36C10G18R0208-1-0014001.pdf
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- Customer Care Network Region 4
- Solicitation number
- 36C10G18R02081
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This document outlines the weights assigned to various clinical line items (CLINs) for the Customer Care Network Region 4 federal contract opportunity. The weights indicate the value or importance of each CLIN for reimbursement purposes. High-level CLINs include Reimbursement for Highly Rural Care Areas, Seasonal Influenza Vaccination, Home Infusion, Urgent and Emergent Medication, Dental Services, and Administrative Services. The Urgent and Emergent Medication CLIN further breaks out weights for Brand Name Medication, Generic Medication, and Dispensing Fee. Optional CLINs cover services like Appointment Scheduling, Care Coordination Follow-Up, Comprehensive Case Management, and Disease Management. The total weights across all CLINs add to 100%. This breakdown of CLIN weights will impact how the contractor managing the Customer Care Network Region 4 contract is reimbursed for different types of services provided to veterans.
36C10G18R0208-1 0014 Amendment A0014 Corrected Table 30 Weights.pdf
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Table 30 Weights
CLIN Description
VA
Weight
VA Sub-
Weight
Unit
Weight
CLIN X002 Reimbursement for Highly Rural Care Areas with Scarce Medical Services 9.0%
CLIN X002AA Highly Rural Care provided in Arizona 7.7% 0.7%
CLIN X002AB Highly Rural Care provided in California 7.7% 0.7%
CLIN X002AC Highly Rural Care provided in Colorado 7.7% 0.7%
CLIN X002AD Highly Rural Care provided in Hawaii 7.7% 0.7%
CLIN X002AE Highly Rural Care provided in Idaho 7.7% 0.7%
CLIN X002AF Highly Rural Care provided in Montana 7.7% 0.7%
CLIN X002AG Highly Rural Care provided in New Mexico 7.7% 0.7%
CLIN X002AH Highly Rural Care provided in Nevada 7.7% 0.7%
CLIN X002AI Highly Rural Care provided in Oregon 7.7% 0.7%
CLIN X002AJ Highly Rural Care provided in Texas 7.7% 0.7%
CLIN X002AK Highly Rural Care provided in Utah 7.7% 0.7%
CLIN X002AL Highly Rural Care provided in Washington 7.7% 0.7%
CLIN X002AM Highly Rural Care provided in Wyoming 7.7% 0.7%
CLIN X005 Seasonal Influenza Vaccination 9.00% 9.0%
CLIN X008 Home Infusion % of billed charges 9.00% 9.0%
CLIN X009 Urgent and Emergent Medication 9.00%
CLIN X009AA Brand Name Medication 33.3% 3.0%
CLIN X009AB Generic Medication 33.3% 3.0%
CLIN X009AC Dispensing Fee 33.3% 3.0%
CLIN X010 Dental Services 9.00% 9.0%
CLIN X011 Administrative Services 34.00%
CLIN X011Ax Administrative Services for Healthcare Services 60.0% 20.4%
CLIN X011Bx Administrative Services for Dental 20.0% 6.8%
CLIN X011CA Administrative Fee for Pharmacy Benefit Management (PBM) 10.0% 3.4%
CLIN X011DA Administrative Fee for Assisted Reproductive Technology services (ART) 10.0% 3.4%
CLIN X012 Implementation and Transition Out 9.00% 9.0%
CLIN X014 Agreed Upon Procedures Audit 2.0% 2.0%
CLIN X016 Optional: Appointment Scheduling & Comprehensive Care Coordination (CCC) 2.00%
CLIN X016AA Optional: Implementation for Appointment Scheduling and CCC at VA Facility 15.0% 0.3%
CLIN X016BA Optional: Implementation for Appointment Scheduling and CCC at Contractor’s site 15.0% 0.3%
CLIN X016Cx Optional: Appointment Scheduling and CCC Administration 70.0% 1.4%
CLIN X017 Optional: Care Coordination Follow-Up 2.00%
CLIN X017AA Optional: Implementation for Care Coordination Follow-Up 30.0% 0.6%
CLIN X017Bx Optional: Care Coordination Follow-Up Administration 70.0% 1.4%
CLIN X018 Optional: Comprehensive Case Management Program 2.00%
CLIN X018AA Optional: Implementation for Case Management Program 30.0% 0.6%
CLIN X018Bx Optional: Comprehensive Case Management Program Administration 70.0% 1.4%
CLIN X019 Optional: Comprehensive Disease Management Program 2.00%
CLIN X019AA Optional: Implementation for Comprehensive Disease Management 30.0% 0.6%
CLIN X019Bx Optional: Comprehensive Disease Management Program Administration 70.0% 1.4%
CLIN X020 Assisted Reproductive Technology (ART) Services 2.0% 2.0%
Total 100.0% 100.0%
New Weight
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