120174 O3 COST PROPOSAL.docx
DOCX document 26 KB Posted
- Solicitation number
- 120174 O3
- Issued by
- Douglas County, Nebraska
About this file
This is a cost proposal form for RFP 120174 O3 seeking a third-party administrator to process medical and dental payment claims/invoices for incarcerated individual healthcare services. The services will be based on an estimated average daily population (ADP) of 5,872 inmates, though the contract will have no minimum/maximum ADP requirements. The contract includes an initial term and two optional renewal periods.
Bidders must provide two cost solutions: a flat monthly rate and a per-incarcerated individual rate for both medical and dental payment processing fees. The State will select either the monthly flat rate or the per-individual rate based on what is deemed in the best interest of the State. The pricing must be all-inclusive with no additional costs permitted. For the per-individual rate, the monthly invoice calculation will use the formula "fee per incarcerated individual multiplied by the average daily population." The form also includes a section for optional services that may be awarded at the time of award or after contract award, though these are not required.
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Text version
Cost Proposal
RFP 120174 O3
Third-party administrator to process payments for claims/ invoices for an incarcerated individual(s) healthcare services.
Bidder Name: _________________________________________
All expenses associated with these services must be bid as all-inclusive. No other costs shall be billed. This is an estimated usage contract based on historical data and will fluctuate based on the average daily population (ADP). The bidder may use the ADP of 5872 and may refer to the historical information provided in the RFP to help aid in developing cost. This contract shall have no minimum/maximum ADP requirements.
The bidder shall provide two (2) cost solutions for the Medical and Dental payment processing fees. One (1) cost solution will be for a flat monthly rate and one (1) cost solution at a rate per incarcerated individual. The State will determine if the award will be based on the monthly flat rate or award at the rate per incarcerated individual, whichever is deemed in the best interest of the State.
1. Bidder shall:
a. Provide a monthly flat rate for both the Medical Payment Processing Fee and the Dental Payment Processing Fee.
| Monthly flat rate |
| Unit of Measure |
| ADP |
| Initial contract term cost per month |
| Renewal 1 |
(Optional) Renewal 2 (Optional)
| Medical payment processing fee |
| Per month |
| 5872 |
| Dental payment processing fee |
| Per month |
| 5872 |
2. Bidder shall:
a. Provide a rate per incarcerated individual for the Medical Payment Processing Fee and the Dental Payment Processing Fee.
i. For billing purposes, the formula used to calculate the processing fee shall be “fee per incarcerated individual multiplied by the average daily population”, the formula used shall be on every monthly invoice.
1. Example: “$19.50 (fee) x 5872 (ADP) = $114,504”.
| Rate per incarcerated individual |
| Unit of Measure |
| ADP |
| Initial contract term cost per individual |
| Renewal 1 |
(Optional) Renewal 2 (Optional)
| Medical payment processing fee |
| Per person |
| 5872 |
| Dental payment processing fee |
| Per person |
| 5872 |
3. OPTIONAL SERVICES, NOT REQUIRED.
a. NDCS may consider awarding optional services as outlined in section V.K. at the time of award or after contract award, if deemed in the best interest of the State.
b. If optional services are provided with the RFP response, the bidder must provide cost for optional services with the response.
c. Bidder may add additional rows if needed.
| Description of Optional Service |
| Unit of Measure |
| Initial contract term cost |
| Renewal 1 |
(Optional) Renewal 2 (Optional)
File details come from the government source that posted it. Updated .