Questions _ Answers_MDE Provider Credentialing_Nov 2020_Amendment 0002.pdf

Questions & Answers_36C10X21Q0024_November 2020_Amendment 0002 Medical Provider Credentialing for VA’s MDE Program

1. Is there an incumbent providing these services currently? If so, can you provide the name of the contractor and the contract number?

Yes. Centretech, contract number VA101V-16-P-3662

2. Will the information for each medical professional (i.e. license number, state of licensure, NPI, etc.) be provided to the contractor and the contractor verifies the information, or will the contractor be starting from scratch to verify?

We provide the information we have in an excel spreadsheet. List of information we currently Providing info from header of spreadsheet we send to current provider under question 3.

3. Can you provide an example of the spreadsheet that will be provided to the contractor to begin the verification process?

Providing header titles of spreadsheet being sent to current provider:

ID

CONTRACT

REPORT YEAR

REPORT MONTH

NATIONAL PROVIDER ID

LAST NAME-FIRST NAME/MIDDLE NAME

PROFESSIONAL TITLE

SPECIALTY

APPOINTMENT STATE

LICENSE NUMBER

LOCATION(S) OF PROVIDER

VENDOR

This portion of the spreadsheet is the information we require (minimally) from the credentialing provider:

LICENSE REVOKED

CREDENTIALS REVOKED

DISCIPLINARY ACTION

CONTRACT STATUS

Valid and Unrestricted (y/n) Comment Last Audit Date

4. There are many definitions or levels of accreditation. What information does the VA require as far as Accreditation?

VA wants to ensure that all examiners are appropriately licensed, credentialed, accredited, etc. in any State of the USA. We are open to discuss the contractor’s definition of “accredited”, upon contract award.

5. Will the VA have access to the NPDB (National Practitioner Data Base)?

VA does not currently use this website.

6. Do you want us to prepare electronic folders with the documents organized and labeled to accompany spreadsheet?

VA is open to discussion and will work with the contractor on how best to address the information storage needs, upon contract award.

7. Does this contract call for the (approximately 12,000) ramp-up credentialing verifications to be re-verified each month along with the new monthly verifications (up to 5,000 each month)?

For example, on the second month, there would be as many as 17,000 credential verifications made and this number would grow each month based on the number of each Monthly Call.

Yes.

8. Conversely, does this contract call for the (approximately 12,000) ramp-up credential verifications to be made in the first month and then each month the contractor would NOT re-verify the original 12,000 but instead only verify the credentials of the new (up to 5000) credentials? All provider names are to be run every month. Names will periodically be removed, but we understand the list will grow exponentially.

9. In the Price/Cost Schedule, under CLIN lines 0004, 1003, 2003, 3003, and 4003, you call for a price on up to 25 Ad Hoc/Single-Examiner Credentialing Requests (to be billed as requests completed). This appears to be in conflict with section G. SCHEDULE OF DELIVERABLES (on the bottom of page 6). In this section, under Ad-Hoc Due Date, it states the Ad-Hoc credentialing checks will be done at not additional charge. Please clarify. VA believes these requests are infrequent and will consist of any information that has already been credentialed and saved by the contractor. The expectation for reporting is the info on the examiner will be pulled from the list/database and checked for any change since last check date. To clear up any confusion, the ad hoc CLIN has been changed to not separately priced.

10. Under section F. SCOPE, line 8., it states verification services for… “current or pending civil or criminal litigation…” is required. Is the county and state of the providers listed so that these sources can be verified for criminal and civil cases? State. Yes.

11. (Note: Checking the county, state, and federal records for criminal and civil cases (for each provider) is quite timely and costly. Our company does perform this service for many companies across the county. We do not know if you want this done on all providers in the database or only on an Ad-Hoc basis. ) We currently track this only on an ad-hoc basis and would like to expand that. VA is open to contractor suggestion.

12. How many years back should we search for current or pending civil and criminal litigation? The

Fair Credit Reporting Act has limitations on such searches for employment purposes. We have not set these parameters and are open to contractor for suggestion.

13. Is the contractor required to follow the Fair Credit Reporting Act provisions and serve as a

Consumer Reporting Agency to the VA under this contract? No.

14. The answer to Question 17 in the previous Q&A states that “Countries are listed in the Contract” but no list appears in the documentation provided. Is there a list of foreign countries/territories that will be covered under this contract, and are there specific credential requirements for those countries?

American Samoa Australia Bahrain Belgium Belize

Canada Colombia Costa Rica Denmark Dominican Republic

Ecuador France Germany Greece Guam Italy Ireland Japan Kuwait Luxembourg Mexico Netherlands Northern Mariana

Islands New Zealand Panama Philippines Poland Puerto Rico Singapore South Korea Spain Thailand

UAE

United Kingdom Uruguay US Virgin Islands

15. Will all existing providers need to be fully reverified every month? For example, if a provider is submitted and verified in January 2021, will all credentials need to be verified again in February 2021 or will they just need to be monitored for sanctions, customer satisfaction data, and credential expirations? Yes.

16. What is the intended use for Customer Satisfaction data and will it be made available to veterans? Customer Satisfaction scores are applied to each vendor’s overall quality score.

Stats from reports may be used for additional internal data reports as well.

17. Does the unit for ad hoc reports (item #0004, pg. 8) represent individual providers and indicate that we should expect no more than 25 total ad hoc requests per one-year period? Yes.

18. What is the scope of the criminal and civil record search requirement?

a. Do you require all countries and all alias names?

b. What is extent of criminal reporting required? Do you require checks for all county criminal and federal criminal records?

We have not set these parameters and are open to contractor for suggestion.

19. For the foreign providers, what screening tools/databases are currently in use?

a. Basic licensing and sanctions databases such as OFAC, Terrorist Watch List, etc. OR are full criminal background checks required in the country of operation?

We have not set these parameters and are open to contractor for suggestion.

20. For healthcare credentialing, which of these is required for contract compliance:

a. License Check

b. Federal and State Exclusions

c. Sanctions

d. Board Actions

e. Verification of Adverse Information (i.e. does the record we ID’d have sufficient identifiers to confirm it was the subject of the report?)

f. Continuous Monitoring and Alerting

All of the above.

21. For the previous contract VA101V16P3662, 36,000 annual checks were forecasted as the requirement.

a. How many actual regular and ad hoc checks were conducted each year on the previous contract?

We anticipate 36,000 checks per year for this contract. Once the contract is awarded and the work has begun, if it appears the workload is significantly higher or lower than VA has anticipated, we will address any changes that may be needed at that time. Historical numbers are not available at this time.

22. Reference: PWS Section F – Scope states, “The scope of this contract shall be to verify credentials for all active and unique non-VA medical providers in all regions across the country and in specified foreign locations.”

Question: Is it the Government’s intent that offerors validate new and existing foreign provider licenses on a monthly basis? If not, how often will the offeror be required to validate foreign provider licenses? Yes.

23. Reference: Solicitation Section E.1 Instructions to Offeror (f) 3. Content Requirements states that Volume III: Price is limited to “Completed Section B.3. Price/ Cost Schedule ONLY”

Question: In order for the Government to gain a clearer understanding of offerors proposals, will the Government allow offerors to provide a brief narrative response as part of their pricing volume to include a Basis of Estimate? Yes, but no longer than 1 page; the business quote instructions will be updated accordingly.

24. In response to RFI question #12 the number of new examiners per month, the response was an estimate of 1000 per month. In the RFP this is stated “up to 5000”. Is this correct that the number of additional examiners could be up to 5000 additional per month?

VA expects an average of approximately 3,000 unique examiners to be added each month.

1,000 – 5,000 is a range.

25. How often will the VA internally re-credential examiners?

Will the database continue to increase year over year after the base year? Yes.

If 12-15,000 examiners are credentialed in 2020, the exponential number could approach 60,000 examiners by the end of period 4. Correct.

26. Do you have a percentage breakdown of the examiners in terms of certification? I.e. MD, DO, PA, NP? If not, is this information you may seek? We will require the contractor to generate reports and respond to data inquiries on a regular and ad-hoc basis. This is a statistic we have not historically tracked.

27. What is the attrition rate for examiners? We do not currently track this, but want this information to be part of the monthly report the contractor will send monthly to the COR.

28. Is there a cap on the number of examiners credentialed by the VA? We estimate approximately 1,000 to 5,000 unique names per month.

29. Do you expect the criminal background check to be performed monthly? Civil and criminal records on the State level are only partially electronic which will impact the time and cost to investigate. VA has not yet firmly established these parameters and will look to the contractor or provide insight.

30. Is the National Practitioner Data Bank acceptable as a source for civil and criminal information?

The NPDB records this information in most jurisdictions and this can be monitored electronically.

Additionally, formal background checks can range in cost from minimal to as much as $1500 per query depending upon the extent of the information needed. VA has not yet firmly established these parameters and will look to the contractor or provide insight. We do not currently use NPDB, but it appears to contain information that would be beneficial to this task.

On the price/cost sheet, what is the unit of measure? Is it a measure of occurrences, not time or quantity? To address this question, a new CLIN will be added for just billing for examiner credentialing, to be invoice per provider credential for invoicing/pricing simplicity. The Price Schedule will be changed accordingly.

In the contract specifics of the RFP and RFI, it states that ad-hoc examiner reviews will be requested from time to time and done at “no additional charge”. However, in the price cost sheet on B.3, the following is stated: “Ad Hoc/Single-Examiner Credentialing Requests (to be billed as request completed)”. Is there separate billing for these inquiries? This CLIN will be changed to be not separately priced.

31. On the B.3 price/cost schedule, the quantity for “ad-hoc” credentialing is 25.00. Is this reflective of the number of estimated instances in a month or period? Annually.

32. The 561611 NAICS size limit is $22 million. Is this the estimated or allocated annual budget for the contract? No.

33. In this “fixed-price” contract, does the VA expect the same level pricing over the 5 periods.

Rationale: As the database grows, so too will the workload required to service the contract appropriately. The Price/Cost Schedule will be updated to account for individual provider credentialing. Quoters are instructed to price for up to 60,000 individual provider credentials per year.

34. Will the VA provide the contractor with its credentialing policies and procedures? VA will provide the contract language used for each MDE vendor as it relates to contracting its examiners.

35. Will the VA allow the vendor to communicate directly with examiners? Rationale: In most jurisdictions, healthcare providers are required to report any adverse personal, civil, criminal, health, or professional sanction issues immediately. A periodic reminder email or educational material around these requirements may assist in the tracking of credentials. As well as periodic reminder of the VA policies and procedures for ongoing professional practice evaluation (OPPE). VA has not yet firmly established these parameters and will look to the contractor or provide insight.

36. “Customer satisfaction reported from customer facing data sources such as Healthgrades, Vitals, RateMDs, WebMD or similar” – Can the government please provide more specifics on the number of customer data sources required and what data should be collected and returned as it will impact the amount of staff effort required? Customer facing data sources may be used at the discretion of the contractor; however, VA will not define a requirement for a particular one.

37. “Additional research may be required on a case-by-case or individual examiner basis (ad-hoc) as a result of negative customer satisfaction comment cards or reports from Veterans related to unsatisfactory service.” – Is there a template the government can share which will help us better estimate the staff effort required? VA does not have a template. Ad-hoc requests are submitted to the contractor by COR email any questions specific to a request may be addressed with the COR upon receipt.

38. “12,000 examiner names from 2020 will be submitted” – In addition to provider name, will there be any other information submitted? Yes

39. “12,000 providers” – Can the government please provide an estimate of how many of the 12,000 providers are Physicians versus Allied Health professionals such as Nurse Practitioners, Physician Assistants, Audiologists, Mental Health professionals other than Psychiatrists, and Dentists? VA does not currently track this but looks to the contractor to provide during contract performance.

40. “in specified foreign locations” – Are the providers in foreign locations licensed in the U.S. or will we need to verify foreign medical licenses/data? Can the government please provide a list of foreign locations involved or are they located just in the Philippines? What approximate number of providers are based in foreign locations? Please see the answer to question number 14.

41. The solicitation states that the scope of work for this contract will begin with a list of approximately 12,000 providers, all of whom were credentialed in 2020 for MDEO. Does this list include their credentials that were already verified, or will we have to re-verify all 12,000 as well as enter them into the new database? Yes, all 12,000 will need to be logged into the database and credentialed. VA will provide the contractor with the information we already have. Entry into database of the 12,000 is necessary, but no new credentialing actions for the 12,000 providers that were credentialed in 2020 is necessary.

42. Is it mandatory to create an e-file on each provider that houses the credentials that you verified or will updating the database with the verified data be enough. (I ask because with some of the online verifications, you can simply change the expiration dates in your database to match the online expirations). You wouldn’t have to print out and save the online verification as proof that you actually completed it. This is at the discretion of the contractor. VA believes the database will be sufficient; however, will discuss this question further, if needed, upon award.

43. How will we receive the names of the new providers? Will the list come with the credentials listed that you will need to verify or do we need to send out something similar to the attached info sheet to each new provider? Contractor will not have provider contact. You will receive an emailed excel spreadsheet with the name and information on each examiner, each month.

44. What suffices as verification of a provider's specialty? Do we need to verify the provider's board status, national certification, or national registration? VA has not fully defined these criteria and will look to the contractor to provide further insight.

45. In regard to Accreditation, is VA asking for verification of the provider's degree? If so, can we use official transcripts or do we have to contact each school or use Student Clearing House? Clearing House provides educational reporting, data exchange, verifications, and research services. VA has not fully defined these criteria and will look to the contractor to provide further insight.

46. In regard to the Price/Cost Schedule for the Base Year, Item number 0001, the quantity is 1 since you will only need 1 database.

Item number 0002, the quantity is 12 since you will have to report to them once per month for 12 months. Unit price is the price per month that you will charge and the amount column is the total for 12 months. I’m not sure what Items numbers 0003 and 004 represent since the solicitation specifies there will be up to 5,000 per month after an initial ramp-up-period in which approximately 12,000 examiner names from 2020 will be submitted. Item 0003 specifies 12 for the monthly call requirement and item 0004 specifies 25 EA for the Ad Hoc/Single Examiner Credentialing Request. Please clarify. Please see the answer from question number 30. a new CLIN will be added for just billing for examiner credentialing, to be invoice per provider credential for invoicing/pricing simplicity. The Price Schedule will be changed accordingly.

Also, to further reduce any confusion, the Monthly Call Requirement will be changed to be not separately priced.

47. What kind of database does VA want us to use or create? Can it be Microsoft Excel? Yes. That is the method of delivery we currently use and we prefer to keep the information communicated to us in the simplest and most succinct manner possible.

48. Since the info in these packets should not contain PII, do they have available, a sample completed packet on one of the providers? We currently do not have a packet on each provider. Each provider is listed in an excel spreadsheet which is updated by the contractor. VA is amenable to discuss a change to this upon definition of the contractor.

49. Will we be allowed to communicate directly with the examiner if necessary? If so, and the examiner is not responsive, how are we to proceed? Not currently.

50. Will the examiner be completing the form or will VA submit all information? VA will submit all information.

51. Will the examiner be asked to sign-off on any data elements? No

52. What is VA expecting in the way of ongoing monitoring of sanctions and expirables? Monthly, unless an ad-hoc inquiry or other request prompts new information.

53. What is the anticipated contract award date? December 1, 2020

Will the data in the VA document contain HIPAA or PII? HIPAA does not apply to medical disability examinations. Examiner name and known NPI number will be provided.

Will the contractor have access to VA licensed software including Rational, SharePoint or Salesforce cloud? We will determine whether the contractor will need access to a VA SharePoint folder to transfer information. Currently, we use excel and email as needed.

Can the government clarify if past performances are limited to a total number of three (3) references or can an offeror submit three (3) references each for the Prime and Subcontractor within the page limitations? Total of three (3) references, no more.

The scope states “Additional research may be required on a case-by-case or individual examiner basis (ad-hoc) as a result of negative customer satisfaction comment cards or reports from Veterans related to unsatisfactory service”. Does the government have an estimate of workload or level of effort of how many “unsatisfactory” ad hoc examiners would need to be accomplished (monthly or yearly)? Per the PWS, approximately 25 per year.

54. In the ramp up period after award, will the contractor need to provide new credential and verification services for the 12,000 names from 2020? Or has this already been completed and the ramp up period will primarily require the data from these 12,000 examiners to be added/formatted to the newly created database? 2020 providers should be used for formatting purposes and be re-checked as well.

55. Do you already have approved credentialing software and individual state licensing databases that the Contractor would utilize for these searches? No

56. If we have databases that we use for credentialing and verification services, would we be able to use those (if needed) and what is the approval process? VA anticipates working with the contractor post award to review/establish the most efficient way to track provider information.

57. How long does it currently take to conduct credentialing and verification services for 5,000? The current estimated time is around 10 business days or less.

58. Will there be a hard Not-to-Exceed limit on the number of provider review requests, or will that figure potentially exceed 5,000 some months? No

59. Do you have any major pain points with the existing process that you would like to be addressed -

- quality of information, timeliness, accuracy of data, reporting, etc.? Although we are not credentialing experts, our intent is to ensure all Veterans are examined by licensed professionals with no history of significant/confirmed customer complaints and no negative legal history.

60. Can you clarify why the Ad Hoc reports are listed at a quantity of 25 each? Is that assuming you would need 2-3 ad hoc reports a couple times a month? Yes

61. We understand from previous Q&A that the database is not yet defined. Is continuing in excel the preferred method or are you looking for a more robust solution that has greater capability? If so, will the budget support it? VA prefers to keep the database and subsequent reporting as succinct and simple as possible. Excel is familiar and easy to sort, but if the contractor has some other idea that would be equally easy to work with, we are open to discuss post-award.

62. Is there an incumbent supporting this effort? If so, are there any contractor employees involved that would require a transition plan? Yes, please see the answer to question #1; and no, no transition plan is required.

63. Approximately what percentage of medical professionals reside in foreign countries? What are the expectations on separation of those foreign locations within the database (aside from a separate tab)? VA has not fully defined these criteria and will look to the contractor to provide further insight.

64. What are the desired expectations for delivery method and format of monthly and ad-hoc reporting? Word document; VA reporting data points and/or criteria will be established in conjunction with new contract

65. Will archiving be required for medical professionals removed from the listing? Possibly

66. For medical professionals removed from list, will immediate alert notifications (within reason) be required? Not that we anticipate.

67. The scope of work states “A database, consisting of the information above, will be created and maintained for all examiners and updated monthly, as adverse actions are noted, as providers become inactive, or on an ad-hoc basis.”

68. Will the government provide the adverse actions or inactivity information to the contractor for inclusion into the data base, or is the contractor required to review all provider information on a monthly basis to determine provider inactivity or adverse actions? VA will provide adverse actions as we become aware. Our intent is the contractor will monitor all unique providers on an ongoing basis.

69. The requirement specifies that Contractor will have completed the 'living data base' within 30 days from receipt of the first list containing all examiner names from handover of the Excel spreadsheet.

a. What is the current format of the spreadsheet? Excel

b. Is the information in Excel database form already? Yes

c. Please provide a copy of the current Excel spreadsheet format showing the column headings, required fields and existing formulas. No spreadsheet will be provided at this time, but please see the answer to question #3 for more information.

70. What is the process for newly creating and looking up medical professionals? For foreign medical professionals? VA has not defined these criteria and will look to the contractor to provide insight.

71. The solicitation states that the contractor shall verify all examiners using “approved credentialing software that includes review of individual state licensing databases.” Please provide the list of approved software or alternatively, organizations, that the contractor may employ for the required credentialing, e.g. NCQA or URAC? VA has not defined these criteria and will look to the contractor to provide insight.

a. What level of and authority for accreditation of the medical professionals is required? Examiner must possess a valid and unrestricted license to practice medicine. We have not defined other criteria.

b. Is it a requirement to verify with multiple agencies, and if so, how many? VA has not defined these criteria and will look to the contractor to provide insight.

72. Will site visits be required in the contract? No

73. What (if any) checks must be performed on existing medical professionals who have been previously verified or are pending civil or criminal litigation, etc? What is the desired time interval for these checks?

74. Same question as above for customer satisfaction reporting (Healthgrades, Vitals, RateMDs, WebMD, etc), will this need to be continually checked as well?

All examiner provider in the ramp-up list should be used to create the contractor database and workflow, as well as be checked for changes from last date reviewed. This will be an ongoing, monthly task.

75. The solicitation states that additional research may be required on a case-by-case basis. Does this elude to research beyond the existing credential check software and/or customer satisfaction reporting?

VA has not defined these criteria and will look to the contractor to provide insight.

76. What is the expectation for transition of database ownership upon completion of the period of performance? VA has not defined these criteria and will look to the contractor to provide insight.

77. The solicitation states that “The vendor’s quote must include a summary description of up to three prior contracts/orders per team member/sub-contractor for projects completed within the last three years.” For a team of a prime and one subcontractor can this be interpreted to mean three past performances each. i/e/ six total, or three total, but the past performance of subcontractor will be considered? Please see the answer to question #53. Maximum of 3 past performance references.

78. Will you consider the past performance of any material subcontractors? Yes

79. Regarding the contract in place for this effort, is the incumbent eligible to bid in this procurement as either a prime or subcontractor? Yes

80. What was the monetary value of the current contract (by period of performance and/or option period)? Approximately $500,000.00 over 4 years

81. What is the anticipated budget for the new contract? The scope has been expanded significantly from the last contract, so very likely more than the $500,000 over 4 years.

82. The deliverable table states that the government will provide the spreadsheet with the new examiner names to the contractor by the 10th of the month and that the contractor must provide a monthly report back to the COR no later than 10 days after receipt of the spreadsheet.

83. Please confirm that the expectation is that contractor perform the credentialing services for up to 5000 new providers per month within the 10 day period. Yes. If the requested turn-around time is found to be insufficient, VA is open to discuss with the contractor and possibly amend during the post-award period.

84. Please explain the pricing and billing for CLIN 0004. The schedule shows a quantity of 25 EA. Is the requested price for a total quantity of 25 Ad Hoc requests, or per Ad Hoc request? Requesting clarification since the description states that the Ad Hoc requests are to be billed as the request is completed rather than after 25 are completed. Per ad-hoc request; VA does not anticipate more than 25 ad-hoc requests per year.