Attachment 07 - Government Response - 36C24C26Q0027 - Vendor Questions.pdf

Insurance Entry and Verification Buffer Support Services

RFQ ID: 36C24C26Q0027

VENDOR QUESTIONS and GOVERNMENT RESPONSE

Q01: Historical Workload Data (Attachment 05) Attachment 05 states that historical workload data by CPAC, VAMC, transaction type, and reporting period will be provided to support quotation preparation, but the Historical Workload Data table in the attachment as issued contains no populated rows (CPAC, facility, quantities, rejection/exception rates, and backlog fields are all shown as placeholder text). Will the Government issue the actual historical data by CPAC/VAMC, including rejection rates and non-chargeable exception rates, in an amendment prior to the response date?

A01: The Government is unable to provide additional historical workload data by CPAC, VAMC, transaction type, or reporting period prior to the response date. Quoters should base their quotations, price estimations, and Basis of Estimate on the aggregate Estimated Ordering- Period Quantities, Planning Productivity Assumptions, and any workload estimates provided in Attachment 05 and Section 2.4 of the PWS.

▪ This response also addresses Q17, Q65, Q99, and Q108.

Q02: Wage Determination / Labor Categories

Section B.5 references a Statement of Equivalent Rates for Federal Hires listing only two labor categories (Financial Accounts Technician, GS-0503-6 and GS-0503-7), both marked "TBD by CO pre-award," and notes that this statement is not a Wage Determination. Is there an applicable Service Contract Labor Standards Wage Determination for this requirement, and if so, will it be provided prior to the response date?

A02: The applicable Service Contract Labor Standards [formerly Service Contract Act] Wage

Determination(s) for this requirement will be provided by amendment prior to award. For pricing purposes, quoters should base labor rates on the Financial Accounts Technician categories referenced in the solicitation. Final wage determinations and locality information [or remote application] will be confirmed at award.

▪ This response also addresses Q20, Q64, and Q105.

Q03: Authorized System Access Method

PWS Section 7.4 states that the Government will identify the authorized access method and any Government-furnished equipment, systems, training, or credentialing support "in the solicitation and/or applicable Task Order." Can the Government confirm the authorized access method (e.g., VA-furnished remote access/VPN, PIV-based access, Citrix, or another method) that will apply at IDIQ award, or will this be defined separately in each Task Order?

A03: Contractor personnel will be required to obtain Personal Identity Verification [PIV] cards to access VA systems. Upon PIV issuance, access will be provided via VA-approved VPN and/or Citrix connectivity from contractor-furnished [not Government-furnished] equipment.

Contractors must supply their own endpoint computers; however, these must conform to VA technical and security requirements, including system patching, endpoint protection, encryption, and network segmentation. Systems must not store VA information locally and must meet VA Office of Information & Technology security baselines. Specific authorization requirements applicable to contractor-furnished endpoints will be identified at Task Order/award, consistent with RFQ Section B.2 and applicable VA security directives.

▪ This response also addresses Q15, Q38, Q39, Q71, Q92, Q102, Q106, and Q107.

Q04: Anticipated Award Date and Transition Time Ordering Period 1 begins 30 September 2026, approximately three weeks after the 8 September 2026 response date. Can the Government provide the anticipated award date and confirm whether any transition or ramp-up period is anticipated between award and the start of Ordering Period 1, or before the first Task Order's period of performance begins?

A04: The Government anticipates issuing the initial Task Order at or near the effective date of contract award, which is targeted for on or about 30 September 2026, pending timely pre-award actions. There may be a ramp-up/transition period between award and commencement of full production, as established in the Task Order. The initial Task Order is expected to satisfy the $500,000 IDIQ guaranteed minimum and will specify covered CPACs/VAMCs, quantities, and period of performance, subject to operational need and available funding. Task Orders may cover all or a subset of the seven CPACs and may be issued in phases.

▪ This response also addresses Q07, Q43, Q61, Q113, and Q119.

Q05: Background Investigation / Credentialing Timeline

PWS Appendix/Section 13 designates Insurance Entry and Verification Personnel and Contractor Management/QC Personnel as Tier 2/Moderate Risk positions. Can the Government provide the typical processing timeline for background investigations and credentialing for Tier 2 positions under this requirement, and confirm whether contractor personnel may begin any preparatory training or onboarding activities prior to final adjudication?

[Note: This question referenced the Tier 2/Moderate Risk designation as originally issued. That designation has since been finalized as Tier 1/Low Risk. See amended Clause C.12 and the response below.]

A05: Personnel risk/sensitivity designations for this requirement have been finalized consistent with VA Directive/Handbook 0710 and the applicable Position Designation Record. All contractor personnel performing under this contract, including Insurance Entry and Verification Personnel and Contractor Management, Supervisory, and Quality-Control Personnel, are designated Non-Sensitive, Tier 1/Low Risk, requiring an SF-85 and PVQ Part A, consistent with the revised Clause C.12 (VAAR 852.204-72). The typical processing time for background investigation initiation and favorable adjudication for Tier 1/Low Risk positions averages 4-8 weeks, but timelines may vary based on individual case volume and completeness of submissions. While awaiting final adjudication, Contractor personnel may participate in preparatory, non-production training activities if permitted by the Government.

There is no pre-set limit on the number of personnel for credentialing and VistA/provider-portal provisioning; VA will coordinate provisioning according to security and onboarding capacity.

▪ This response also addresses Q44, Q110, and Q111.

Q06: Place of Performance / Telework

PWS Section 7.4 states that Government workspace will not be provided unless expressly stated otherwise, and Section 7.5 requires availability during Eastern Time business hours. Can the Government confirm whether fully remote/telework performance is permitted for all contractor personnel, and whether there are any requirements that personnel or data remain within the continental United States?

A06: Contractor personnel may perform work remotely from secure work environments, including home offices, within the continental United States (CONUS). Performance outside the United States is not permitted. Personnel and data must remain within CONUS at all times, consistent with PWS Section 7.4.

▪ This response also addresses Q72 and Q117.

Q07: First Task Order Scope

Can the Government indicate whether the first Task Order issued after award is expected to satisfy the $500,000 IDIQ guaranteed minimum, and if so, provide a general indication of which CPAC(s) or region(s) it is expected to cover?

A07: Please see A04

Q08: Ordering Period 2 and 3 Reverification Quantities

Section B and Attachment 05 show an evaluated quantity of zero for reverification actions (CLINs 1001 and 2001) in Ordering Periods 2 and 3, with all reverification volume concentrated in Ordering Period 1. Can the Government confirm this reflects an expectation that the existing reverification backlog will be fully resolved during Ordering Period 1, with no further reverification volume anticipated in Periods 2–3?

A08: The zero quantity for reverification actions during Ordering Periods 2 and 3 reflects the current expectation that the reverification backlog will be eliminated in Period 1. If subsequent reverification volumes are identified, the Government reserves the right to issue additional Task Orders under those CLINs at the offered unit prices.

▪ This response also addresses Q62.

Q09: Can the Government identify which positions are considered Key Personnel for this requirement and provide the minimum qualification requirements for each position?

A09: The Contractor shall provide a Manager/Supervisor to manage the workload and contractor personnel. The Manager/Supervisor shall possess at least five years of experience working in and managing a healthcare revenue system. The individual should also have knowledge of insurance verification and coverage to include but not limited to current working knowledge of Coordination of Benefits; Termination of Coverage; Current knowledge of insurance plans such as Medicare, Medicare Replacement policies, Medigap policies, commercial health plans, HRA, HSA, etc.

▪ This response also addresses Q41, Q56, and Q95.

Q10: Does VA require the insurance verification personnel to work at a VA facility, an approved contractor facility, or can they perform the work remotely?

A10: Personnel may perform the work remotely from secure offices or home offices within CONUS and are not required to work at a VA facility. Performance outside the United States is not permitted. Both corporate facilities and home offices are allowed, provided security and VA information protection requirements are met.

Q11: Can the Government provide an anticipated FTE range associated with the estimated workload?

A11: The Government is unable to provide an anticipated FTE range at this time. For planning purposes, the Government's estimated productivity assumptions are approximately 35 actions per labor hour for reverification actions and 24 actions per labor hour for new-policy actions, consistent with PWS Section 2.4. These are planning assumptions only and do not constitute contractual productivity standards or staffing requirements.

Q12: Can the Government provide available information regarding historical surge periods or significant workload fluctuations and clarify the expected Contractor response time when additional workload is assigned?

A12: Upon award, workload will be available and is expected to remain relatively consistent due to existing backlogs. Distribution to the Contractor will be phased in accordance with the Task Order and operational capacity. Please see A31. If additional or surge workload is assigned beyond planned volumes, the expected Contractor response time will be defined in the applicable Task Order, consistent with the contract's performance standards.

Q13: Given the short turnaround time, would the Government consider extending the proposal due date to provide offerors additional time to prepare a complete and responsive submission?

A13: Yes. The proposal due date will be extended to 14 September 2026 at 1:00 PM Eastern Time.

Q14: Is there an incumbent contractor currently performing the work?

A14: No. There is no incumbent contractor currently performing this work.

▪ This response also addresses Q118.

Q15: Can the Government identify the Government-furnished equipment, systems, connectivity/access solutions, credentials, and other resources VA anticipates providing? If Contractor-furnished equipment is required, can the Government clarify the applicable VA technical and security requirements?

A15: Please see A03

Q16: Can the Government clarify whether prior knowledge or experience with Medicaid policies is required for personnel performing the work?

A16: Prior knowledge or experience with Medicaid policies is not specifically required. Personnel should, however, have knowledge of commercial health plans and Medicare.

Q17: Attachment 05 (Historical Workload and Planning Information), pages 2-3, presents a Historical

Workload Data table with placeholder notation ([CPAC], [Facility], [MM/YYYY], [Quantity], etc.)

rather than populated historical figures. Will the Government issue a version of this table populated with actual historical data by CPAC/VAMC, transaction type, and reporting period, or should Quoters develop their Basis of Estimate using only the aggregate Estimated Ordering- Period Quantities, Ordering Period Allocation Table, and Planning Productivity Assumptions provided on pages 1-2 of Attachment 05?

A17: Please see A01

Q18: If actual historical data will not be issued prior to the 8 September 2026 quotation due date, can the Government confirm that Quoters' Basis of Estimate assumptions regarding historical rejection rates and non-chargeable exception rates (for which no historical figures are currently provided) will not be scored unfavorably relative to any internal Government benchmark not disclosed in the solicitation?

A18: If actual historical data is not issued prior to the quotation due date, Offerors' Basis of

Estimate assumptions regarding historical rejection rates and non-chargeable exception rates will not be scored unfavorably against any internal Government benchmark that is not disclosed in the solicitation. Evaluations will be based only on the information provided in the solicitation and attachments. The Government will assess proposals for reasonableness and consistency with the stated planning assumptions but will not utilize undisclosed internal benchmarks for scoring purposes.

Q19: Attachment 05 references historical backlog that may include actions unavailable for Contractor processing due to incomplete source information or unavailable system access. Can the Government clarify whether the 804,000-action existing backlog cited on page 2 is expected to be assigned to the awardee upon contract start, and if so, over what phased timeframe?

A19: Please see A31

Q20: Reference: Document and Page – RFQ p. 34; Section C.6

The solicitation incorporates the Service Contract Labor Standards and lists SCA classes "Financial Accts Tech GS-0503-6/7" with wages/fringe shown as "TBD by CO pre-award," but no Service Contract Act Wage Determination (number, revision, or locality) is attached. Because performance is contractor-site/remote and nationwide, which Wage Determination(s) and locality apply, and will VA amend the solicitation to provide the applicable WD(s) so all quoters price labor on a common basis before quotes are due?

A20: Please see A02

Q21: Reference: Document and Page – PWS p. 4 and 16; Section PWS 4.1.1 and PRSM

Task 4.1.1 does not establish a timeliness standard per action. The timeliness AQL (≥93%) is measured against "the delivery period established by the applicable Task Order," but no baseline delivery period/turnaround (e.g., number of business days from when an action becomes available) is stated in the PWS or a sample Task Order. What delivery period(s) does VA anticipate for reverification and new-policy actions, so quoters can size staffing to the timeliness standard?

A21: For quotation planning purposes, quoters should assume delivery periods for reverification and new-policy actions in the range of 3–7 business days from the date an action is assigned and available. Actual delivery periods and milestone ramp-ups will be specified in each Task Order based on operational needs and the quantity of work made available.

▪ This response also addresses Q48, Q67, Q83, Q103, and Q109.

Q22: Reference: Document and Page – PWS pp. 11-12; Section PWS 8.1 PWS 8.1 estimates non-chargeable exceptions at ~10–15% of daily workload, and these are not billable. Do the CLIN evaluated quantities represent only billable accepted completed actions — meaning the contractor must actually work a larger gross volume that also includes non-billable exceptions and rejected actions — and is VA anticipating the labor spent documenting/ transferring non-chargeable exceptions to be recovered under a per-accepted-action unit price?

A22: The CLIN evaluated quantities represent only accepted completed actions, consistent with Section B.2.1 and B.3.1 of the solicitation. Contractors must process a larger gross volume of actions than the evaluated quantities reflect, since gross workload will include non-billable Contractor-caused rejected actions and non-chargeable exceptions in addition to accepted completed actions. Only accepted completed actions are payable; the cost of processing non-chargeable exceptions and correcting Contractor-caused rejected actions is not separately billable and is included in the Contractor's per-accepted-action unit price, consistent with Section B.2.2 and PWS Section 8.1.

Q23: Reference: Document and Page – PWS p. 14; Section PWS 11.5

PWS 11.5 states VA will provide VistA and related-application training to contractor personnel.

What is the expected format, duration, capacity (seats per cohort), and lead time for VA-provided training and account provisioning, and when relative to award/Task Order start will it begin? Transition and ramp-up are not separately priced, so these assumptions materially affect pricing.

A23: Please see A74

Q24: Reference: Document and Page – PWS p. 5; Section PWS 4.1.6

Is there a limit on the number of concurrent VA system (VistA) or provider-portal accounts VA will grant to contractor staff?

A24: No. There is no fixed limit on the number of concurrent VA system [VistA] or provider-portal accounts VA will grant to contractor staff; provisioning will be managed according to operational need and onboarding capacity.

Q25: Reference: Document and Page – PWS p. 4; Section PWS 4.1

How will workload be assigned to and pulled by the contractor (e.g., shared VistA work queues, CPAC-assigned worklists, or a buffer/queue tool), and how will the "date an action became available for Contractor processing" be system-documented? That timestamp is the basis for both timeliness measurement and non-chargeable-exception determinations.

A25: Work will be assigned by individual CPAC Insurance Verification managers according to which individual VAMCs need support, and will be assigned or pulled via VistA insurance buffer queues, worklists, or related VA modules accessed remotely. The official date/time an action is "assigned and available" is the date and time the work is assigned to the contractor.

▪ This response also addresses Q52.

Q26: Reference: Document and Page – RFQ pp. 85-86; RFQ Section E, Evaluation – Factors and Basis for Award The solicitation lists four factors (Key Personnel, Technical Approach, Past Performance, Price) under a comparative best-value approach but does not state the relative importance of the factors to one another, or of all non-price factors combined relative to price. Will the Government provide the relative order/weighting of the evaluation factors.

A26: The Government will evaluate conforming quotations under a comparative, best-value tradeoff approach as stated in FAR 52.212-2 of the solicitation. The four factors: Key Personnel, Technical Approach, Past Performance, and Price are listed in the order presented but are not assigned numerical, color, or adjectival ratings or relative point weights. The Government will compare quotations directly against one another to identify meaningful strengths, weaknesses, risks, and discriminators, and will make award to the Quoter whose conforming quotation represents the best value considering Price and the non-price factors.

The Government may select other than the lowest-priced quotation when non-price benefits justify the additional price. No further relative weighting will be disclosed, consistent with the comparative evaluation method stated in the solicitation.

▪ This response also addresses Q37.

Q27: Reference: Document and Page – RFQ p. 76; 1.1 General Format

Is a list of acronymns included in 35 page limit for Vol. 2?

Note: Reproduced exactly as submitted by the Vendor, including apparent typographical errors/omissions in the original text.

A27: No. For purposes of the 35-page combined limit for Volume II and Volume III, all pages count, including cover pages, tables of contents, section dividers, narratives, tables, charts, graphics, resumes, and attachments; this includes acronym lists, Key Personnel statements of commitment, and the substitution plan, consistent with Addendum to FAR 52.212-1, Section

1.1. Any content beyond page 35 will not be evaluated.

▪ This response also addresses Q28.

Q28: Reference: Document and Page – RFQ p. 80; PWS 4.3

Are statements of commitment from proposed KP and the substitution plan included in 35 page limit?

A28: Please see A27

Q29: Reference: Document and Page – SF1449; Block 20

The ordering period is stated as "one 3-year ordering period. No option periods." It also lists three separate one year periods. What is the meaning of the three one year periods and can VA clarify the discrepancy?

A29: The contract will have a three-year ordering period, without separate option years. Individual

Task Orders may be issued for periods up to, but not exceeding, the IDIQ term; actual Task Order periods will be specified on award.

▪ This response also addresses Q30.

Q30: Reference: Document and Page – SF1449; Block 20

Are task orders limited to a one year period or can they extend acorss the entire 3 year period?

A30: Please see A29

Q31: Reference: Document and Page – PWS p.2; PWS 2.4

What relase rate of actions shall the vendor plan for? The PWS estimates the backlog at 804,000 actions. Will the Government spread the disribution of backlog actions across the base year in an consistent manner rather than releaseing them all at one time? A consistent release rate will enable the vendor to plan staffing levels.

A31: Backlog and new policy actions will be released to the contractor in a consistent and manageable fashion, not all at once, to enable reasonable staffing and production planning.

Distribution will be phased in accordance with the Task Order and operational capacity.

▪ This response also addresses Q19 and Q32.

Q32: Reference: Document and Page – RFQ p.19; CLIN 1002

Will new Policy Actions be distributed at a consistent rate over the course of the period of performance? If not, what variability should the Vendor expect to see?

A32: Please see A31

Q33: Reference: Document and Page – RFQ p.36, p.26; C.3, B.6.2

Is section Section C.3 (a) applicable?states: "When the Government requires supplies or services covered by this contract in an amount of less than $500,000.00, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract. Section B.6.2 states that the guaranteed minimum is $500,000. C.4(b)states "The Government shall order at least the quantity of supplies or services designated in the Schedule as the "minimum." Is the Government obliigated to order a minimum of $500,000 in services?

A33: The Government is obligated to order at least the $500,000 minimum during the term of the contract, through one or more Task Orders.

Q34: Reference: Document and Page – RFQ p.70; RFQ Instructions 1.1

What is the minimum font size for a table or and graphic?

A34: The minimum font size for tables and graphics is 10 points, unless otherwise specified in the solicitation instructions. All text, including tables and graphics, must be legible and comply with accessibility standards. Vendors are responsible for ensuring that submitted materials are clear and readable.

Q35: Reference: Document and Page – RFQ p.14; RFQ Instructions 5.f

Will contractors be expected to furnish contractor furnished equipment to staff providing services? Paragraph 5f states" If non-VA owned equipment must be used to fulfill the requirements of a contract, it must be stated in the service agreement, SOW or contract."

A35: Contractor personnel must use contractor-furnished equipment for all performance, as no

Government-furnished hardware or workspaces are provided unless expressly specified otherwise in the Task Order.

Q36: Reference: Document and Page – RFQ p.33; Section C.1(m)

Will Contractor be given the opportunity to cure issues of late delivery?

A36: For most performance deficiencies, the Government will provide written cure notice and an opportunity to correct the deficiency before pursuing termination for cause, in accordance with FAR 52.212-4(m) and applicable contract terms. However, Section C.1(m) of the contract specifically excludes late delivery from the cure-notice requirement. For late delivery, the

Government is not obligated to issue a cure notice before pursuing termination for cause or other contractual remedies.

Q37: Reference: Document and Page – RFQ p.93; Section 52-212-2

Will the government weigh all four factors equally in its evaluation of Quotes?

A37: Please see A26

Q38: PWS §§7.2.5 and 7.4 state that the contractor will provide the equipment, connectivity, and other resources needed unless the Government identifies specific Government-furnished resources. RFQ Technical Approach §5.5 also states that contractor-furnished equipment cannot be used to access or handle VA information unless it is specifically authorized. Task Order Template §5.1 indicates that the authorized access method and any Government-furnished equipment will be identified in the applicable Task Order.

Could you please clarify whether we should provide the endpoint computers used to access VA systems or whether VA will provide them ?

If we are responsible, can we get the general equipment specifications. Things like, vendor approval steps security settings, sanitation requirements, etc..

This will help us be more accurate in calculating costs for our proposal.

A38: Please see A03

Q39: Reference: Q-001; Section B.4 / B.6.3; E.1 §5.5 | p. 21, 23, 74-75

Please clarify what Government-furnished equipment, remote-access resources, software, system credentials, and provider-portal access the VA anticipates providing to contractor personnel at task order start, and identify any contractor-furnished equipment or connectivity that is permitted or expected.

A39: Please see A03

Q40: Reference: Q-002; E.1 §5.6; PWS §11.5 referenced | p. 75

Please identify the VA-provided training expected for VistA and related applications, including intended audience, training duration, delivery method, prerequisites, and whether training will be available before production work begins.

A40: Please see A74

Q41: Reference: Q-003; E.1 §§4.1-4.3 | p. 73

Does the Government require a minimum number or specific categories of key personnel (for example, Program Manager, Operations Lead, and Quality Lead), or may each Quoter designate the key positions it considers critical to its approach?

A41: Please see A09

Q42: Reference: Q-004; B.6.2 and FAR 52.216-19 | p. 22-23, 32

Please confirm whether the Government intends the $500,000 guaranteed minimum to be satisfied through one or more task orders whose individual values may be less than $500,000, and if so, please clarify the intended application of FAR 52.216-19(a) to individual task orders.

A42: The $500,000 guaranteed minimum represents a contractual government obligation over the term, not necessarily in a single Task Order; multiple orders may aggregate to the minimum.

Task Orders may individually be for less.

Q43: Reference: Q-005; B.2; B.6.2; E.1 §7.3 | p. 19, 22-23, 76-77

For planning purposes, does the VA anticipate issuing the initial task order at or near contract award, and can the Government provide its current best estimate of the initial task order period, CPAC/VAMC coverage, and approximate mix of reverification versus new-policy actions?

A43: Please see A04

Q44: Reference: Q-006; VAAR 852.204-72 / E.1 §5.5 | p. 55-58, 74-75

What is the Government’s current estimated elapsed time for Tier 2 background investigation initiation, PIV issuance, and logical access provisioning for contractor personnel, and may personnel begin any non-production training or readiness activities while access is pending?

A44: Please see A05 Note: This response reflects the finalized Tier 1/Low Risk designation, which superseded the Tier

2 reference in the original question. See amended Clause C.12.

Q45: Reference: Q-008; B.2.1; B.6.7; E.1 §§7.1-7.3 | p. 19-25, 76-77 – Q-007 was skipped by Vendor

For zero-quantity CLINs 1001 and 2001, should Quoters propose the same reverification unit price used for CLIN 0001 unless cost conditions change, or may pricing vary by ordering period based on documented BOE assumptions?

A45: Quoters must provide a unit price for CLINs with zero evaluated quantities in Periods 2–3; the

Government reserves the right to issue Task Orders under these CLINs if additional need is identified.

▪ This response also addresses Q96 and Q116.

Q46: Reference: Q-009; Historical Workload Data table; E.1 §7.3 | p. Att. 05 p. 2-4; Sol. 76-77

Attachment 05's Historical Workload Data table contains only placeholder fields ([CPAC], [Facility], [Quantity]) and no actual historical data. Will the Government amend Attachment 05 to provide the referenced historical workload data by CPAC and VAMC, including assigned/completed volumes, Contractor-caused rejection rates, non-chargeable exception rates, ending backlog, and seasonal patterns? If not, please confirm that Quoters should rely solely on the aggregate planning estimates in PWS Section 2.4 and the Attachment 05 summary tables.

A46: Please see A01

Q47: Reference: Q-010; B.3.1; PWS §4.2 | p. Sol. 21-22; PWS p. 5-6

Please clarify how an individual 'action' is counted for assignment and billing purposes. For example: (a) if one patient record requires verification of multiple insurance policies, is each policy a separate action; (b) if a single reverification results in a policy update, termination, or resequencing, is that one action or multiple; and (c) is an action counted per buffer entry, per policy, or per patient encounter?

A47: Actions are counted per policy. Each policy that is added, verified, or updated, including

Medicare policies and reverification actions, is counted as a separate action, even if multiple actions occur for one patient record.

▪ This response also addresses Q68 and Q69.

Q48: Reference: Q-011; PWS §4.1.1, §12.4 PRSM; TO Template §3.4 | p. PWS p. 4, 16-17; TO p. 3-4

What delivery periods does the Government anticipate establishing in initial Task Orders for reverification actions and new-policy actions (for example, X business days from the date an action is assigned and available)? If delivery periods will vary by CPAC or workload type, please describe the anticipated range.

A48: Please see A21

Q49: Reference: Q-012; B.2 / B.2.1; B.6.2 | p. Sol. 19-23

Please confirm how the Government will treat a quotation whose Total Evaluated Price exceeds the IDIQ contract maximum of $5,499,000. Would such a quotation remain eligible for award (with the Government simply ordering fewer actions within the ceiling), or does the Government intend the evaluated quantities and the contract maximum to be internally consistent (in which case, will the maximum be adjusted by amendment)?

A49: Quotations whose Total Evaluated Price exceeds the IDIQ contract maximum of $5,499,000 will not be eligible for award, consistent with Section B.6.2 of the solicitation. The evaluated quantities and the contract maximum are intended to be internally consistent, and the Government does not intend to adjust the contract maximum by amendment. Quoters must ensure their Total Evaluated Price does not exceed the stated contract ceiling.

Q50: Reference: Q-013; §8.1; §4.2; B.3.3 | p. PWS p. 12; Sol. 22

When a non-chargeable exception is transferred to the CPAC and the underlying payer, system, or source-data condition is subsequently resolved, will the action be reassigned to the Contractor as a new assigned-and-available action that is billable upon accepted completion? Or is the original documentation-and-transfer effort the Contractor's only involvement?

A50: If a non-chargeable exception is subsequently resolved and the action re-assigned, the contractor may invoice the (now) accepted completed action upon proper completion.

Documentation for each exception must meet Task Order and PWS 8.1 requirements.

Q51: Reference: Q-014; §2.4; §4.1; Att. 05 | p. PWS p. 2-3; Att. 05 p. 1-2

For the estimated Medicare policy actions, please describe: (a) the source of the Medicare enrollment/eligibility data the Contractor will work from (e.g., CMS data exchange output, VA-provided files, patient-supplied information); (b) whether performing Medicare policy actions requires access to any CMS or non-VA systems or portals; and (c) whether the Medicare workload is expected to be front-loaded, steady-state, or event-driven across Ordering Periods 2 and 3.

A51: For Medicare policy actions, the source of Medicare enrollment/eligibility data will be VA-provided files. Medicare policy actions include but are not limited to verification and data entry for traditional Medicare Parts A and B, based on information from patient records, CMS output, and VA-provided data. Each distinct Medicare policy record entered or updated is a single new-policy action, consistent with the general action-counting rule in A47.

▪ This response also addresses Q70 and Q90.

Q52: Reference: Q-015; PWS §4.1.1; TO Template §3.4 | p. PWS p. 4; TO p. 3-4

How will insurance actions be assigned to the Contractor (for example, via VistA insurance capture buffer queues by facility), and what system of record will document the date an action became 'assigned and available' for purposes of the 93% timeliness calculation? Will the Contractor have visibility into that timestamp for each assigned action?

A52: Please see A25

Q53: Reference: 1; PWS; 2.4; p.2

What percentage of the projected new-policy workload consists of Medicare additions versus commercial insurance additions?

A53: The Government does not have a precise percentage breakdown of Medicare versus commercial insurance additions within the projected new-policy workload beyond the quantities already published in Attachment 05 and PWS Section 2.4 [approximately 1,640,000 Medicare policy actions of the total 1,800,800 estimated new-policy actions]. Quoters should base their technical and pricing approach on those published planning quantities.

Q54: Reference: 2; PWS; 4.1.3, 8.1; pp.4 & 12

What specific criteria distinguish a contractor-caused rejected action from a non-chargeable exception?

A54: A contractor-caused rejected action fails due to a contractor's error, omission, or failure to follow PWS/instructions. A non-chargeable exception results from a payer, system, or source-data condition beyond the contractor's control, documented per PWS 8.1 and transferred to CPAC for resolution.

Q55: Reference: 3; PWS; 4.1.3; p.4

Can the Government provide historical rejection rates by action type and location?

A55: The Government does not have additional historical rejection-rate data by action type or location to provide prior to the quotation due date. For planning purposes, PWS Section 8.1 estimates non-chargeable exceptions [a separate category from Contractor-caused rejected actions, as described in A54] at approximately 10–15% of daily workload; no comparable historical figure is available for Contractor-caused rejection rates specifically.

Q56: Reference: 4; PWS; 11.1; pp.13-14

How many key personnel positions does VA expect offerors to identify in their proposal?

A56: Please see A09

Q57: Reference: 5; PWS; 3.0, 4.0; p.3

Does VA permit contractors to utilize automation tools, robotic process automation (RPA), AI-assisted verification capabilities, or workflow automation technologies to support performance?

A57: The contractor may propose automation (including RPA or AI) provided all PWS requirements, VA privacy/security rules, manual accuracy standards, and system access constraints are met.

Q58: Reference: 6; PWS; 2.4, 4.1; pp.2-4

Are there restrictions on automated Medicare verification or batch-processing capabilities when processing Medicare policy actions?

A58: Automated batch processing of Medicare workload is permitted where supported by VA applications and payer systems.

Q59: Reference: 7; PWS; 4.1.6; p.5

Who bears responsibility for obtaining and maintaining payer portal credentials when provider registration is required?

A59: The contractor is responsible for establishing and maintaining all required provider portal accounts and credentials, including training, unless a specific portal requires Government sponsorship, in which case VA will facilitate.

Q60: Reference: 8; RFQ; E; pp.70+

Will the Government consider experience gained through subcontractor performance when evaluating past performance and technical capability?

A60: The Government will consider relevant past performance of proposed major subcontractors where the subcontractor will perform a significant portion of the requirement, consistent with the technical and workshare detail in the quotation.

▪ This response also addresses Q87.

Q61: Reference: 9; General; N/A; N/A

Is there an anticipated timeframe for release of the first task order?

A61: Please see A04

Q62: Reference: 10; Attachment 5; Ordering Period Allocation Table; p.1

Can the government explain why they expect reverification actions to be 0 in OY 2 and OY3?

A62: Please see A08

Q63: Reference: 36C24C26Q0027; Set-Aside and Eligibility Requirements; p. 86-87

The solicitation identifies this requirement as a 100% Service-Disabled Veteran-Owned Small Business set-aside. Please confirm that the prime quoter must be certified by the Small Business Administration as a Service-Disabled Veteran-Owned Small Business and listed in the Small Business Administration certification database at both the time of quotation submission and contract award.

A63: The prime offeror must be a SBA-certified Service-Disabled Veteran-Owned Small Business and must be listed in the SBA certification database at both quotation submission and contract award.

Q64: Reference: Solicitation 36C24C26Q0027; Section C.6, Federal Acquisition Regulation 52.222-

42; p. 34

The solicitation incorporates the Service Contract Labor Standards and lists the Financial Accounts Technician rates as "To Be Determined by the Contracting Officer Pre-Award." No wage determination is included, and the place of performance is not specified. Will the Government provide the applicable Department of Labor wage determination before the quotation deadline and clarify whether the applicable wage determination for remote personnel will be based on each employee's actual work location, a designated contractor facility, or another Government-specified place of performance?

A64: Please see A02

Q65: Reference: Attachment 05, Historical Workload and Planning Information; Historical Workload

Data; Section E.1, Paragraph 7.3; p. 2-3; 76 The solicitation states that Attachment 05 provides historical workload information by Consolidated Patient Account Center, Veterans Affairs Medical Center, transaction type, and observed exception rates. The historical tables contain only placeholders. Will the Government provide the populated historical workload data referenced in Attachment 05, including monthly assigned and completed volumes by location and action type, contractor-caused rejected actions, non-chargeable exceptions, ending backlog, source, reporting cutoff date, and material workload conditions?

A65: Please see A01

Q66: Reference: Solicitation 36C24C26Q0027; Attachment 01, Performance Work Statement;

Attachment 03, Task Order Template; Section B.6.3; Section 7.2; Sections 2 through 5; p. 22- 23; 10; 2-4 Task orders will identify covered locations, quantities, delivery requirements, transition activities, and Government-furnished resources. No completed initial task order is included.

Does the Government anticipate issuing the initial task order concurrently with the indefinite-delivery, indefinite-quantity contract award? If so, will the Government provide the anticipated locations, quantities, funding, period of performance, transition schedule, and Government dependencies for the initial task order?

A66: The Government anticipates phased Task Order issuance by CPAC, VAMC, or facility grouping to address operational priorities. The exact schedule and sequence will be outlined in each Task Order.

▪ This response also addresses Q94.

Q67: Reference: Attachment 01, Performance Work Statement; Attachment 03, Task Order

Template; Sections 4.1.1 and 7.2; Section 3.4; p. 4 and 10; 3 Timely completion will be measured against delivery periods established in individual task orders. The delivery periods and backlog milestones are not provided. What delivery periods does the Government anticipate establishing for reverification actions and new-policy actions under the initial task order? Please also provide the expected backlog-reduction milestones and final completion date for the approximately 804,000-action backlog.

A67: Please see A21

Q68: Reference: Solicitation 36C24C26Q0027; Attachment 01, Performance Work Statement;

Section B.3.1; Section 4.2; p. 20; 5-6

Payment is based on each Government-accepted completed action, but the documents do not fully define the transaction boundary for counting an action. Please define the unit of measure for 1 accepted completed action. Specifically, when a veteran record requires research, updates to multiple policies, medical and prescription coverage coordination, sequencing changes, or entries in more than 1 system, does each policy-level transaction count as a separate action, or does the complete veteran-record transaction count as 1 action?

A68: Please see A47

Q69: Reference: Solicitation 36C24C26Q0027; Attachment 01, Performance Work Statement;

Sections B.2.1 and B.3.1; Section 4.1; p. 18-20; 3-5 The pricing schedule contains separate contract line items for reverification and new-policy actions. How should the contractor classify and invoice an assigned reverification action that results in the identification and entry of a new policy? If the contractor both reverifies an existing policy and enters a new policy for the same veteran record, may the contractor report 2 completed actions, or must the work be classified under a single action type?

A69: Please see A47

Q70: Reference: Attachment 01, Performance Work Statement; Attachment 05, Historical Workload and Planning Information; Section 2.4; Current Planning Information; p. 2; 1-2 The Government estimates approximately 1,640,000 new Medicare policy actions but does not define the Medicare policy types or workload composition. Will the Government identify the Medicare policy types included in the estimated workload, such as Medicare Parts A, B, C, and D, Medicare Advantage, and supplemental coverage, and provide the estimated quantity by policy type? Please also confirm whether each separately entered Medicare policy constitutes 1 new-policy.

A70: Please see A51

Q71: Reference: Solicitation 36C24C26Q0027; Attachment 01, Performance Work Statement;

Attachment 03, Task Order Template; Section E.1, Paragraph 5.5; Section 7.4; Section 5.1; p.

74; 11; 4-5 The contractor must use the authorized access method and may not use contractor-furnished equipment to handle Department information unless expressly authorized. The solicitation does not identify the authorized access architecture or equipment allocation. Will the Government provide Government-furnished computers, Personal Identity Verification credentials, authentication devices, virtual desktop access, and other equipment required for each contractor employee? If contractor-furnished equipment will be authorized, please identify the required technical and security configuration and approval process.

A71: Please see A03

Q72: Reference: Attachment 01, Performance Work Statement; Solicitation 36C24C26Q0027;

Section 7.4; Section B.2, Information Security; p. 11; 7-15 Performance must occur from a secure work environment, but Government workspace generally will not be provided. Please confirm whether personnel may perform from secure home offices, whether performance must occur from an approved corporate facility, or whether both models are permitted. Please also identify any geographic, physical-security, workspace-inspection, or United States residency restrictions that apply.

A72: Please see A06

Q73: Reference: Attachment 01, Performance Work Statement; Section 4.1.6; p. 5

The contractor must obtain and maintain access to assigned insurance-provider portals. Will the Government provide a list of the insurance-provider portals anticipated for performance and identify which party is responsible for account sponsorship, licensing fees, multifactor-authentication devices, credential administration, and portal-specific training?

A73: Yes. Consistent with A59, the Contractor is responsible for provider-portal account sponsorship, licensing, credential administration, and training, except where a specific portal requires Government sponsorship. The Government does not have a definitive list of insurance-provider portals to provide at this time, as portal requirements may vary by

CPAC/VAMC.

Q74: Reference: Attachment 01, Performance Work Statement; Solicitation 36C24C26Q0027;

Section 11.5; Section E.1, Paragraph 5.6; p. 14; 74 The Government will provide training on Veterans Health Information Systems and Technology Architecture and related applications, as applicable. Will Government-provided system training be available to all operational personnel or only key personnel? Please provide the anticipated training duration, delivery method, class capacity, prerequisites, schedule, frequency, and expected time between personnel sponsorship and training completion.

A74: System training on Veterans Health Information Systems and Technology Architecture

(including VistA and related applications) will be provided by the Government to all contractor personnel requiring access to perform the work, not only to key personnel. Training will be delivered virtually, typically using Microsoft Teams or a similar VA-approved platform.

Written training materials and VA Standard Operating Procedures (SOPs) will also be provided. Initial training sessions are expected to be about 3 days per required system/module, depending on complexity and personnel's prior experience. Class size will be managed to balance efficiency and interaction, with multiple sessions offered as needed to accommodate all operational personnel. Personnel must be sponsored by the VA for system access (i.e., initiated background investigation and onboarding), but need not await final access adjudication to attend preparatory training. Training cohorts will be scheduled during ramp-up and as new personnel are onboarded. Refresher or update training will be provided on an as-needed basis whenever system changes or significant updates occur. The typical timeframe from personnel sponsorship to completion of required training and access provisioning is 2–4 weeks, subject to onboarding volume and credentialing progress. A train-the-trainer approach is permitted if proposed by the contractor and approved by the Government, provided all staff ultimately performing system actions have completed the required training. This 2–4 week timeframe for sponsorship, training, and access provisioning is independent of the background investigation and adjudication timeline described in A05, and the two processes may run concurrently.

▪ This response also addresses Q23, Q40, Q88 and Q112.

Q75: Reference: Attachment 01, Performance Work Statement; Attachment 03, Task Order

Template; Sections 4.1 and 11.4; Section 8.1; p. 3-5 and 14; 7-8 Performance must comply with Consolidated Patient Account Center guidebooks, Department policy, and facility-specific procedures that have not been provided. Will the Government provide the current insurance verification guidebooks, standard operating procedures, workflow diagrams, data-entry standards, and representative facility-specific instructions before the quotation deadline? If the documents cannot be provided, will the Government summarize material workflow differences among the 7 regional centers?

A75: The Government will provide training on VistA and related applications, as described in A74.

The Government will also provide existing CPAC guidebooks and Standard Operating Procedures (SOPs) as reference material to support Contractor performance. Consistent with PWS Sections 11.4 and 11.5, the Contractor remains responsible for ensuring its personnel possess the underlying insurance entry and verification domain knowledge necessary to perform the work, and for providing any additional training needed beyond VA-provided VistA/system training, at no separate cost to the Government per Section B.1.

Q76: Reference: Attachment 01, Performance Work Statement; Sections 4.1 and 4.4; p. 3-8

The contractor must process assigned actions and report pending workload, but the assignment and queue-management process is not identified. What Department systems, modules, work queues, interfaces, and reports will be used to assign work, record completion, return rejected actions, identify exceptions, and validate accepted actions? Will the Government provide system-generated workload and performance extracts to support contractor reporting and invoice reconciliation?

A76: Work is managed and assigned via VistA insurance buffer queues, CPAC/VA facility worklists, or similar systems, consistent with the assignment process described in A25. Completed, rejected, and exception actions are tracked using these tools, and status/timestamps are accessible to both contractor and Government for reconciliation and reporting. VA will provide periodic system-generated workload and performance extracts, as required, to support contractor reporting and invoice reconciliation.

Q77: Reference: Attachment 01, Performance Work Statement; Section 7.5; p. 11

Normal Government operating hours are stated, and a key person must be available during specified Eastern Time hours. May production personnel process assigned insurance actions outside normal Government operating hours, including evenings, weekends, and federal holidays, provided all access, security, and performance requirements are met?

A77: Personnel may process actions outside normal Government operating hours provided…