21-R-0051 Solicitation.pdf

SEE ADDENDUM

(No Collect Calls)

W91QVN21R0051 14-Apr-2021

b. TELEPHONE NUMBER

315-755-3360

8. OFFER DUE DATE/LOCAL TIME

01:00 PM 14 May 2021

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W91QVN9. ISSUED BY

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a. UNLESS BLOCK

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

MS. HAN, CHIN OK

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, AND 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED ORX

SMALL BUSINESS

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

411TH CONTRACTING SUPPORT BRIGADE, KOREA

SERVICES DIV, UNIT #15289

APO AP 96271

UNITED STATES

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE F3J4MD 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

51 MDG/FM

MR. PAK, CHI

MEDICAL EQUIPMENT MANAGEMENT

APO AP 96278

UNITED STATES

TEL: 784-2601 FAX:

FAX:

TEL: SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$35,000,000

NAICS:

518210

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF82

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f . TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

W91QVN21R0051

Section SF 1449 - CONTINUATION SHEET

DELIVERY INFORMATION

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 POP 09-JUL-2021 TO

08-JUL-2022

N/A 51 MDG/FM

MR. PAK, CHI

MEDICAL EQUIPMENT MANAGEMENT

APO AP 96278

UNITED STATES

784-2601

FOB: Destination

F3J4MD

0002 POP 09-JUL-2022 TO

08-JUL-2023

N/A (SAME AS PREVIOUS LOCATION)

0003 POP 09-JUL-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

1001 POP 09-JUL-2021 TO

N/A (SAME AS PREVIOUS LOCATION)

1002 POP 09-JUL-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

1003 POP 09-JUL-2022 TO

N/A (SAME AS PREVIOUS LOCATION)

2001 POP 09-JUL-2023 TO

08-JUL-2024

N/A (SAME AS PREVIOUS LOCATION)

2002 POP 09-JUL-2023 TO

N/A (SAME AS PREVIOUS LOCATION)

2003 POP 09-JUL-2023 TO

N/A (SAME AS PREVIOUS LOCATION)

3001 POP 09-JUL-2024 TO

08-JUL-2025

N/A (SAME AS PREVIOUS LOCATION)

3002 POP 09-JUL-2024 TO

N/A (SAME AS PREVIOUS LOCATION)

3003 POP 09-JUL-2024 TO

N/A (SAME AS PREVIOUS LOCATION)

4001 POP 09-JUL-2025 TO

08-JUL-2026

N/A (SAME AS PREVIOUS LOCATION)

4002 POP 09-JUL-2025 TO

N/A (SAME AS PREVIOUS LOCATION)

4003 POP 09-JUL-2025 TO

N/A (SAME AS PREVIOUS LOCATION)

INSPECTION AND ACCEPTANCE TERMS

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A Government N/A Government

0002 N/A Government N/A Government

0003 N/A N/A N/A Government

1001 N/A Government N/A Government

1002 N/A Government N/A Government

1003 N/A N/A N/A Government

2001 N/A Government N/A Government

2002 N/A Government N/A Government

2003 N/A N/A N/A Government

3001 N/A Government N/A Government

3002 N/A Government N/A Government

3003 N/A N/A N/A Government

4001 N/A Government N/A Government

4002 N/A Government N/A Government

4003 N/A N/A N/A Government

PERIOD OF PERFORMANCE

Base Year: 9 Jul 21 – 8 Jul 22 (CLINs 0001 – 0003)

1st Option: 9 Jul 22 – 8 Jul 23 (CLINs 1001 – 1003)

2nd Option: 9 Jul 23 – 8 Jul 24 (CLINs 2001 – 2003)

3rd Option: 9 Jul 24 – 8 Jul 25 (CLINs 3001 – 3003)

4th Option: 9 Jul 25 – 8 Jul 26 (CLINs 4001 – 4003)

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 12 Months One (1) FTE Coding Technician

FFP

One (1) Full Time Equivalent (FTE) Coding Technician (Outpatient/Inpatient) to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

PSC CD: Q601

NET AMT

0002 12 Months Two (2) FTEs Medical Coding Auditors

FFP

Two (2) Full Time Equivalent (FTEs) Medical Records Coding Auditor to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

Estimated Cost for War Hazard Losses is

FFP

Zero(0).

1001 12 Months OPTION One (1) FTE Coding Technician

FFP

One (1) Full Time Equivalent (FTE) Coding Technician (Outpatient/Inpatient) to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

1002 12 Months OPTION Two (2) FTEs Medical Coding Auditors

FFP

Two (2) Full Time Equivalent (FTEs) Medical Records Coding Auditor to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

OPTION Estimated Cost for War Hazard Losses is

FFP

Zero(0).

2001 12 Months OPTION One (1) FTE Coding Technician

FFP

One (1) Full Time Equivalent (FTE) Coding Technician (Outpatient/Inpatient) to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

2002 12 Months OPTION Two (2) FTEs Medical Coding Auditors

FFP

Two (2) Full Time Equivalent (FTEs) Medical Records Coding Auditor to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

OPTION Estimated Cost for War Hazard Losses is

FFP

Zero(0).

3001 12 Months OPTION One (1) FTE Coding Technician

FFP

One (1) Full Time Equivalent (FTE) Coding Technician (Outpatient/Inpatient) to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

3002 12 Months OPTION Two (2) FTEs Medical Coding Auditors

FFP

Two (2) Full Time Equivalent (FTEs) Medical Records Coding Auditor to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

OPTION Estimated Cost for War Hazard Losses is

FFP

Zero(0).

4001 12 Months OPTION One (1) FTE Coding Technician

FFP

One (1) Full Time Equivalent (FTE) Coding Technician (Outpatient/Inpatient) to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

4002 12 Months OPTION Two (2) FTEs Medical Coding Auditors

FFP

Two (2) Full Time Equivalent (FTEs) Medical Records Coding Auditor to perform non-personal services in accordance with Para. 5 of the Performance Work

Statement (PWS) for the 51st Medical Group, Osan Air Base, Korea

OPTION Estimated Cost for War Hazard Losses is

FFP

Zero(0).

PWS

PERFORMANCE WORK STATEMENT (PWS)

Medical Coding Service

51st Medical Group

Osan Air Base, Korea

PART 1

GENERAL INFORMATION

1. GENERAL: This is a non-personnel services contract to provide MEDICAL CODING SUPPORT The

Government will not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn is responsible to the Government. The contractor shall provide the non-personal services of MEDICAL CODING SUPPORT;

including 2 FTE MEDICAL RECORDS CODING AUDITOR, 1 FTEs CODING TECHNICIAN

(Outpatient/Inpatient Clinic) at the 51st MEDICAL GROUP, OSAN AIR BASE, REPUBLIC OF KOREA which shall contribute to a stable workforce tasked with providing quality health care services to a diverse population.

Contract personnel providing medical coding support will also be referred to as “coders” throughout the rest of the document. The Contractor shall furnish all management, tools, equipment, supervision, reports, consultation and labor necessary to ensure that the Contractor provides coders & auditors for the 51st Medical Group (MDG). The

Contractor shall provide services at the 51st Medical Group, Osan Air Base (AB), also referred to as the “medical treatment facilities” (MTFs) herein. Performance shall be according to the requirements contained in this performance work statement (PWS).

1.1. DESCRIPTION OF SERVICES: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items and non-personal services necessary to perform

MEDICAL CODING SUPPORT as defined in this Performance Work Statement except for those items specified as government furnished property and services. The contractor shall perform to the standards in this contract.

1.2. All services shall be provided in accordance with established standards, principles and ethics of the profession and applicable professional specialty organizations, The Joint Commission (JC) standards, AAAHC, Accreditation

Association for Ambulatory Health Care, applicable Department of Defense (DoD) and Air Force specific regulations, directives, and policies, and military treatment facilities (MTF) specific policies, procedures, and job descriptions. Contract health care staff (contract personnel) shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients. The Contractor shall provide non-personal services for varied ancillary healthcare specialties in accordance with established principles and ethics of the medical profession, the national standards established by the JC, the professional standards at the medical treatment facility (MTF), and the American Board of applicable specialty. The Contractor shall be held accountable for compliance to the standards listed in the Comprehensive Accreditation Manual for Hospitals

(CAMH) dated 2011 or current version.

1.3. BACKGROUND:

1.3.1. The mission of the military healthcare system (MHS) is to ensure the nation has available at all times a healthy military force supported by a combat ready healthcare system. Health care services for eligible MHS beneficiaries are provided at Military Treatment Facilities (MTF) located on or near military installations or posts.

The military treatment facility may be a clinic, hospital, or medical center. Clinics are outpatient facilities offering primary care or simple specialty care (routine exams, tests, and treatments). The clinic may be stand-alone site or satellite of a larger clinic, hospital, or medical center. The 51st Medical Group mission is to seamlessly transition from community healthcare to contingency operations and respond to a full spectrum of health requirements, prepare medically ready forces, expand medical capabilities, and sustain war reserve materiel in support of 7 Air

Force (AF) and United States Forces Korea (USFK). The contractors provides Medical Management services to over 12,000 beneficiaries. The contractors work with other members of the Medical Management Team, all clinical and patient administrative areas of the MTF to provide individualized care and promote a positive outcome for the beneficiaries through collaborative and effective nursing practices.

1.4. OBJECTIVES: Perform the full spectrum of services as a Medical Coding Service Provider to support 51st

Medical Group’s mission. The contractor shall provide all labor, materials, tools, equipment, transportation, and materials necessary to recruit, qualify, and retain a contractors throughout the duration of this contract.

1.4.1. All services shall comply with established standards, principles, and ethics of the Medical Coding

Management profession and applicable professional specialty organization, the Joint Commission (JC) standards, the professional standards at the MTF, the Accreditation Association for Ambulatory Heath Care (AAAHC), applicable Department of Defense (DoD), Air Force Instructions (AFI)-44-174 & 44-173, AFMAN 41-120, AF

Guide to Population Health, DoD Medical Management Guide and Medical Group Instruction (MDGI) 44-106.

These documents are available in the MTF and maintained by the Government. Supplements or amendments to instructions or publications from any organizational level may be issued during the life of the contract. The

Contractor shall immediately implement those changes. The contractors shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for patients. The contractors shall be held accountable for compliance to the standards listed in the Comprehensive Accreditation Manual for

Hospitals (CAMH) dated 2011 or current version.

The contractors shall be held accountable for relevant action items in the Defense Health Agency (DHA) Data

Quality Management Control (DQMC) User’s Guide or the most recent guidance Data Quality manual.

physicians, nurse practitioners, physician assistants, registered and licensed practical nurses, and other support personnel. All contact personnel shall perform essentially the same functions, within scope of acceptable practice for the specific specialty or position, as those required by Air Force or Government service health care professionals of similar experience and similar duty assignments. The scope of services provided in military treatment facilities cover the same range of services as those that are provided in civilian treatment facilities of similar size and scope of services.

1.5. SCOPE: The 51MDG/CC is seeking assistance in improving their medical coding support and overall resource management processes and performance, including better positioning for the Assistant Secretary of Defense for

Health Affairs’ Perspective Payment System, acceleration of reimbursement enhancement, cost savings initiatives and implementation of comprehensive, commercial best practices based systems. As a result, these MTFs require coding services to be provided in support of these initiatives. The contractor shall provide non-personal services for supplemental staffing for coding personnel to perform outpatient record coding, inpatient record coding, ambulatory procedure coding, and related medical record functions covering a wide range of medical specialties for the Medical

Treatment Facilities (MTFs). Outpatient records coding will primarily be a review of the electronic medical record initiated by healthcare provider, but there may be instances where actual coding needs to take place. Inpatient coding will include coding of all documentation from admission to disposition to include any related surgeries and procedures. Ambulatory procedure coding will include coding of all outpatient surgeries and procedures. Auditing, training and feedback tailored to the healthcare providers will be provided by coding auditor. Auditing will be provided for outpatient coding, inpatient coding and ambulatory procedure coding, as required. Training and feedback will be provided primarily to the professional staff. However, it may also include the non-professional staff and the ancillary support staff. Related medical records functions including, but not limited to, pulling, copying, scanning and filing of outpatient records, inpatient records and ambulatory procedure records may be required. The Biometric Data Quality Assurance Service (BDQAS) will need to be utilized by coders as a means to identify encounters in the MTF that could be coded incorrectly and fix as needed. Further encounter coding audits will need to be conducted on any encounters flagged as data quality errors to ensure measures are taken to correct these errors. A COR will perform functional oversight, consultation and analysis for the MTF staff

1.5.1. PERIOD OF PERFORMANCE: The period of performance shall be for one (1) Base Year of 12-months and four (4) 12- month option years.

1.5.2. Type of Contract: The Government contemplates award a Firm-Fixed Price contract.

1.6. PERFORMANCE QUALITY:

1.6.1. Quality Control: See Exhibit 1

1.6.2. Quality Control Plan. See Exhibit 1

1.6.3 Quality Assurance Surveillance Plan: See Exhibit 1

1.6.4. Recognized Holidays: See Exhibit 1

1.6.5. Hours of Operation: See Exhibit 1

1.6.6. Absences and leave: See Exhibit 1

1.6.7. Continuity of Services/Replacement Staff: See Exhibit 1

1.6.8. Scheduled and Unscheduled Absences: See Exhibit 1

1.6.9. Place of Performance: See Exhibit 1

1.6.10. Reserved

1.6.11. National Agency Check: See Exhibit 1

1.6.12. Identification Badge: See Exhibit 1

1.6.13. Vehicle Registration: See Exhibit 1

1.6.14. Safeguarding Government Property/Information:

1.6.15. Contractor’s Qualification.

1.6.15.1. Prime Contractor’s Prior Experience: The Prime Contractor shall have at least two (2) years of experience within the last five (5) years in providing Medical Record or Medical Staff Services support or Medical Coding management. The experience of a subcontractor cannot be substituted for the Prime Contractor’s experience. The offeror shall provide evidence of prior experience in the following format:

The title and number of the contract/project

Description of work completed

Length of contract/project (year/month/date – year/month/date)

Value of contract/project for total amount

Complete point of contact at Client Organization (including name, phone number, email address)

1.6.15.2. The contractor must provide personnel to provide the following service: Personnel for Coding Technician have at least 2 (two) years’ experience in outpatient or inpatient coding

1.6.15.2.1 License: The contract personnel is required to have at least one accreditation from a nationally recognized in the United States accrediting medical coding body to include, Certified Coding Specialist (CCS), Certified

Coding Specialist-Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder-

Hospital (CPC-H), Registered Health Information Technician (RHIT), or Registered Health Information

Administrator (RHIA).

1.6.15.2.2. Experience: The contract personnel must have proficient knowledge of medical terminology, anatomy, pharmacology, surgical and medical procedures sufficient to code for optimum billing. This knowledge extends to a number of medical and surgical specialties and human physiological systems. The contract personnel must have knowledge of accepted medical abbreviations and their meanings and interpretation. The contract personnel must have knowledge in the use of specialized references, such as medical nomenclatures, medical dictionaries and texts and medical journals to accurately spell out and use medical terminology. The contract personnel must have knowledge of basic computer functionality.

1.6.15.2.2.1 The contract personnel shall be responsible for verifying and coding of the diagnosis, evaluation and management, admissions, surgeries, procedures or any other codes required for the completeness and accuracy of the record. Supports the Third Party Collection office (as needed) to ensure they have the documentation to submit a claim for reimbursement, to include coding of episode of care if required. Reviews and verifies component parts of medical record to ensure completeness and accuracy of diagnosis, operations, and special therapeutic procedures that must conform to the Center for Medicare and Medicaid Services (CMS) and Department of Defense Coding

Guidelines. Codes and/or reviews principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs with International Classification of Diseases 9th Revision

Clinical Modification (ICD-9-CM), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding

System (HCPCS) – all levels, and any other coding classification systems required by the Department of Defense

(ICD-10-CM/PCS when available). Inputs codes into applicable coding system made available for each individual

MTF. These systems include, but are not limited to: CCE, CHCS (ADM), Essentris, and AHLTA.

1.6.15.3 The contractor must provide personnel to provide the following service: Personnel for Coding Auditors have at least 2 (two) years of medical auditing experience.

1.6.15.3.1 License: The contract personnel is required to have at least one accreditation from a nationally recognized in the United States accrediting medical coding body to include, Certified Coding Specialist (CCS), Certified

Coding Specialist-Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder-

Hospital (CPC-H), Registered Health Information Technician (RHIT), or Registered Health Information

Administrator (RHIA).

1.6.15.3.2 Education: The contract personnel must have associates degree in Healthcare or related field

1.6.15.3.3 Experience: The contract personnel must have extensive knowledge of International Classification of

Diseases (ICD) and Healthcare Common Procedure Coding System (HCPCS) (CPT, E&M, etc.) codes and coding practices. The contract personnel must have ability to recognize the correct sequence of diagnoses and procedures.

The contract personnel must have knowledge of DoD coding guidelines, Federal/state compliance regulations. The contract personnel must have knowledge of medical terminology, anatomy and physiology.

1.6.15.3.4 The contract personnel must have knowledge in computer operation including utilization of the

Composite Health Care System (CHCS), Ambulatory Data System (ADS), AHLTA, Essentris, word processing, spreadsheets, and other program applications, as necessary. The contract personnel must have skill in oral and written communication sufficient to prepare comprehensive reports, to make presentations of findings and recommend corrective action, and effectively interact with hospital personnel and professional organizations. The contract personnel must have skill in collecting and organizing data sufficient to compile statistical reports, analyze trends, and show differences between related variables to determine accuracy and completeness of records. The contract personnel must have knowledge of data collection methods for basic health care, research information and statistical reporting Analytical ability. The contract personnel must have ability to maintain confidentiality. The contract personnel must have knowledge of laws and regulations on the confidentiality of medical records.

1.6.15.4. English Requirement: The Contractor personnel working on this contract shall be able to communicate in the English language at the intermediate level as exemplified in their written and verbal skills in the performance of their duties under this contract. Government will assess language skills of all Contract employees who are required by terms of this PWS to be proficient at speaking English through performance of services. If the Government, at its sole discretion, determines that the language skills of a Contractor employee does not meet the language proficiency skills required of the position, the Government reserves the right to require the Contractor to provide a new Contract employee that does possess the required language proficiency skills required of the position, at no additional cost to the Government.

1.6.16. Key Personnel: See Exhibit 1

1.6.17. Post Award Conference/Periodic Progress Meetings: See Exhibit 1

1.6.18. Organizational Conflict of Interest: See Exhibit 1

1.6.19. Confidentiality of Information: See Exhibit 1

1.6.20. Communication: See Exhibit 1

1.6.21. Professional Liability: See Exhibit 1

1.6.22. Responsibility and Procedures: See Exhibit 1

1.6.23. Contractor Responsibility: See Exhibit 1

1.6.24. Compliance with Laws and Regulations: See Exhibit 1

1.6.25. Orientation, and Training: See Exhibit 1

1.6.26 In/Out-Processing: See Exhibit 1

1.6.27. Training Requirement: See Exhibit 1

1.6.28. Computer Training: See Exhibit 1

1.6.29. Health and Immunization Requirement: See Exhibit 1

1.6.30. Media and Other Inquires: See Exhibit 1

1.6.31. Appearance: See Exhibit 1

1.6.32. Inspection: See Exhibit 1

1.7. ADMINISTRATIVE: SEE EXHIBIT 1

1.7.1. Records: See Exhibit 1

1.7.2. Data Rights: See Exhibit 1

1.7.3. Emergency Healthcare for contractors: See Exhibit 1

1.7.4. Monthly Progress Report Meeting: The Contract Manager shall conduct a monthly progress report meeting with the COR and FRED. The meeting can be held physically or via teleconference. The topics of the meeting must at least include PWS Part 5. The Contract Manager shall communicate to the appropriate site managers and track to completion all action items that result from this meeting.

1.7.5. HIPAA Compliance: See Exhibit 1 and Attachment I

1.7.6. Work Roster: The Contract Manager shall provide the COR a list of all employee names providing services in support of this contract. This list shall be provided to the COR by the 20th of the month for the upcoming month.

1.8. ACCESS AND GENERAL PROTECTION/SECURITY POLICY AND PROCEDURES: SEE EXHIBIT

1.

1.9. CONTRACTOR VERIFICATION SYSTEM (CVS): SEE EXHIBIT 1

1.10. PATIENT SENSITIVITY: SEE EXHIBIT 1

1.11. SAFETY REQUIREMENT: SEE EXHIBIT 1

1.12. CONTRACT MANAGEMENT: SEE EXHIBIT 1

PART 2 DEFINITIONS & ACRONYMS

2. DEFINITIONS AND ACRONYMS:

2.1. DEFINITIONS

2.1.1. AMBULATORY DATA SYSTEM (ADS). This computer system produces forms on which the providers identify the appropriate billing codes for diagnoses and procedures for each patient.

2.1.2. ARMED FORCES HEALTH LONGITUDINAL TECHNOLOGY APPLICATION (AHLTA) contains the

MTF’s appointment scheduling program, pharmacy, lab, and radiology ordering system and is interlinked with other departments in the MTF. In addition, it contains the electronic medical records for MHS beneficiaries.

2.1.3. COMPOSITE HEALTHCARE COMPUTER SYSTEM (CHCS) is the military’s world-wide automated medical information system interfaces with 40 plus external clinical and administrative systems.

2.1.4. CONTRACTOR. A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.5. CONTRACTING OFFICER (KO). A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.6. CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the contracting officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

2.1.7. DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the

Performance Work Statement.

2.1.8. DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

2.1.9. KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.9. PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

2.1.10. QUALITY ASSURANCE. The government procedures to verify that services being performed by the

Contractor are performed according to acceptable standards.

2.1.11. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP). An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.12. QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

2.1.13. SUBCONTRACTOR. One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.1.14. WORK DAY. The number of hours per day the Contractor provides services in accordance with the contract.

2.1.15. WORK WEEK. Monday through Friday, unless specified otherwise.

2.2. ACRONYMS:

AAAHC Accreditation Association for Ambulatory Health Care

ADM Ambulatory Data Module

ADP Automated Data Processing

ADS Ambulatory Data System

AETC Air Education and Training Command

AFARS Army Federal Acquisition Regulation Supplement

AFI Air Force Instruction

AHA American Hospital Association

AHLTA Armed Forces Health Longitudinal Technology Application

AKO Army Knowledge Online

AMA American Medical Association

AOD Administrative Officer of the Day

AR Army Regulation

BAA Business Associate Agreement

CAC Common Access Card

CAMH Comprehensive Accreditation Manual for Hospitals

CDC Centers for Disease Control and Prevention

CFR Code of Federal Regulations

CHCS Composite Health Care System

CLIN Contract Line Item Number

CONUS Continental United States (excludes Alaska and Hawaii)

COR Contracting Officer Representative

COTR Contracting Officer’s Technical Representative

CPT Current Physicians Terminology

CVS Contractor Verification System

DA Department of the Army

DD Department of Defense

DEERS Defense Enrollment Eligibility Reporting System

DoD Department of Defense

DoDI Department of Defense Instruction

DFARS Defense Federal Acquisition Regulation Supplement

EFT Electronic Funds Transfer

FAR Federal Acquisition Regulation

FNP Family Nurse Practitioner

FRED Functional Requirements Evaluator Designee

FSO Facility Security Officer

FTE Full Time Equivalent

FW Fighter Wing

HCP Health Care Provider

MEDCENs Army Medical Centers

MEDCOM Medical Command

MHA Mental Health Assessment

MHS Military Healthcare System

HIPAA Health Insurance Portability and Accountability Act of 1996

JC Joint Commission

KO Contracting Officer

LADS Labor and Delivery Statistics System

MDG Medical Group

MEDCENs Army Medical Centers

MEDCOM Medical Command

MHS Military Healthcare System

MTF Military Treatment Facility

OCONUS Outside Continental United States (includes Alaska and Hawaii) OIC Officer in Charge

OSHA Occupational Safety and Health Administration

PACAF Pacific Air Forces

PAM Pamphlet

PAR Performance Assessment Report

PHA Preventive Health Assessment

POC Point of Contact

PRS Performance Requirements Summary

PWS Performance Work Statement

PL Public Law

QA Quality Assurance

QASP Quality Assurance Surveillance Plan

QC Quality Control

RVU Relative Value Unit

SF Standard Form

SGP Chief of Aerospace Medicine

SGH Chief of Medical Staff

TA Trusted Agent

TASS Trusted Associate Sponsor System

TAMC Tripler Army Medical Center

UCAPERS Uniform Charts of Accounts Personnel System

PART 3

GOVERNMENT FURNISHED PROPERTY, EQUIPMENT, AND SERVICES

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

There will be no Government Property provided.

3.1. FACILITIES: The Government will provide the use of all available MTF facilities and support services, materials, publications, forms, and equipment for contract performance. The Contractors shall keep Government furnished supplies, equipment, and work areas in a safe, orderly, and clean condition. The

Contractors shall not use Government facilities, supplies, or equipment in private practice or for any purpose other than providing the healthcare services required under this contract.

3.2. BUSINESS EQUIPMENT: Telephones, facsimile machines, copiers, scanners, printers, and computer equipment are authorized for transactions of official government business only and shall not be used for personal business. Personal long-distance calls are not authorized and the cost of all personal long-distance calls made may be deducted from the Contractor’s invoice payments. Telephones, facsimile machines, and computer equipment are subject to communications security monitoring at all times

3.3. .MATERIALS: The Government will provide applicable policy letters, instructions, regulations, forms, and other publications. These materials will be available in the MTF and maintained by the Government.

3.4. WORKSPACE: The Government will provide workspace for the contractors for contract performance.

Space used by the contractors may be used for other purposes during contractors’ absence. Items of clothing, personal effects, or equipment cannot be secured during their absence. The Government will not incur any liability for theft, damage to, or loss of personal items.

3.5. TRAINING: Government will provide training in use of military medical computer software such as

AHLTA, CHCS, and ASIMS

PART 4

CONTRACTOR FURNISHED ITEMS AND SERVICES

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1. GENERAl: The Contractor shall furnish all labor, tools, equipment, transportation, and materials necessary to recruit, qualify, and retain three (3) contractors to provide services that are personal in nature for the duration of this contract.

4.2. The contractor is required to provide contract personnel with all required medical coding books, manuals or other coding reference material. Examples of coding reference material include but are not limited to, ICD-10-CM, APA HCPCS and APA CPT. Coding books should be the most updated version available to ensure medical staff are receiving proper guidance from contract personnel.

PART 5

SPECIFIC TASKS

5. SPECFIC TASKS:

5.1 BASIC SERVICES FOR THE MEDICAL CODING TECHNICIAN: Contract personnel must review, identify and/or code the correct diagnosis and procedure based on physician and/or clinical staff’s recorded documentation and established sequencing rules and guidelines. Ensure proper sequencing of all codes to obtain optimal resource allocation. Identify additional diagnoses/procedures to optimize reimbursement; i.e., complications, co-morbidities, therapeutic and diagnostic procedures.

5.2. TASKS: The Medical Coding Technician shall perform the following tasks:

5.2.1. Utilizes appropriate data codes and system commands for data entry. Performs edit checks on data entered prior to transmittal and corrects errors as indicated. Computer system concerns should be brought to the attention of the Quality Assurance Personnel (QAP), DHA Global Service Center, or 51 MDG Medical

Information Systems Staff, as quickly as possible to minimize work stoppage. During periods of system downtime, codes shall be captured utilizing the MTF’s contingency plan.

5.2.2. Analyzes medical record documentation for consistency and completeness for coding purposes using established criteria and regulations. Examines all documents in the record for authorized signature and patient identification to ensure all documents contain sufficient documentation to support the diagnosis and treatment administered, and that results obtained are adequately described. Identifies Third Party Billing information per

Data Quality Directives and identify lack of proper documentation to on site auditor or clinical and Data

Quality staff. Determines who is the responsible attending staff physician according to pertinent and current

AF and DoD guidelines.

5.2.3. Interprets and verifies the reason for the encounter, including cause(s), diagnosis, procedures(s), performed and significant related diseases to assure record contents meets JCAHO and AF and DoD regulation requirements for the highest attainable quality.

5.2.4. Obtain clarification as needed from clinical staff on errors or missing documentation noted. Corrections to the documentation and coded entry shall be completed per MTF and Command guidance and policy. Track all errors noted for training and education purposes to ensure the MTF and other contractor staff’s training templates will accurately reflect the true nature of what needs to be trained.

5.2.5. The contract personnel shall be given system access capabilities applicable to coding functions and at the discretion of the MTF and Command. System access may vary by MTF and be in accordance with DoD and

Air Force System upgrades and platform application changes.

5.2.6. Maintains current reference material. Ensures all updates are posted accurately and as updates are received. Ensures all system pick-lists match current codes, and works with MTF staff when outdated codes are noted.

5.2.7. Identifies potential or existing medico-legal problems to supervisor; i.e. malingering cases, therapeutic misadventures, child abuse, and therapeutic abortions. The contract personnel must ensure that all sensitive records be secured due to medical-legal potential. The contract personnel shall be responsible for safeguarding both the record and its informational content against loss, defacement and tampering, and from use by unauthorized individuals while in the contract personnel’s control.

5.2.8. Contract personnel will ensure all records are returned to the appropriate location as defined by the MTF within a timely manner.

5.2.9. The contract personnel shall review and/or code 95% of all outpatient clinic visit records within 3 days post visit, APVs within 15 days, and inpatient visits within 30 days.

5.2.10. Manually coded outpatient visits productivity: 15/hour (depending on acuity of visit) with a 95% accuracy rate (the current Air Force Standard for coding accuracy).

5.2.11. Review of automated outpatient coding productivity: 20/hour (depending on acuity of visit) with a 95% accuracy rate.

5.3. BASIC SERVICES FOR THE MEDICAL RECORDS CODING AUDITOR: Contract personnel shall have technical expertise required to complete all tasks outlined in 5.2.above, and may be solely assigned those tasks as outlined by the MTF or Command and/or in addition to the tasks defined in 5.3.

5.3.1. Tasks: The Medical Records Coding Auditor shall perform the following tasks:

5.3.2. Contract personnel shall review inpatient and outpatient encounters in accordance with all A.F. and DoD instructions and guidance. Examples of such guidance are but not limited to AFI 41-210; Military Health

Systems (MHS) Coding Guidelines, or others as defined by A.F. and/or DoD.

5.3.3. Contract personnel are expected to adhere to all policies outlined, as well as any changes provided by the

AF or DoD that may occur during the term of this contract. Command and MTF staff will provide changes to policy to all contracting personnel upon implementation.

5.3.4. Current coding audit methodology is specific and outlines the nature, timeliness, and occurrence of all audits, and the contractor staff is required to follow the specific methodology concerning audits. The contract personnel are required to conduct audits for MTF specific needs. These needs can be, but are not limited to, the following: Data Quality related coding audits, new provider audits, clinical areas of concern regarding coding, problematic coding noted by particular clinical staff, and out-of- rotation audits.

5.3.5. Contract personnel shall be responsible for conducting audits of the medical records and all other pertinent documents for accuracy and completeness. The contractor shall be responsible for validating the diagnosis, evaluation and management, procedure, and all other codes required to process the encounter as complete and support the billing office.

5.3.6. Contract personnel shall be responsible for performing independent audits determining the need for training of its employees and all clinical staff involved in the documentation and coding process. A formal training plan will be developed to address 1) new provider orientation, 2) recurring provider training as a result of monthly coding audit findings, and 3) semi-annually staff training. A formal training plan will be submitted to the government within 30 days of hire. Formal training plans will be reviewed semi-annually. All training must be documented and maintained in a file plan.

5.3.7. Training may be conducted in learning settings determined by each clinic’s needs. Training can be conducted in small or large groups, or one-on-one as needed. Training shall be given to all new clinical staff members prior to them seeing patients. Training should also be delivered to the professional staff with coordination with the Chief of Staff.

5.3.8. The contractor is required to train monthly based off of previous Air Force Medical Operations Agency

(AFMOA) and provider audit findings.

5.3.9. Contract personnel are responsible for ensuring all professional staff members are aware of their personal coding errors so corrections can be made. This should be completed at the time the errors are noted.

5.3.10. Contract personnel are required to ensure all professional staff members receive standardized guidance regarding coding on monthly basis.

5.3.11. Contract personnel will provide internal monitoring and graphical metrics of audits and training and provide reports regularly and as requested by the MTF and/or Command.

5.3.12. Contract personnel will be required to conduct coding reviews of professional staff and other contract personnel (if applicable), on a regular basis and report findings as a deliverable to Command.

5.3.13. Contract personnel may be called upon to attend regular data quality meetings and brief staff, provide metric data of coding activities, and provide other coding specific support within the MTF.

5.3.14. Contract personnel may be required to attend training, briefings, clinical Staff Assistance Visits, and other meetings that may require coding expertise.

5.4. OTHER TASKS OF MEDICAL RECORDS CODERS

5.4.1. Contract personnel may be required to assist as necessary within an area outside of the clinical setting with prior coordination and approval with the QAP. Examples of this may be the billing department, command section, or other sections requiring the assistance and expertise of a coding/auditor/trainer specialist.

5.4.2. AFMOA Audit. An independent, centralized audit cell is planned by AFMOA in the near future. Until that time contract personnel will continue to complete the AFMOA Audit requirements. When the audit cell is stood up, the Coding Technicians/Medical Coding Auditors will be responsible for the following:

5.4.3. AFMOA Audit Documentation Retrieval. Contract personnel shall retrieve, copy, and forward encounter documentation monthly for the AFMOA audit. Detailed pull lists will be available for download on/about the

15th of the month. Transmission of requested records will be completed within 10 days receipt of the pull list.

5.4.4. Documentation for the dates of service to be reviewed will be retrieved from AHLTA and Essentris (to include Inpatient, APV, Obstetrics, and Emergency Room). Copied documentation (non-AHLTA encounters

(Emergency Room, Obstetrics, etc), APV, and inpatient records) shall be forwarded (thru secure electronic media transmission or registered/certified mail (if records are sent by mail)) to AFMOA or designated office for independent review, auditing activities. Records are to be treated as protected health information, e.g.

appropriate containers for mailing and return receipt for mailed documents.

5.4.5. Submit copied Inpatient and/or APV records to include all documentation relative to the encounter. This may include:

Summary sheet documenting the codes selected by the MTF personnel

Face Sheet or coversheet if different from summary sheet

Discharge Summary

Anesthesia Record

History and Physical exam

Transcribed operative report—all pages

Report of other procedures

Report of any special procedures such as EKG, MRI

Consultation reports

Admission notes

Progress notes from physicians, nurse practitioner, physician assistant or other specialty provider

Pathology report

Medication records/reports

*Emergency Room documentation

*Outpatient visit documentation

Any documentation referenced during the encounter such as patient, social, or family history from a previous visit.

*Also included when these visits resulted in an admission. Ambulance records or copies of any records from transferring hospital would be included.

5.4.6. Submitted ER, Obstetrics, or Non AHLTA Records**

Emergency Room record

Obstetric record

Progress notes of the date of service of the encounter

Medication records

Report of other procedures

**Any other documentation applicable to the encounter should be submitted

5.4.7. On an annual basis, the TRICARE Management Activity performs an audit of coding services. This audit reviews inpatient, outpatient, and ambulatory procedure services. To meet the requirements of this audit or other AFMOA/DoD directed audits, the MTF is responsible for sending the requested record documentation. The contract Coding Technicians/Medical Coding Auditors are responsible for ensuring the requested records are copied and forwarded (per memo instructions) to the designated point of contact for these audit services.

5.4.8. The contract personnel shall be monitored and expected to complete audits reviews as outlined in the most current audit requirements and guidance from HQ AFMOA Coding Program Office.

5.4.9. Minimum provider audits: 4/hour with a 95% accuracy rate. Accuracy should be monitored by peer reviews or program manager.

5.4.10. Training: Professional coding staff shall provide training and feedback to providers in order to improve provider knowledge and coding accuracy. This shall begin with initial training within 30 days of a new provider’s arrival at the MTF. Thereafter, it can be “provider requested” or “accuracy driven” training sessions. A provider requested training session shall be scheduled as soon as possible, but no later than 7 calendar days from receipt of the request. The training should be conducted as soon as possible, but no later than 21 calendar days from the request date. Focused training is identified by the coding validation process, internal audits, AFMOA results or external reviews. Recurring monthly training (i.e., lunch session, clinic staff meetings) is encouraged; quarterly training is required. Further training may be advisable as dictated by results of the monthly AFMOA audit and errors identified by the on-site coders when performing their workload requirements. Training documentation must be maintained and reported monthly. The supporting documentation should include the training topics, the materials, list of attendees, and a critique from the providers/coders that were trained. For MTFs below the 95% accuracy threshold, training will be increased based upon a contractor correction action plan and/or AFMOA approved internal training plans. Training materials developed by the contractor must be approved by QAP and/or AFMOA Coding Program Office and maintained in the Quality Control Plan.

5.4.11. REPORT/DELIVERABLES

5.4.12. The contract representative is responsible but not limited to submitting the following reports to the

MTF QAP or designated representative at AFMOA Coding Program Office in the performance of this task. All reports are the property of the United States Government.

5.4.13. The Monthly Program Status Report (MPSR) shall be prepared by the contractor for the MTF, the

AFMOA Coding Program Office QAP and the Contracting Officer. The MPSR includes metrics related to personnel availability, productivity, quality assurance and customer satisfaction referencing the Service

Summary and other contract requirements. The report must be received by the QAP and the Contracting

Officer in an electronic format. Contractors will send the report by attaching the Excel file in an e-mail to the

Contracting Officer. Reports must be received no later than the 15th of each month (for the previous month) and 10 days prior to submission of the invoice to allow adequate validation of the workload numbers by the

QAP.

5.4.14. MPSR spreadsheet may be updated by the Contracting Officer as needed during the life of the contract.

The MPSR should include details and trending of information to include, but not limited to:

5.4.15. The Contractor shall maintain a current listing of all personnel

5.4.16. The contract representative is responsible but not limited to submitting the following reports to the QAP or designated representative at AFMOA Coding Program Office in the performance of this task. All reports are the property of the United States Government.

5.4.17.