Amendment 0001 UPDATED Attachment B Pricing.xlsx
XLSX spreadsheet 32 KB Posted
- Solicitation number
- 36C10G23R0004
About this file
This document includes a solicitation for Electronic Data Interchange (EDI) and Paper to Electronic (P2E) transaction services. The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Office of Integrated Veteran Care (IVC) requires a Healthcare Clearinghouse (HCCH) contractor to provide incoming and outgoing EDI transactions and support a paper to electronic capability. The solicitation seeks to increase electronic transactions and reduce paper submissions to comply with legislation and facilitate administrative simplification. Interested offerors must register in SAM and submit proposals by February 17, 2023 to Justin.Sink@va.gov and Terri.Duenas@va.gov. Questions are due by January 25, 2023. The solicitation is unrestricted and has a NAICS code of 518210 with a $40 million size standard. The HCCH contractor will provide HIPAA-compliant data and processes to over one million medical providers to support payments for Veterans' healthcare.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| UPDATED Solicitation 36C10G23R0004 Amendment 0002.pdf | ||
| 36C10G23R0004 0002_2.docx | DOCX document | |
| Amendment 0001 Solicitation 36C10G23R0004 VA HCCH EDIP2E Services .pdf | ||
| 36C10G23R0001 0001 Combined Synopsis Amendment 0001.pdf | ||
| Attachment D Question and Answers.xlsx | XLSX spreadsheet | |
| Attachment E Quality Assurance Surveillance Plan.pdf | ||
| Amendment 0001 Updated Attachment A Performance Work Statement EDIP2E.pdf | ||
| 36C10G23R0004 0001_1.docx | DOCX document | |
| Solicitation 36C10G23R0004 VA HCCH EDIP2E Services.pdf | ||
| Attachment A Performance Work Statement EDIP2E .pdf | ||
| Attachment B Pricing.xlsx | XLSX spreadsheet | |
| Attachment C Past Performance Questionnaire.docx | DOCX document | |
| Attachment D Questions.xlsx | XLSX spreadsheet | |
| 36C10G23R0004_1.docx | DOCX document |
Show all 14
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
NOTES
| NOTES: |
| 1. Offerors shall only input pricing information in cells highlighted in yellow. |
| 2. Tab 2 Summary is an autofill tab. Therefore no entries are to be made in that tab. |
| 3. Offerors shall input price per claim in all "Per Claim Price" tabs. Cells are highlighted in yellow. |
| 4. VA anticipates CLIN X016 to be exercised in the final Option Period; however, CLIN X016 may be exercised at any point throughout the contract period. |
Summary
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | BASE PERIOD | OY1 | OY2 | OY3 | OY4 | OY5 | OY6 | OY7 | OY8 | OY9 | Transition Services | TOTAL |
| 0001 | Ramp-Up and Initial Implementation | $0.00 | $0.00 | ||||||||||
| X002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements) | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X007 | Health Care Claim Status Request and Response 276/277/277CA (includes acknowledgements) Hosted Transactions | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X008 | Health Care Claim Status Request and Response 276/277/277CA (includes acknowledgements) Direct Real-Time transactions | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X009 | Health Care Claim Status Request and Response 277RFAI | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X013 | Paper to Electronic (P2E) Conversion | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X014 | Rejection Claim plus USPS First class Postage | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X015 | Receipt and upload to Database | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | ||
| X016 | Transition Support | $0.00 | $0.00 | ||||||||||
| TOTAL | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 | $0.00 |
Base Period Price
| Base Period Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 0001 | Ramp-Up and Initial Implementation | 6 | Month | $0.00 |
OY 1 Per Claim Price
| Option Year 1 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 1002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 45,147,968 | EACH | $0.00 | |
| 1003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 1,750,000 | EACH | $0.00 | |
| 1004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 8,600,000 | EACH | $0.00 | |
| 1005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 17,458,157 | EACH | $0.00 | |
| 1006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 19,149,246 | EACH | $0.00 | |
| 1007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 740,012 | EACH | $0.00 | |
| 1008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 1 | EACH | $0.00 | |
| 1009 | Health Care Claim Status Request for Additional Information 277RFAI | 1 | EACH | $0.00 | |
| 1010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 240,000 | EACH | $0.00 | |
| 1011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 1 | EACH | $0.00 | |
| 1012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 1,584,800 | EACH | $0.00 | |
| 1013 | Paper to Electronic (P2E) Per Page Conversion | 29,216,400 | EACH | $0.00 | |
| 1014 | Rejection Claim plus USPS First class Postage | 300,316 | EACH | $0.00 | |
| 1015 | Receipt and upload to Database | 16,507,400 | EACH | $0.00 |
OY 2 Per Claim Price
| Option Year 2 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 2002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 49,662,765 | EACH | $0.00 | |
| 2003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 1,925,000 | EACH | $0.00 | |
| 2004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 9,460,000 | EACH | $0.00 | |
| 2005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 19,203,973 | EACH | $0.00 | |
| 2006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 21,064,171 | EACH | $0.00 | |
| 2007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 814,014 | EACH | $0.00 | |
| 2008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 1,000 | EACH | $0.00 | |
| 2009 | Health Care Claim Status Request for Additional Information 277RFAI | 1,000 | EACH | $0.00 | |
| 2010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 264,000 | EACH | $0.00 | |
| 2011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 1,000 | EACH | $0.00 | |
| 2012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 1,743,280 | EACH | $0.00 | |
| 2013 | Paper to Electronic (P2E) Per Page Conversion | 32,138,040 | EACH | $0.00 | |
| 2014 | Rejection Claim plus USPS First class Postage | 333,348 | EACH | $0.00 | |
| 2015 | Receipt and upload to Database | 18,158,140 | EACH | $0.00 |
OY 3 Per Claim Price
| Option Year 3 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 3002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 54,629,042 | EACH | $0.00 | |
| 3003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 2,117,500 | EACH | $0.00 | |
| 3004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 10,406,000 | EACH | $0.00 | |
| 3005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 21,124,371 | EACH | $0.00 | |
| 3006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 23,170,589 | EACH | $0.00 | |
| 3007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 895,416 | EACH | $0.00 | |
| 3008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 2,000 | EACH | $0.00 | |
| 3009 | Health Care Claim Status Request for Additional Information 277RFAI | 2,000 | EACH | $0.00 | |
| 3010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 290,400 | EACH | $0.00 | |
| 3011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 2,000 | EACH | $0.00 | |
| 3012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 1,917,608 | EACH | $0.00 | |
| 3013 | Paper to Electronic (P2E) Per Page Conversion | 35,351,844 | EACH | $0.00 | |
| 3014 | Rejection Claim plus USPS First class Postage | 366,683 | EACH | $0.00 | |
| 3015 | Receipt and upload to Database | 19,973,954 | EACH | $0.00 |
OY 4 Per Claim Price
| Option Year 4 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 4002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 60,091,947 | EACH | $0.00 | |
| 4003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 2,329,250 | EACH | $0.00 | |
| 4004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 11,446,600 | EACH | $0.00 | |
| 4005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 23,236,809 | EACH | $0.00 | |
| 4006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 25,487,648 | EACH | $0.00 | |
| 4007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 984,958 | EACH | $0.00 | |
| 4008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 5,000 | EACH | $0.00 | |
| 4009 | Health Care Claim Status Request for Additional Information 277RFAI | 5,000 | EACH | $0.00 | |
| 4010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 319,440 | EACH | $0.00 | |
| 4011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 5,000 | EACH | $0.00 | |
| 4012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 2,109,369 | EACH | $0.00 | |
| 4013 | Paper to Electronic (P2E) Per Page Conversion | 38,887,025 | EACH | $0.00 | |
| 4014 | Rejection Claim plus USPS First class Postage | 403,352 | EACH | $0.00 | |
| 4015 | Receipt and upload to Database | 21,971,349 | EACH | $0.00 |
OY 5 Per Claim Price
| Option Year 5 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 5002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 66,101,142 | EACH | $0.00 | |
| 5003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 2,562,175 | EACH | $0.00 | |
| 5004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 12,591,260 | EACH | $0.00 | |
| 5005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 25,560,490 | EACH | $0.00 | |
| 5006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 28,036,413 | EACH | $0.00 | |
| 5007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 1,083,454 | EACH | $0.00 | |
| 5008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 5,500 | EACH | $0.00 | |
| 5009 | Health Care Claim Status Request for Additional Information 277RFAI | 5,500 | EACH | $0.00 | |
| 5010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 351,384 | EACH | $0.00 | |
| 5011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 5,500 | EACH | $0.00 | |
| 5012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 2,320,306 | EACH | $0.00 | |
| 5013 | Paper to Electronic (P2E) Per Page Conversion | 42,775,728 | EACH | $0.00 | |
| 5014 | Rejection Claim plus USPS First class Postage | 443,688 | EACH | $0.00 | |
| 5015 | Receipt and upload to Database | 18,158,140 | EACH | $0.00 |
OY 6 Per Claim Price
| Option Year 6 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 6002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 72,711,257 | EACH | $0.00 | |
| 6003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 2,818,393 | EACH | $0.00 | |
| 6004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 13,850,386 | EACH | $0.00 | |
| 6005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 28,116,539 | EACH | $0.00 | |
| 6006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 30,840,055 | EACH | $0.00 | |
| 6007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 1,191,800 | EACH | $0.00 | |
| 6008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 6,050 | EACH | $0.00 | |
| 6009 | Health Care Claim Status Request for Additional Information 277RFAI | 6,050 | EACH | $0.00 | |
| 6010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 386,523 | EACH | $0.00 | |
| 6011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 6,050 | EACH | $0.00 | |
| 6012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 2,552,337 | EACH | $0.00 | |
| 6013 | Paper to Electronic (P2E) Per Page Conversion | 47,053,301 | EACH | $0.00 | |
| 6014 | Rejection Claim plus USPS First class Postage | 488,057 | EACH | $0.00 | |
| 6015 | Receipt and upload to Database | 19,973,954 | EACH | $0.00 |
OY 7 Per Claim Price
| Option Year 7 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 7002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 79,982,383 | EACH | $0.00 | |
| 7003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 3,100,233 | EACH | $0.00 | |
| 7004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 15,235,425 | EACH | $0.00 | |
| 7005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 30,928,193 | EACH | $0.00 | |
| 7006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 33,924,061 | EACH | $0.00 | |
| 7007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 1,310,980 | EACH | $0.00 | |
| 7008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 6,655 | EACH | $0.00 | |
| 7009 | Health Care Claim Status Request for Additional Information 277RFAI | 6,655 | EACH | $0.00 | |
| 7010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 425,176 | EACH | $0.00 | |
| 7011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 6,655 | EACH | $0.00 | |
| 7012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 2,807,571 | EACH | $0.00 | |
| 7013 | Paper to Electronic (P2E) Per Page Conversion | 51,758,632 | EACH | $0.00 | |
| 7014 | Rejection Claim plus USPS First class Postage | 536,863 | EACH | $0.00 | |
| 7015 | Receipt and upload to Database | 21,971,349 | EACH | $0.00 |
OY 8 Per Claim Price
| Option Year 8 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 8002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 87,980,622 | EACH | $0.00 | |
| 8003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 3,410,257 | EACH | $0.00 | |
| 8004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 16,758,968 | EACH | $0.00 | |
| 8005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 34,021,013 | EACH | $0.00 | |
| 8006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 37,316,468 | EACH | $0.00 | |
| 8007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 1,442,078 | EACH | $0.00 | |
| 8008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 7,321 | EACH | $0.00 | |
| 8009 | Health Care Claim Status Request for Additional Information 277RFAI | 7,321 | EACH | $0.00 | |
| 8010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 467,694 | EACH | $0.00 | |
| 8011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 7,321 | EACH | $0.00 | |
| 8012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 3,088,329 | EACH | $0.00 | |
| 8013 | Paper to Electronic (P2E) Per Page Conversion | 56,934,496 | EACH | $0.00 | |
| 8014 | Rejection Claim plus USPS First class Postage | 590,550 | EACH | $0.00 | |
| 8015 | Receipt and upload to Database | 16,507,400 | EACH | $0.00 |
OY 9 Per Claim Price
| Option Year 9 Pricing | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| 9002 | Health Care Claim (includes Institutional, Professional, and Dental) 837 batches transactions (includes acknowledgements, 999/277CA) | 96,778,685 | EACH | $0.00 | |
| 9003 | Health Care Claim (includes Institutional and Professional) 837 Medicare Crossover batch transactions (includes acknowledgements, 999/277CA) | 3,751,283 | EACH | $0.00 | |
| 9004 | Health Care Claim Payment/Advice 835 (includes acknowledgements) for both Medicare Crossover and non-Medicare Crossover batch transactions | 18,434,865 | EACH | $0.00 | |
| 9005 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Hosted Real Time transactions | 37,423,115 | EACH | $0.00 | |
| 9006 | Health Care Eligibility Benefit Inquiry and Response 270/271 (includes acknowledgements) Direct Real-Time transactions | 41,048,115 | EACH | $0.00 | |
| 9007 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Hosted Transactions | 1,586,286 | EACH | $0.00 | |
| 9008 | Health Care Claim Status Request and Response 276/277 (includes acknowledgements) Direct Real-Time transactions | 8,054 | EACH | $0.00 | |
| 9009 | Health Care Claim Status Request for Additional Information 277RFAI | 8,054 | EACH | $0.00 | |
| 9010 | Health Care Services Review – Request for Review and Response 278 (includes acknowledgements) Hosted Real-Time transactions | 514,464 | EACH | $0.00 | |
| 9011 | Health Care Services Review - Request for Review and Response 278 (includes acknowledgements) Direct Real-Time transactions | 8,054 | EACH | $0.00 | |
| 9012 | Health Care Claim Attachment 275 (includes acknowledgements) Batch Transactions | 3,397,162 | EACH | $0.00 | |
| 9013 | Paper to Electronic (P2E) Per Page Conversion | 62,627,946 | EACH | $0.00 | |
| 9014 | Rejection Claim plus USPS First class Postage | 649,605 | EACH | $0.00 | |
| 9015 | Receipt and upload to Database | 18,158,140 | EACH | $0.00 |
X016 Transition Service Pricing
| Transition Services Pricing (CLIN X016) | |||||
| ITEM NUMBER | DESCRIPTION OF SUPPLIES/SERVICES | QTY | UNIT | UNIT PRICE | TOTAL PRICE |
| X016 | Transition Support | 6 | Months | $0.00 |
File details come from the government source that posted it. Updated .