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This document is a combined synopsis and solicitation from the Department of Veterans Affairs seeking a healthcare clearinghouse to support electronic data interchange transactions and processing of paper-based health claims and associated medical documentation. Key details include that the VA is seeking these services to support the Veterans Health Administration and Office of Community Care in processing over 27 million transactions annually. Interested vendors must be registered in SAM and able to accept a one-year base period of performance with three optional one-year extensions. Quotes are due by July 6, 2020 and the contract will be awarded based on best value considering technical capability, past performance, socio-economic status and price. The associated NAICS code is 518210 with a size standard of $35 million.

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File Type Posted
36C10G20Q0003 0003 SF 30.docx DOCX document
Attachment H QASP Final.docx DOCX document
36C10G20Q0003 0002 SF 30.docx DOCX document
Amendment A-0002 Question and Answer.pdf PDF
Attachment E Solicitation Provisions Rev.docx DOCX document
Attachment H QASP Rev Final.docx DOCX document
Attachment A Schedule 1 Rev Final.docx DOCX document
Attachment D PWS Rev Final.docx DOCX document
Attachment C Contract Clauses Rev Final.docx DOCX document
36C10G20Q0003 0001 SF 30.docx DOCX document
Solicitation 36C10G20Q0003 Question and Answers.pdf PDF
Attachment C Contract Clauses .pdf PDF
Attachment A Schedule .pdf PDF
ATTACHMENT F PAST PERFORMANCE REFERENCES.pdf PDF
36C10G20Q0003.pdf PDF
Attachment H QASP.pdf PDF
Attachment E Solicitation Provisions .pdf PDF
ATTACHMENT G PAST PERFORMANCE QUESTIONNARE.pdf PDF
Attachment B Contract Administration .pdf PDF
Attachment D PWS .pdf PDF
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QUESTIONS

PWS SEC/Clause/Provision/Attachment
ANSWERS
112
per transaction 837 and 275Per Attachment H (QASP,) Page 2: “The contractor shall provide services capable of receiving a minimum of 500,000 paper claims and 800,000 paper claims’ attachments via postal mail per month in a single

location.” Paper to Electronic (P2E): Base Year Unit Total of 27,768,842. How does the VA calculate and define “claim” volume and “transaction” volume More specifically, please describe the calculation methodology to bridge “paper claims” of 500,000 and “paper claims’ attachments” of 800,000 to the Base Year Unit Total for P2E of 27,768,842.

Transaction is defined as an 837 or 275 – a Claim make’s up an 837.

The numbers here were reversed the QASP will updated to reflect 800,000 claims, and 500,000 attachments. This is expected per month as a minimum, but could be more. Higher numbers are if there is more.

113
“The contractor shall provide services capable of receiving a minimum of 500,000 paper claims and 800,000 paper claims’ attachments via postal mail per month in a single location”. What does VA consider the maximum number of expected paper claims per month during the first year?

The number here were reversed the PWS will updated to reflect 800,000 claims, and 500,000 attachments.

114
Are attachments considered “transactions” or “claims”?

Attachments are considered Transactions.

115
In VA OIG REPORT #18-01214-157, “Health Information Management Medical Documentation Backlog” the VA-OIG audit team calculated that as of July 19, 2018, VA medical facilities had a cumulative medical documentation backlog of paper documentation that measured approximately 5.15 miles high and contained at least 597,000 individual electronic document files dating back to October 2016.

Does the VA envision that as part of this contract that the contractor will process the documents referenced above and will the vender be expected to implement a new and timely process to perform this work?

Refer to numbers utilize in the RFP, not what is in the report referenced.

116
The solicitation includes conflicting instructions about the number of past performance references sought:

"The offeror shall complete Attachment F: Past Performance References in its entirety, listing a total of three contracts (emphasis added)/orders for work performed in the past three years or currently being performed...". (Solicitation Provisions, p.12) "Factor 2 - Past Performance (no more than 3 page narrative/reference not to exceed 5 projects (emphasis added). Questionnaires do not count against page total.) Provide for subcontractors who will perform 20% or more of the work)." (Solicitation Provisions, p.15) Please clarify the maximum number of Past Performance references to be provided: 3, or 5? Please confirm that each Past Performance Reference to be submitted by the offeror on Attachment 7 is to be a maximum of 3 pages. Please confirm that the page limit for Volume II is three pages per reference.

Past Performance Reference refer to Attachment F. Past Performance Questionnaires (Attachment G) are provide by the offeror’s reference(s), and not provided by the offeror. Volume II states, “3 page narrative.”

117
The response provided to question 18 about the file size limits for email submissions (“Please refer to Attachment E, pg 8 (a), and pg 9- PROPOSAL FILES”) did not specify the file size limit. Please specify the maximum size of an email that the VA can accept for this solicitation (e.g., 5MG? 10 MG? etc.).

Proposals can be sent in separate concurrent emails.

118
The response to Question #49 indicates that “VA anticipates a steady decrease in paper over the next 48 months as more providers convert to electronic transactions” , yet the pricing schedule shows P2E volume rising from 27.7 million in the base period to 36.9 million in the third option period, reflecting a 33% increase over the next 48 months. Please clarify this apparent discrepancy.

We do anticipate a decrease. Our best estimate is 15.6M per year for each of the 4 years, however, it is only an estimate and may be as high as we have stated in the pricing proposal.

119
The response to Question 86 (Refer to PWS Section 5.5) remains ambiguous and open for a wide range of peculation. We ask that VA consider adding an estimated level of effort for each size implementation (e.g., small = .50 FTE; medium = 2.5 FTE; large = 10.0 FTE, etc.), or some other way of more objectively calculating the requirement, so that all offerors are pricing apples and apples. As an alternative, VA may wish to modify the CLINs from Schedule A, to indicate that they will be requested and negotiated only with the apparently successful offeror, similar to the approach taken with the Subcontracting Plan.

VA estimates Small Implementations as Technical Writer, 1 SME, Full Time at 8 hrs./day, and, 1 Consulting Manager, Half time-over the 2 weeks/14 day period. VA Estimates Medium Implementations as 1 Senior Health Plan Expert, 1 Technical Writer, Half Time, and 1 Project Manager, 1 SME, and 1 Consultant, Full Time at 8 hrs./day, over the 10 week/70 day period. VA estimates Large Implementations as 1 Senior Health Plan Expert, 1 Business Process Engineer, 1 Technical Writer, Half Time at 4 hrs./days or equivalent, 1

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