246-21-Q-0010 Questions 04062021.docx

Question/Answer Submittal for 246-21-Q-0010

(monthly) for the institutional (UB04/837I) claims and professional (1505/837P) claims: 11500/month combined, do not have individual numbers.

Eligibility volume: Estmated: 8000/month

1. We want to confirm that the total number of facilities is 11. Correct

1. Please provide the number of estimated eligibility transactions per month 8000

1. Please provide the number of eligibility transactions using DDE access None, we use the free service with Novitas

1. Please provide the number of claims per month 11500 (These are for mostly Private Payers, we use state and Novitas portals for Medicare and Medicaid)

1. Please provide the number of Medicare claims per month using DDE access. To export?? We upload directly to Novitas, we use DDE only for claims corrections, I do not have an estimate of how many that may be per month.

1. Please confirm that the system should support a maximum of 50 users is per facility or for the entire contract? We only have 2 sites (hospitals- Lawton, Claremore)) that would need 20-25 users, the other sites, may need 10-15 users per site (Wewoka, Pawnee, Clinton, Anadarko, El Reno, Haskell) some of the smaller sites (Carnegie, Watonga, OCA Clinic) would only need 3-5 users.

1. May we request the fixed rate for all services to be broken up into the following:

6. Onboarding services including, training, payer enrollment, system setup etc. Only for the base year.

6. The monthly cost for the licensed number of claim/ERA and eligibility transactions.

1. Please note, it may be better for IHS to request this as an annual license. This way the monthly spikes and dips in the number of transactions are averaged over a year.

1. Please note that DDE transactions are cheaper than other transactions. It may be beneficial to separate the two out as DDE is subsidized by CMS.

1. Please note that claim transactions are usually more expensive than eligibility transactions so it may be better to separate the two

1. Please note that claim transaction includes the ERA (Electronic Remittance Advice)

1. Please note that sometimes additional fees are charged by the payer including Medicaid that are "pass thru fees" and billed to OCAO

6. Additional cost if the number of transactions exceeds the licensed number of claims or eligibility transactions You are fine to submit pricing freely as possible.

1. May we request a time of one week from your response to the questions to submit our response. Granted.