ATTACHMENT C - QUESTIONS SPREADSHEET_ ANSWERS.xlsx
XLSX spreadsheet 21 KB Posted
- Solicitation number
- 36C10G22R0015
About this file
This document contains answers to questions from offerors regarding a solicitation to price Medicare claims using CMS methodologies. The Department of Veterans Affairs requires these pricing services to validate payments made through their Community Care program. Offerors must be able to accurately price sample claims provided using the appropriate fee schedules. If awarded, the vendor will provide pricing and payment details for individual claims submitted. Invoices will be prorated at a fixed monthly fee. Training of users and customer service support is also required. Ongoing pricing would utilize the vendor's self-service portal or bulk files if elected by VA. The period of performance and pricing terms were not specified.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10G22R0015 0002.docx | DOCX document | |
| ATTACHMENT F - Sample Claims.xlsx | XLSX spreadsheet | |
| 36C10G22R0015 0001.docx | DOCX document | |
| ATTACHMENT E -QASP.pdf | ||
| 36C10G22R0015 0001.docx | DOCX document | |
| 36C10G22R0015.docx | DOCX document | |
| ATTACHMENT B - PAST PERFORMANCE QUESTIONNAIRE.docx | DOCX document | |
| ATTACHMENT A - PRICING SPREADSHEET.xls | XLS spreadsheet | |
| ATTACHMENT D - PWS.pdf | ||
| ATTACHMENT C - QUESTIONS SPREADSHEET.xlsx | XLSX spreadsheet |
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Text version
Sheet1
| Page # | RFP Section Reference | Question | Answer |
| 5 of 9 | Attachment D: Performance Work Statement - Calculation of Medicare Claims Pricing Item #7: Mandatory Tasks and Associated Deliverables | If the Claim Data provided to Contractor (or Offeror in the case of the the sample claims for assessing Sub-Factor 1: Pricing Accuracy) is not adequate to calculate the accurate Medicare fee-for-service payment under the appropriate fee schedule or prospective payment system, will the Government consider the explanation of the missing or inappropriate data as full-filling the pricing accuracy component of Sub-Factor 1? | Claim sample data provided in this solicitation will be sufficient to return accurate CMS reimbursement. |
| 55 of 57 | E.5 52.216-1 TYPE OF CONTRACT (APR 1984) | Please define "C-Type contract" and we would like to request clarification on whether the firm fixed price is per claim or whether the exercise of the base period or option periods ensures a minimum FFP that equates to the total number of claims identified for that period. | C-Type contract is defined as contracts of all types except indefinite-delivery contracts. Reference FAR 4.1603 Procedures |
| Page 4 - 36C10 Doc | Invoicing | Will the monthly invoices be prorated at a fixed monthly fee based on the total annual value/amount or based on actual total claims usage during that specific monthly period? | The monthly invoices will be prorated at a fixed monthly fee based on the total/annual value. Should the total number of claims exceed the amount listed, additional claims/funds will be added to the contract up to the NTE amount. |
| Page 28 | Sample Claims Data Analysis | Will we receive immediate notification once the sample claims are posted? With only 48 hours available this inital file will need re-formatted, QA, etc. | An email will not be sent out from the Government, however, there is an option through SAM.gov to receive alerts when a solicitation amendment has been posted. Additionally, SAM.gov site can be checked for postings at any time. |
| Page 28 | Sample Claims Data Analysis | Can we receive the sample claims at an earlier date? | No, all offerors will receive the sample claims via amendment to the solicitation. VA allows 48 hours to ensure the vendor is capable of providing responses quickly, as required by the solicitation. |
| Page 28 | Sample Claims Data Analysis | Will the VA format the sample claims file into our Standard CSV Format prior to posting to our organization? | The sample claims will be provided in the same Excel format to all potential vendors. |
| Page 28 | CSV Claims Submission - Ongoing | If awarded, will the VA format the claims into our Standard CSV Format prior to submission for pricing? | VA intends to use self-service via the vendor's portal for individual claim pricing if awarded. If VA elects to use bulk pricing, VA can provide future data in Standard CSV format as it comes from VA's data warehouse to the awarded Vendor as outlined in the PWS. |
| Page 28 | CSV Claims Data Analysis | Will each sample claim submitted been successfully priced without any errors? | Sample claims have been selected to test potential vendor pricing systems for various situations. This allows VA to confidentially award a vendor that will provide accurate claim pricing and prove to be a SME in CMS reimbursement. |
| Page 28 | CSV Claims Submission- Ongoing | If awarded, our system is built for self-service with easy import/export of CSV files into our system for pricing claims. Will the VA use this self-service model or will the vendor be expected to receive data files and price and return? If so, frequency? | The required tasks are for manual input of de-identified claim data. The optional bulk data task will involved data files and if exercised, could be emailed to the contractor or possibly uploaded by VA. Frequency is unknown at this time. |
| Page 29 | PPQ | What is the distribution/return process of the PPQ's? | Please review Attachment B - Past Performance Questionnaire for the return process |
| Page 29 | PPQ | Do I need to submit name, emails etc of x# of refeneces for the PPQ? If so, where would you like this submission? | Please review Attachment B - Past Performance Questionnaire for the return process |
| N/A | Customer Service Load | What will be the estimated customer service total annual hours to fully support the 40 users, etc? | Customer service, after initial training, will be based on support needed for reimbursement clarifications and if any discrepancies are identified. |
| N/A | Training | We will assume full "initial" training of the 40 users on our system. What is the estimated assumptions for re-training for new users, updating of new users, ongoing support of complex claims, etc? | After initial training, awarded vendor would only need to train users for major system changes or updates. If claim pricing has discrepancies, VA would need customer service from awarded vendor to provide such details, including but not limited to wage index, CCR, etc. in order to drill down where pricing differences occur. |
| Page 8 | Contracting | Will the VA provide a sample Master Service Agreement that outlines the terms set forth as the RFP documents have outlined or will the vendor be required to provide a MSA? | A Master Service Agreement is not required. |
| Page 30 | SF 1449 | Will the VA provide the SF1449 for review/signature? | Yes, upon issue of award, the awardee will receive a copy of the contract for review / signature |
| PWS Attachment D, Pages 6 and 7 | Task #2 and #3 sections | Regarding the “identification of any line items included in bundled payment amounts”, can you provide an example of the information the VA would like included in the pricing output? In particular, can the government further clarify “to include Medicare edits”. | VA is seeking to award to a vendor that can provide details for each claim submitted for pricing. The details will change based on the type of fee schedule involved per claim. Types of details include, but not limited to, facility wage index used, CCR used, status indicator applied to each HCPCS/CPT code, outlier payment information, etc. The awarded Vendor is to provide any Medicare edits applied to a line item or claim level such as, but not limited to, invalid CPT code, MUE edits, reductions for modifiers or provider type, etc. |
| PWS Attachment D, Page 4 | Task #2 and #3 sections | Is DRG to be recalculated by the contractor (i.e. using the ICD codes) and compared to the claim input DRG? | Yes |
| PWS, Page 9 | PWS Section 9 - Quality Assurance Surveillance Plan (QASP) | The PWS references a QASP to be found in Attachment A - Quality Assurance Surveillance Plan. There is no Attachment A with a QASP. Will and can the government provide the referenced QASP as part of Q&A responses. | The QASP has been attached to this amendment. (Attachment E) |
| RFP, Page 28, Proposal Section Table vs Page 31, Price Factor | Volume IV SF1449, Amendments (SF30) & Other Documents vs Price Factor, 4th Paragraph | For the purposes of clarity, as this is a factor for compliance, what "other applicable and required documents" are required to meet this requirement. Page 28 within the table indicates only the SF1449 and SF30s) are required but on page 31, 4th paragraph, 3rd sentence makes mention of "other applicable and required documents". Please clarify and note any other "other applicable and required documents" beyond the SF 1449 and SF 30s required to be submitted. | Offerors shall sign and return the SF1449 and all Amendments and submit as its Volume IV. Currently, there are no other documents required by this solicitation. |
| RFP, Pages 36-55 | Offeror Representations and Certifications | This section of the RFP has many provisions that are blank or not filled-in based on the representation or certification. Is the governments expectation for the bidder to complete the applicable blank sections or are these representations and certifications mean to stay as presented in the RFP? | 52.212-3 The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision. |
| PWS, Page 7 | Task 3 | For the bulk data files, what is the expected frequency of bulk files (i.e.: month/quarterly) or will it be just one bulk data file annually? | If VA elects to use bulk pricing it will be used on an ad hoc basis. |
| RFP, Page 28 | Table - Volume II Past Performance | Please confirm that Past Performance requirements are one (1) page for the summary and three (3) past performance references (each 2 pages) for a maximum of 7 pages? | One (1) page summary of all submissions. Three (3) Past Performance Ratings -Limited to 2 pages per CPARs and/or PPQ (for total of 6 pages). Including the summary, this will be 7 total pages. |
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