an implementation date is scheduled.)There will be a separate fee to download the chargemaster file. Typically tough Cimarron. This will be the responsibility of the Billings Area IHS.Task 2: Quarterly Chargemaster Report Management• Run Chargemaster reports, RVU and analyze the data on a quarterly basis. Vendor will also provide a summary of the findings and recommendations to use for discussion purposes during quarterly conference calls.• When not on site, conduct a quarterly 1-2 hour conference call with Executive Management Team and department heads to discuss findings, financial impact, status, patterns and trends.• Vendor will review charge capture and revenue report data to determine if there are trends and patterns that may affect reimbursement.Task 3: Business Office/Revenue Cycle SupportVendor to work with new staff on how to access and run reports, analyzing the data and interpreting the data from RPMS. Vendor will cover the following areas:• Defining reports• Creating reports• Interpreting reports• Printing reports• Exporting to Excel• Organizing the reportsReport Analysis:RPMS reports to be reviewed:o BLRP - Bills listing report o BRRP - Flagged As Billable reporto CLRP - Closed Claims reporto AOI - Aged Open Item reports o ASM - Aging Summaryo TSR - Transaction Summary by Paymentso TSR - Transaction Summary by Adjustmentso RVU - Provider Relative Value Unit Reporting• Visits per FTE• Work RVU per FTE• Annualized Work RVU per FTE• Average Work RVU per Visit(The reports shall provide a comparison of each Provider to the average per specialty.) Reporting analysis results:• Identify whom the report results are intended • Ensure employees have a chance to carefully review and discuss the report data and understand the results• Provide administration with recommendations to action plans, including who is going to follow up on the recommendations and timelines.Task 4: Fee Schedule Analysis• Vendor will work with Finance to develop a fee schedule pricing strategy for Fiscal Year 2017. • Vendor to conduct a fee schedule analysis of current fee schedule by comparing the current fees to Medicare's fee data for physician services, medical services, lab, DME and drugs and apply where available. • Vendor will focus the review on high volume services that would have the greatest financial impact. Vendor will work with billing staff to pull (EOB's) and CHS data to help determine appropriate rate settings for geographic area. • Vendor will work with staff to monitor payments on high dollar services to ensure the fees are priced appropriately and maximize legitimate reimbursement. • Vendor support will include pricing in the fee schedule analysis and work with staff to determine if fees are appropriate for Billings Area and payer population. Task 5: Semi Annual Site Visit/Off Site Training and Audits • Vendor will conduct a combination of on-site and off-site audits and trainings to each department including:o Physicians o Nursing Staffo Coding Staff on regulations and service coverage requirements Audit 150-300 Chart per quarter• Inpatient not to exceed 50 records• Observation not to exceed 50 records• Day Surgeries not to exceed 50 records• Ambulatory 150-300 recordso Business Office Staff Claims Denial  Claims Process for Dentrixo Administrative Staffo Patient Registration Staffo Ancillary Service Staff To include but not limited to Laboratory and Radiologyo All Departments on the Use of charge tickets and importance of documentation to support billed charges • Vendor will work with Service Unit and Area Office staff to identify training needs and develop a schedule for each site visit. • Vendor will provide a report of findings and recommendations following each site visit, audit or off-site training. • Vendor will work with staff to review templates to ensure documentation requirements are met for compliance and communicate recommendations and/or changes needed.Task 6: Maintenance and UpdatesVendor shall provide ongoing maintenance of the Chargemaster system including updating charge tickets annually or as needed, creation of new charge tickets as new departments/services are implemented and quarterly maintenance of the transaction code tables.The following procedures will be included in the maintenance and support:• Delete old CPT/HCPCS and revenue codes• Add new CPT/HCPCS and revenue codes• Incorporate Chargemaster supply list• Price each code• Update all chargemaster charge tickets to reflect current codes• Update all physician super bills to reflect current codes• Provide on-going chargemaster support toughout the contract period• Download updated changes to the programming contractor to be loadedContractor will be required to comply with FAR 52.204-9 Personal identity verification of contractor personnel, HIPAA business associates agreement and Business Partner Interconnection Security Agreement. A HIPAA business associate agreement is used to define and show intent to adhere to HIPAA law regarding privacy and security of information the business associate comes into contact with. A Business Partner Interconnection Security Agreement is used to define procedures of reciprocal cooperation and coordination between the Indian Health Service (IHS) and a business partner to identify and implement information security safeguards and responsibilities required for the establishment of a connection between the IHS network and the business partner's network. System Interconnection means the direct connection of two or more IT systems for the purpose of sharing data and other information resources. SPECIAL CONTRACT REQUIREMENTS: Contractors cannot serve as expert witnesses in any suit against the Federal Government. The Privacy Act of 1974 mandates that the Contractor maintain complete confidentiality of all administrative, medical and personnel records, and all other pertinent information that comes to his/her attention or knowledge. The Privacy Act carries both civil and criminal penalties for unlawful disclosure of records. Violation of such confidentiality shall be cause for adverse action. All IHS regulations and policies applicable to these Acts shall be enforced.GOVERNMENT FURNISHED PROPERTY: The Indian Health Service will be responsible for getting the Contractor access and clearance to all pertinent computer systems necessary to carry out the services. COMPUTER SECURITY: Pursuant to the Federal Information Security Management Act of 2002 (FISMA), the contractor will be required to complete a course in Computer Security Awareness Training (CSAT). This training must be completed annually by all employees including contractors, volunteers, students, and summer externs. The Contractor will be required to comply with the Federal Information Processing Standards Publication (FIPS PUB) Number 201, "Personal Identity Verification of Federal Employees and Contractors," and the associated Office of Management and Budget (OMB) implementation guidance for personal identity verification for all affected contractor and subcontractor personnel. Access/clearance to all pertinent computer systems, including completing the Security Checklist, Rules of Behavior form, Security training; Business Associate Agreement and Business Partner Interconnection Security Agreement (BPISA), should be coordinated with each respective Service Unit. CONTRACTING OFFICER AUTHORITY: Authority to negotiate changes in the terms, conditions or amounts cited in this contract is reserved for the Contracting Officer. CONTRACTING OFFICER'S REPRESENTATIVE (COR): The COR shall be responsible for: (1) Monitoring the Contractor's technical progress, including surveillance and assessment of performance and recommending technical changes; (2) Interpreting the Statement of Work; (3) Technical evaluation as required; (4) Technical inspections and acceptance; and (5) Assisting the Contractor in the resolution of technical problems encountered during performance of this contract.INVOICE SUBMISSION AND PAYMENT: The Contractor shall submit its invoice to the Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107, with a courtesy copy to the Area Health Information Management (HIM) Consultant, P.O. Box 36600, Billings, Montana 59107. The Contractor agrees to include the following information on each invoice: (1) Contractor's name and address; (2) Contact name, title, and telephone number; (3) Contract Number; (4) Invoice number and date; (5) Description, quantity, unit of measure, unit price, and extended price of supplies delivered or services performed; (6) Remit to Address; (7) Taxpayer Identification Number (Employer Identification Number or Social Security Number); and (8) Data Universal Numbering System (DUNS) number (to ensure payment is made to the correct bank account) and vendor mailing address, as provided in the System for Award Management (SAM), formerly known as the Central Contractor Registration (CCR) database. Payment shall be made by the Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107. PROVISIONS AND CLAUSES: The following provisions and clauses apply to this acquisition. The FAR provision 52.212-1 Instructions to Offerors Commercial Items; and 52.212-3 Offeror Representations and Certifications Commercial Items are incorporated by reference. The provision at 52.212-2 applies to this acquisition and is provided in full text. FAR 52.212-2 EVALUATION - COMMERCIAL ITEMS (OCT 2014): (a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers:FACTOR 1: TECHNICAL CAPABILITYSubfactor 1.1: Executive Summary (Synopsis of the Offeror's Proposal). The Offeror shall include a narrative statement that provides a brief history of the Offeror. In the event that the Offeror is planning to propose a teaming, mentor/protégée, or a subcontracting relationship, narrative statements must also be included for the additional organizations, as well as a clear delineation of tasks that they will be expected to support.Subfactor 1.2: Offeror's resource capacity to simultaneously implement, support and maintain Chargemaster services for 6 health care facilities in the Billings Area within tee months of contract award. The submission shall include the revenue enhancement services the offeror is proposing to provide.Subfactor 1.3: Offerors shall provide examples of the past achievements and performance that reflects its ability to provide services timely, effectively, and accurately. Subfactor 1.4: Offeror's compliance capabilities in regards to the Billings Area's State regulations, traditional regulatory agencies, and laws. Offeror shall disclose any violations of regulatory compliance, accreditation in the previous 3 years.Subfactor 1.5: Offeror's methodology and information technology security policy to protect the sensitive patient data. The evaluators need to understand the offeror's record authentication process that properly restricts the access to the patient data, and records disposition process following completion of documentation in the IHS EHR.Subfactor 1.6: Offerors shall propose a sustainable and effective Quality Assurance and Surveillance Plan to ensure quality services are being deployed. The proposed plan should contain quarterly reporting deliverables that will be used by Federal staff to monitor services being performed at all locations.Subfactor 1.7: Provide the breakdown of the components and functionalities of Chargemaster services. The description shall include an overview of the technical platform, installation effort, and level of user training required to operate the chargemaster.FACTOR 2: MANAGEMENT APPROACH/KEY PERSONNELSubfactor 2.1: Management Approach/Enhanced Support. Ability of the contractor to provide enhanced support using key methods, techniques, processes, procedures, etc.; to provide additional support to monitor and measure complex processes, identify and mitigate potential risks, ensure the accuracy and timeliness of critical data and reports and communicate effectively to meet the needs of the IHS customers and users.Subfactor 2.2: Offeror's plan to establish and maintain an adequate pool of staff, and other contractor personnel necessary to successfully meet the requirements of the contract without any performance lapse. FACTOR 3: RELEVANT PAST PERFORMANCESubfactor 3.1: The Offeror's relevant past performance information. The Past Performance volume shall include the following information for each contract: Several points of contact (Contracting Officer, Contracting Officer's Representative and any other pertinent officials that can verify performance) - name, agency/company, address, phone number and email addressContract titleContract number (and task order number when applicable)Total original, present and/or final contract dollar value Project description and size informationRelevancy to the SOW for the subject solicitationProvide an explanation of problems, delays, cost overruns and corrective actions takenContract holder status (prime or sub-contractor)Subfactor 3.2: All concerns shall submit a short narrative that describes their experience in working with communities and organizations that represent a broad range of American Indian and Alaska Native people. Also, offeror shall demonstrate their understanding of IHS mission, goals and customers. FACTOR 4: COST/PRICEThe offeror agrees to hold the prices in its offer firm for 90 calendar days from the date specified for receipt of the offers. The price proposal should adhere to the pricing structure established in the "Price Schedule". The offeror's price proposal must be based on the offeror's technical proposal and the Government's statement of work. The "Price Schedule" shall be completed by the offeror in accordance with the following: (1) All prices contained in the price schedule must reflect an all-inclusive monthly rate. Price is not assigned an adjectival rating or scored. It will be evaluated to determine whether it is reasonable and if the quotation reflects an understanding of the requirement. This factor will be evaluated utilizing price analysis techniques identified in FAR Part 15.404-1. Analysis will include review of price reasonableness and balanced pricing. Offerors are cautioned that "materially unbalanced" prices and/or unreasonably high or low prices may cause your quotation to be deemed unacceptable and rejected.Technical and past performance, when combined, are considered approximately equal to cost or price. (b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award. EVALUATION APPROACH: The content of the written quotations, as well as information derived from discussions/negotiations, if discussions are held, will be evaluated to determine the degree and extent to which the requirements and objectives set forth in the solicitation are satisfied. No assumption will be made by Government evaluators regarding areas not defined in the offeror's written material/information provided to the Government for evaluation. EVAULATION METHODOLOGY: A technical evaluation panel will evaluate the quotations. The quotations will be evaluated in accordance with the aforementioned factors. Any quotation that is unrealistic, in terms of technical approach, schedule commitments, and or costs (high or low) will be deemed unacceptable.BASIS FOR AWARD: Selection of the successful offeror will be made based on the evaluation criteria. The quotations will be evaluated and a contract awarded under the Best Value Continuum approach to permit tradeoffs among cost or price and non-cost factors. This will allow the Government to consider award to other than the lowest priced offeror or other than the highest technically rated offeror who meets or exceeds the technical acceptability standards established in the factors referenced above.The following FAR and Health and Human Services Acquisition Regulation (HHSAR) clauses are applicable: 52.204-4, 52.204-7, 52.204-9, 52.204-13, 52.204-16, 52.204-17, 52.204-18, 52.204-19, 52.209-7, 52.209-11, 52.211-16, 52.212-4, 52.212-5, 52.215-5, 52.217-8, 52.217-9, 52.223-6, 52.225-20, 52.225-25, 52.229-3, 52.232-11, 52.232-18, 52.232-39, 52.232-40, 52.233-2, 52.242-15, 52.242-17, 52.244-6, 352.215-70, 352.222-70, 352.239-73 and 352.239-74. The following FAR clauses cited in 52.212-5 are applicable to the acquisition: 52.203-6 with Alternate I, 52.204-10, 52.209-6, 52.209-9, 52.209-10, 52.219-4, 52.219-8, 52.219-9 Alt II, 52.219-28, 52.222-3, 52.222-19, 52.222-21, 52.222-26, 52.222-35, 52.222-36, 52.222-37, 52.222-40, 52.222-50, 52.222-54, 52.223-18, 52.225-13 and 52.232-33. Upon request, the Contracting Officer will provide full text copies of the FAR and HHSAR provisions and clauses. The provisions and clauses may also be accessed electronically at https://www.acquisition.gov/ and http://www.hhs.gov/grants/contracts/contract-policies-regulations/hhsar/part-352-solicitation-provisions-contract-clauses/index.html. PROPOSAL SUBMISSION INSTRUCTIONS: The Contractor shall submit a completed copy of FAR 52.212-3 with its offer. Contractors intending to conduct business with the Federal Government must register with the System for Award Management (SAM). SAM replaces the Department of Defense's Central Contractor Registration (CCR) database. SAM is now the primary Government repository, which retains information on Government contractors. You may register via the Internet at www.sam.gov. All responsible offerors may submit a quotation, which shall be considered by the Agency. Offers shall be submitted to the Billings Area Indian Health Service, 2900 Fourth Avenue North, Billings, Montana 59101, no later than 5:00 p.m. Mountain Time on March 27, 2017. The offer must be submitted in a sealed envelope, addressed to this office, showing the time specified for receipt, the solicitation number, and your company name and address. Offers will also be accepted by e-mail at Rita.Langager@ihs.gov or by fax at (406) 247-7108.
RFQ-10-17-026-REL Department of Health and Human Services Indian Health Service
3/6/17, 6:54 PM