Medical Coding RFQ Questions.docx

RFQ Questions

1. Please confirm that this procurement is restricted to Service-Disabled Veteran-Owned Small Business concerns that are SBA-certified and listed as certified SDVOSBs in the SBA Veteran Small Business Certification Program database and SAM.gov at the time of initial offer submission, including price. Yes

a. Please also confirm that offers from entities that are not SBA-certified/listed as SDVOSBs at the time of offer submission will be considered ineligible and will not be evaluated for award, consistent with FAR 52.219-27, 13 CFR part 128, and applicable VAAR requirements. Yes

2. Can you confirm the anticipated average monthly encounter volume, and provide any available breakdown between inpatient, outpatient, and specialty services? The coding workload for this requirement is limited to outpatient encounters across several specialties. It does not include inpatient coding or pro-fee at this time. A detailed specialty mix will be provided at award, but vendors should anticipate a consistent outpatient workload with variations across specialty clinics.

3. Is medical coding currently being performed in-house, through contractor support, or a hybrid model? All medical coding functions are currently performed in-house by government staff. This procurement seeks to supplement internal resources to ensure timely, accurate outpatient coding and support continuity of operations.

4. Beyond the stated 5-day turnaround requirement, are there any current backlog conditions or priority turnaround expectations the contractor should be aware of? In addition to the standard 5-day coding turnaround requirement, the station currently has an estimated backlog of approximately 3,000 outpatient encounters. These existing backlogged encounters will be prioritized upon contract start. Vendors should be prepared to dedicate sufficient staffing to reduce this backlog while maintaining compliance with ongoing turnaround expectations.

5. What electronic health record (EHR) and coding platforms will coders be expected to utilize (e.g., VistA, Cerner Millennium, or other systems)? Coders will be required to work within VA’s existing systems, including VIRR software, VistA, and CPRS. Access to these systems will be granted following completion of all VA credentialing and onboarding requirements. Vendors should ensure staff are familiar with VA-specific workflows or are capable of quickly adapting to these systems.

6. Are there existing QA audit protocols, scoring methodologies, or reporting formats that the selected contractor will be required to follow or integrate with? The Government will continue to conduct internal quality assurance using existing VA QA methodologies and scoring standards. These internal audits will be used to evaluate overall compliance with VA coding requirements. The contractor, however, is expected to implement its own internal QA processes to ensure coder accuracy, consistency, and compliance prior to Government review. Vendors may use their own audit tools, processes, and reporting formats, provided they meet industry best practices. The contractor’s QA efforts should be proactive and sufficient to maintain performance at or above VA standards.

7. Does the VA anticipate this requirement to be fulfilled through a fully remote workforce, or are there any on-site or hybrid expectations? This requirement is intended to be fulfilled entirely through fully remote workforce. No on-site presence is expected. Contractors should ensure their staff have secure remote work capabilities and are able to meet all VA privacy

8. To promote fair competition, please provide copies of the documents listed on page 4 of the Synopsis document, which appear to be restricted to access within the VA intranet . If any directive, handbook, SOP, reference cited in the summary is restricted to VA intranet access, the Government will provide the full document set to the awarded contractor during post-award onboarding. Vendors should base proposals on the summaries and requirements in the solicitation and PWS.

9. Please confirm if there is a page count limitation and font restrictions for the ‘Technical or Quality’ section There is no page count limitation, but please attempt to keep submissions concise.

10. Please confirm anticipated productivity standards by encounter type (outpatient, ancillary, lab, ED). The anticipated productivity standard for outpatient encounters, including ancillary, lab, and ED, is 13.9 encounters per hour per coder.

11. Please confirm whether invoicing will be based on a total firm fixed price methodology (equal invoice amounts per month) or whether it is fixed price per unit, billable by number of units completed each month. Invoicing will follow a fixed-price-per-unit structure, billed monthly based on the number of completed units.

12. Please confirm the approximate amount of time required to gain access to the required VA systems, including the amount of mandatory training vs approximate waiting time. The estimated time required to obtain access to the necessary VA systems is approximately two to three months. This includes both mandatory training and the typical system-access waiting period.

13. Please confirm that pricing should only be submitted in the Word document table on page 1 of the Synopsis document and no separate pricing document or visible calculations are required. Please submit pricing on the word document table provided.

14. Please provide a breakdown of the approximate split between outpatient, emergency, laboratory, and ancillary encounters per year, and confirm that the unit price is a blended rate applicable to any encounter type within this scope. This contract covers outpatient coding only. Emergency, laboratory, and ancillary encounters are included within outpatient services. The unit price is a blended rate applicable to any encounter type within the outpatient scope.

15. 4.1.L - please confirm the reference to paper documentation; is the coder anticipated to complete anything on paper records? There is no expectation that coders will need to work from paper records. All documentation is processed electronically.

16. 4.1.O – in cases where encounters are identified as duplicates or erroneous because a patient was not seen, please confirm whether the contractor can invoice for the effort required to make this determination. Yes, the contractor may invoice for the effort required to identify encounters that are duplicate or erroneous due to the patient not being seen.

17. 4.1.Y – Will the government consider changing this requirement to 5 business days, particularly considering weekends and the limitation on coding during federal holidays? Also, please confirm if this applies only to fully complete records and that the timeline will be waived in the event of queries / encounters with insufficient documentation. The government cannot modify the requirement of five-business days timeframe. This requirement applies to fully completing records. For encounters requiring queries or with insufficient documentation, the contractor should follow VA query guidelines, including all required timeframes for opening and closing queries.

18. 7.0 - Please confirm if the government defines the quantity required for a ‘representative sample’ or if this is determined by the vendor. The government does not define the specific quantity for a “representative sample.” This is determined by the vendor as part of their audit methodology.

19. 7.0 – Please confirm that the cost of the audit requirements should be built into the overall unit prices. The cost of the audit requirements should not be incorporated into the unit pricing. The contractor will conduct audits as part of their own internal quality-assurance process, and the government will perform its audits separately as part to the VA quality-assurance process.

20. Please confirm whether contractor-owned laptops are allowed/expected for this work as long as they meet the associated IT Security requirements, or whether GFE will be provided. Contractor-owned laptops may be used for this work, provided they meet all VA and federal IT security requirements. Government-furnished equipment will not be issued.

21. Will coders with current DHA Tier 1 security approval be granted reciprocity to waive the additional VA background check and fingerprints? The VA does not grant reciprocity for DHA Tier 1 security approvals automatically. All contractor staff must complete the full VA background investigation and fingerprinting process, regardless of prior federal security clearances.

22. May vendors use their own coding audit tools to supplement the VA encoder as long as they meet federal IT security standards? Yes, vendors may use their own coding audit tools to supplement the VA encoder as long as all tools fully comply with federal and VA IT security standards.