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36C10B18R2676 A0003 Questions and Answers RFP 36C10B18R2676.docx

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Question No.

Solicitation Section
Question/Comment/Suggestion
VA Response
Change to the Solicitation Yes or No
1.
General
What are the start and end dates for the Base Period and each option period?
The anticipated start date and end dates for the base period of 12 months is August 1, 2018 through July 31, 2019. Each subsequent Option Period shall be August 1, 2019 through July 31, 2020, August 1, 2020 through July 31, 2021, and August 1 2021 through July 31, 2022.
No
2.
General
What is the expected award date?
The anticipated award date is July 16, 2018.
No.
3.
General
What is the rationale for not including a Transition In period?
The requirement does not include a transition in period as the FSC could not define the period of time that may be required.

No

4.
General
What is the rationale for not including a Transition Out period at the end of the contract?
The requirement does not include a transition out period as the FSC could not define the period of time that may be required.

No

5.
Performance Work Statement (PWS) B.2.2.d
Section B.2 IT Contract Security speaks of custom software development. What software development do you perceive will be necessary?
None.
No
6.
PWS
Please explain the sources of each transaction, and the targets for the transactions.

A. Can this information be broken down by;

1. Type of Transaction

2. Geography of transaction.

B. By type of transaction, what percentage is estimated to require conversion to EDI formats?

C. Can you tell us the volume of users that submit CMS - 1450?

A.1. Yes. See PWS paragraph 5.2.1 for transaction types.

A.2. No B. 2.5%, or approx. 18K/month C. Information will be provided to awardee.

No

7.
PWS
Do you expect the awardee to make EDI connections with submitting entities and, if so, how many and where?
Yes, awardee should be able to accept EDI claims from providers.

FSC does not have estimates of how many and where.

No

8.
PWS
Can you supply a list of institutions and provider offices to which connections have been made?
No, current vendor has that list. As stated in Q7, awardee should be able to accept EDI claims from providers.
No
9.
PWS Section 5.2.1
Can you elaborate on the 99% accuracy metric; how is this measured or calculated?
Measured by random sampling of claims received.
No
10.
PWS Section 5.2.1
For Optional Tasks, can you confirm that If an Optional Task is exhausted that the next Optional Task prices would be applied for the next set of 10 Lots only and not for all claim volumes achieved? (e.g. prices are charged based on the transaction counts with in Optional Task purchases, not total cumulative claim levels achieved)
The optional tasks are by claim types and by each period of performance. Only the maximum amount can be exercised in each period for the price in that period.
No
11.
PWS Section 5.2.1
Why are there no Rx base or Option Periods?
There are no RX requirements in the Base Period; however, there areoptional tasks for Rx Claims. Reference chart at PWS Section 5.2.1.
No
12.
Section C.3
Can you clarify C.3 52.217-7 – does this indicate that additional volumes may be purchased at the Base Period rates in the Schedule?
FAR 52.217-7 applies to the Optional Tasks in the price schedule.

The optional tasks are by claim types and by each period of performance. Only the maximum amount can be exercised in each period for the price in that period.

No

13.

Will commercial companies with no PPIRS presence be penalized for only submitting commercial past performance?
No, as per Section E.11(2)(II) of the Solicitation, Offerors shall submit up to five (5) contracts (including Federal, State, and local government and private)

Additionally, in the case of an Offeror without a record of relevant past performance or for whom information on past performance is not available, the Offeror may not be evaluated favorably or unfavorably on past performance.

No

14.

Section B.2.5.h speaks to bio-medical devices. What bio-medical devices do you expect to be involved with this contract?
None
No
15.
General
Can you supply annual historical transaction data from the current contractor?
No.
No
16.
General
Do you have a Companion Guide that can be shared so we can understand what type of edits are needed?
There is no Companion Guide.
17.
General
Is there an associated companion guide for custom edits that the VA has in place for HIPAA standard transactions?
There is no Companion Guide.
No
18.
General
Can you share historical information about what edits have been done?
No.
No
19.
Section 6.2
Section 6.2 speaks to needed security clearances, and that for tasks 5.1 and 5.2 a Moderate Background Investigation is needed. We perceive you meant Tasks 5.2.1 and 5.2.2. Could you please validate that perception or supply us with the written tasks?
Investigations are required in performance of section 5.2, Clearinghouse Services.
Yes. Remove 5.1 from MBI requirement.
20.
General
If our staff currently does not have the required Moderate Background Investigations, what is the time period we have to complete them? Where can we obtain the directions to obtain these and the process to follow?
See section 6.2.2 for directions.
No
21.
General
What are the expected requirements for customer service and is bi direction support contemplated (e.g., submitter and recipient support)? For instance;
a.How many phone calls can be expected?
b.What are the reasons for those calls?
c.To whom are calls transferred for questions for which we do not have answers?
d.What other service mechanisms are used today (e.g., email, chat)
The Government has no insight into customer service calls types, number, or process as customer service support is between the current vendor and providers who submit claims.

No

22.
E.11- Proposal Submission Instructions
The government requires unit prices to two decimal places. We currently charge transaction unit prices in cents to two decimal places. That is, we may charge 6.25 cents for a transaction. If this is at variance with your direction, please explain why our two decimal places on cents is not valid.
The example is compliant with instructions.

The instructions are for purposes of the extended price, since calculated by unit price X quantity. Based on our Purchase Order system restrictions, extended pricing in line items cannot go beyond two decimals.

No

23.
General
We assume all set up, connections, implementation, project management, travel and transition in and out costs etc. will need be amortized across the unit pricing. Is that a correct assumption?
The Government does not provide guidance on a vendor’s cost method.
No
24.
General
a. What are the storage requirements for data in terms of short term storage, long term archiving, and data accessibility service levels? .

b. What storage periods are required time and are there any special other requirements?

For a and b, Records Management should align with VA Directive 6300.
No
25.
General
We manage our transactions through a portal to provide transaction visibility, tracking and monitoring capability to our commercial customers. Do you want a portal for real time transparency into transactions?
A portal for real time transparency into transaction is not a requirement of the PWS.
No
26.
General
Please supply a copy of the previous award notification and a redacted contract of the incumbent.
Your request can only be satisfied through a Freedom of Information Act request.
No
27.
General
Is there eligibility verification required as part of the edits mentioned in the RFP?
The contractor will not do any eligibility verification edits.

No

28.
E.11- Proposal Submission Instructions
In Section E.11.2(vi)(1), reference is made to ‘all certifications requiring original signature’. We request a list of all those certifications requiring such an original signature and those which are handled through the normal System for Award Management process. Our goal is to ensure we are complying with your exact expectations.
Per Section E.11 (2)(vi)(1), an authorized official of the firm shall sign the Standard Form (SF) 1449 and any Amendments, SF 30.
No
29.
E.11- Proposal Submission Instructions
In Section E.11.2(v)(3), veterans are defined as honorably discharged members of an active duty military, reserve or National Guard. We have employees who still serve with the National Guard and reserve, and their discharge dates are in the future. May we count these employees as veterans?
No. Per Section E.11 (2)(V)(3) A Veteran is defined as an honorably discharged member of active duty military, reserve or National Guard.

No

tha30.
B.2
In Addendum B, B2, Access to VA Information and VA Information Systems, point “e.”, it states that “outsourced operations must be located within the U.S. to the maximum extent practical”. Is Puerto Rico considered an ‘on-shore’ U.S. location for the purposes of this RFP?
Yes.
No
31.
General
Questions are due May 31. However, the VA did not provide a date as to when your answers will be available to the vendors. Since answers to questions are necessary to create a competitive and compliant bid, will the submission date be revised for each day the vendor does not receive answers from the VA?
An extension to June 18, 2018 was granted.
No

32.

Considering the extensive RFP review necessary for a competitive and compliant bid, would the VA consider a two-week extension with responses due on June 19?
An extension to June 18, 2018 was granted.
No

33.

There are multiple references to payer IDs, but no indication of how many payer IDs may be required. Since the number of payer IDs is needed for pricing, please provide a description of the types and volume associated with each.
Payer ID is not required for pricing. Pricing is based off transaction type. The payer ID will be provided to the awardee.
No

34.

The solicitation does not mention which VA/VHA programs would be included in this service, though it appears to only be applicable to CBO Purchased Care programs. Is that the case, or may services be provided to CBO Revenue Operations as well?
No, this contract is to support FSC only. If CBO Revenue Ops needs information, we will send it to them.
No

35.

This solicitation appears to contemplate conducting EDI transactions with FSC as a gateway to CBO Purchased Care programs. Please provide a list of which Purchased Care programs are included (e.g., but not exclusive to: Fee Basis, CHAMPVA, Children of Women Vietnam Veterans, and Camp Lejeune).
This information will be provided to the awardee because it is subject to change at any time.
No

36.

When the clearinghouse has provider support issues which must be addressed by the VA/VHA (e.g., missing/invalid ERAs, provider enrollment, claim rejections, real-time systems unavailable, etc.), will the clearinghouse be required to work though the FSC only, or will it have direct access to “business” personnel within the VA/VHA?
In accordance with clause C.10 in the Solicitation, VAAR 852.270-1, the Contracting Officer will designate a Contracting Officer Representative for coordination with the FSC.
No
37.
PWS 3.0
The third sentence of the first paragraph refers to the clearinghouse assisting with “printing of standard claim forms in certain situations where electronic transmission is not feasible”, yet there is no further mention of what such circumstances might be or what requirements might apply to the printing and delivery of such forms. Please elaborate and where appropriate, provide volume around the printing.
Auditors require an image of a printed claim form instead of using the data from an 837 submission. Annual requirement is 500.
No
38.
PWS 5.1.3
The third paragraph item 3 requires a Monthly Summary Paper Claim Report “for network submitters sending paper to payer by payer ID”. However, almost as a matter of definition paper payers do not have payer IDs. Is it FSC’s intent that the clearinghouse should generate the report based on VA mailing addresses appearing on claims which the clearinghouse prints?
It is the FSC intent to provide the payer ID to the awardee.
No
39.
PWS 5.1.3
The 4th paragraph specifies that the clearinghouse will annually render up to 500 claims received electronically into printed claim images based on claim numbers provided by the Government, but does not specify what claim numbers the Government will provide.

a. Can FSC state that the claim number will be the 2300/REF with REF02=D9 value submitted by the clearinghouse to uniquely identify claims?

b. How does FSC expect the claim images to be delivered?

a. Auditors require an image of a printed claim form instead of using the data from an 837 submission.

b. Images are delivered electronically No

40.
PWS 5.1.4
The 3rd paragraph requires certification by CAQH Phase 2 for both batch and real-time eligibility. Typically, only one or the other is utilized.

a. Can the FSC please clarify if they anticipate needing batch 270/271

b. and if so for what VA plan(s)?

a. Yes, awardee should be able to handle 270/271 batches.

b. For 270/271 transactions No

41.
PWS 5.2
Item 1 states that “documenting” the receipt date of electronic media claims from providers is a requirement, but does not specify the form or medium in which the documentation should be reported, stored or delivered.

a. Does this mean that the clearinghouse must record the information in its systems, or

b. Does FSC require reporting? Please clarify and elaborate.

For a and b, the receipt date is documented on the 837.
No
42.
PWS 5.2
Item 2 states that the clearinghouse should validate medical claims using “FSC provided required information”.

a. Does the FSC require validation rules above and beyond the rules documented in the TR3s for the 837 transactions?

b. If so, can FSC provide the number of such non-standard requirements it has?

c. Furthermore, are they VHA program/Payer ID specific, or applicable across the board to all claims delivered to FSC?

a. Yes, we have additional validation rules depending on whether the claim was originally a paper claim or is program specific.

b. 23 rules for professional claims, depending on the program; 27 rules for institutional claims; depending on program

c. They are program specific.

No

43.
PWS 5.2
Item 9 specifies Coordination of Benefits payer to payer claims –

a. Does this refer specifically to Crossover claims received from Medicare?

b. Or will connections to other payers be required as well?

c. Will these payer to payer transactions only be in the direction of payer FSC, or will there be bidirectional as in FSC payer?

a. We do not receive claims from Medicare.

b. For the purpose of this effort, the FSC is the only payer.

c. COB will be from FSC to provider.

No

44.
PWS 5.2
Item 9 bullet 2 identifies the 824 transactions as one of the acknowledgment types. Since the 824 is not required per the TR3 ASCX12X186 section 1.6.3 for compliance. Please clarify when the 824 would be used.
At this time, the FSC does not use 824 transactions.
No
45.
PWS 5.2.1
The Optional Tasks imply that the clearinghouse should only “complete” them (i.e., process the transactions) if the tasks are exercised, implying that the clearinghouse should not “complete” the tasks (i.e., process the transactions) if the task is not exercised. If the optional task is not exercised and the volume is exceeded by providers, what action is expected from the clearinghouse?
The optional tasks are by claim types and by each period of performance.

Only the maximum amount can be exercised in each period for the price in that period.

During performance, if the Contractor anticipates exceeding any optional task claim type maximum quantity, then it would alert the COR and CO for appropriate action.

No

46.
PWS 5.2
a. When you reference CMS-1450 claims (UB), is that an OCR claim?

b. When you reference an 837 claim, is that inclusive of professional, institutional, and dental? And if so, how many dental claims are there?

c. Are you going to also scan ADA claims?

d. When you refer to other government agencies will additional payer IDs be required?

e. Will you need dental attachments for dental claims?

a. The Form CMS-1450, also known as the UB-04, is the standard claim form to bill Medicare Administrative Contractors (MACs) when a paper claim is allowed.

b. See section 5.2 for 837 claim information. Transaction numbers will be provided to the awardee.

c. No, we are not scanning ADA claims.

d. Payer ID’s will be provided to the awardee.

e. No, dental attachments are not needed at this time.

No

47.
PWS 5.2.1
The chart of Transaction Types has “N/A” for pharmacy claims in the Base/Option Period, then 0-5,000,000 for Optional Task 1. What are FSC’s specific plans with respect to pharmacy claims – will they not be part of the initial implementation? 2. Will they be added later? If so, when?
1. Implementation of Pharmacy transactions will be exercised in the quantities stated under Optional Task 1.

2. The Government reserves the right to exercise optional tasks. However, it is not required to do so.

No

48.
PWS 5.2.1
In the table under the column called Transaction Type row 5 list multiple transactions but has claims at the end of it without further clarification. Claims are already covered in rows 1-3, & row 6 can you clarify the difference for claims listed in row 5?
Upon review, the table under 5.2.1 in the Performance Work Statement has been revised.
Yes. The word “claims” from row 5 in the table has been removed.
49.
PWS 5.4 and 6.2.2
The VA has previously determined that PII/PHI received by a Healthcare Clearinghouse (HCCH) immediately becomes property of the clearinghouse, and no longer belongs to the VA; as such VA security requirements no longer apply to the data, which the HCCH must protect according to the applicable healthcare regulations.

This solicitation does not seem to acknowledge that determination, which is reflected in the language of solicitation #VA259-17-R-0181 (“As a HIPAA covered entity, no A&A will be required to be completed on behalf of the VA since the vendor is required by law to follow NIST/FISMA standards. No VA system access identified. No VA background investigations or VA training required”.) and #solicitation #VA777-17-N-0061 (“6.20 Recognize that when PII/PHI data is transferred from the VHA to the HCCH, it becomes HCCH data and that the HCCH is responsible for complying with all applicable Federal Information Security Management Act (FISMA) and HIPAA rules and regulations.“).

Can you please explain the rationale for excessive security requirements when compared to other past solicitations for similar services?

This contract will adhere to VA Directive 6513, Secure External Connections, Oct 12, 2017. See Appendix A for additional references and Appendix B for the definition of “external connection.”

No

50.
B.7 Price Schedule
The table combines the 270/271, 276/277 275 and 278 transactions into a single line item. This seems inappropriate since the 275 is a batch transaction while the others are traditionally conducted in real-time mode and have vastly different processing requirements. Please split these transactions out. To facilitate accurate pricing, can you provide the volume for the batch and real-time transactions.
No, the Government does not have the volume estimates for the batch and real time transactions.
No
51.
PWS 5.5 and B.7 Price Schedule
The solicitation refers to pharmacy and NCPDP transactions but seems to do so only in the context of “claims” and “paper claims” (5.2 #9 mentions “pharmacy claims”, #10 discusses future versions of paper claims, 5.2.1 and B.7 both refer to “pharmacy claims”).

a. Is it FSC’s intent to conduct real-time NCPDP eligibility and claim transactions with pharmacies on behalf of the VA/VHA Purchased Care programs, b..or does it intend only to receive 837 claims that include charges for pharmacy services?

a. No, at this time, 837 claims include pharmacy charges.

b. Pharmacy claims are an optional task.

No

52.
B.2 and Addendum B
Sections B.2 (pages 5-13) and Addendum B (pages 37-46) are almost verbatim duplicates. Please reconcile the two sections and delete the duplicate.
Upon review, the solicitation has been revised as such: IT Contract Security, Section B.2 has been removed and all paragraphs have been re-numbered.
Yes.
53.
PWS 5.2
On section 5.2. point 4, the VA refers to encrypted TIFF images that need to be converted to 837 transaction files.

1. Will the files be encrypted before the transmission or the transmission will be encrypted?

2. In addition, what is the FSC encryption method?

1. Receive encrypted TIFF images from the FSC and convert those TIFF images into HIPAA compliant 837 transaction files within two (2) business days of receipt of the TIFF images.

2. Electronically transmit the encrypted HIPAA compliant 837 transaction files to the FSC. Encrypt PHI/PII data transmitted to or from VA with FIPS 140-2 (or its successor) validated encryption No

54.
PWS 5.2
On section 5.2 point 9, fourth bullet, the document refers to several form types: HCFA OCR, Dental Camp pharmacy claims 270/271/275/276/277and 278.

a. Can the VA explain what are the expectations for each transaction type and;

b. Confirm which of them will require OCR processing?

For a and b, OCR work is for paper claims received and then converted to an 837 EDI transaction.
No
55.
PWS 5.2.1
Section 5.2.1, please provide details on the FSC accuracy requirements.
Measured by random sampling of claims received.
No
56.
PWS 5.2.1
Section 5.2.1, transaction volumes table, line one. Is this line the only reference to the volume of Tiff images that will require OCR processing?
While the Government cannot predict the future volume, historically it has been about 18K claims per month.
No
57.
General
a. Will all forms submitted for OCR conversion to 837 be CMS standard forms?

b. Will correspondence documents submitted for OCR processing?

For a and b, all paper claims submitted from a provider will need to go through OCR conversion.

While the Government cannot predict the future volume, historically it has been about 18K claims per month.

No

58.
General
Since different form types require different levels of effort, can the OCR volume be broken by Professional, Institutional, Dental, red and black forms?
The Government does not have the breakdown as it is currently handled as one rate.
No
59.
General
Please confirm that there will be no mailroom processing required?
No mailroom processing will be required.
No
60.
General
Please advise when the contract start date is?
The anticipated start date for the contract is August 1, 2018.
No
61.
PWS 5.2
Please specify which transactions FSC needs to be downgraded to 4010 (if any), and in which direction the downgrade needs to go (FSC to Providers, or FSC from Providers). If any, can you please provide the estimated volume.
We do not expect any downgrading to 4010.
No

62.

For accurate pricing, and proper forecasting of our development efforts, what is VA’s business need and intent for the 824 transactions.
We are not currently using the 824 transaction because it is not a standard transaction yet.

No

63.

Please know that the VA Vendor Portal still has the original end date for Solicitation #36C10B18R2676 and as such, it does not accept any submissions since the original end date has passed
Section E.11 in the Solicitation, Proposal Submission Instructions has been revised accordingly.

Submission to the vendor portal has been removed and proposal submission shall be through email to Lauren.Sankar@va.gov.

Yes

64.

What is the turn-around time on pharmacy claims and 835 transactions?
The 835 is the response transaction to the 837 and the FSC will send those out through the vendor.

No

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