RFP 36C77620R0016 Question RESPONSES 01252021 v4_.pdf

RFP 36C77620R0016 Questions

Question 1.

Attachment, Section: 3.5.2.14, 12.4-12.6 Page: 37, 53 RFP Question:

Question:

Is it VA’s intent that these restrictions apply to only the dedicated support staff requested in 3.5.1/3.5.2/3.13.4?

Response: The intent is that anyone who works with VA PHI will abide by these restrictions. Please refer to sections 3.5, 3.5.2.14, 12, 12.4. 12.5 & 12.6 of the Performance Work Statement (PWS).

Question 2.

Attachment, Section: PWS 8 D.1 IT CONTRACT SECURITY Page: 48, 79 RFP Question: Multiple Question: There appears to be some redundancy in the security-related sections. Items are not necessarily worded identically, and they may conflict. For example:

• PWS #8 Information System Hosting on pg. 48 vs. D.1 #5 Information System Hosting on pg. 79

• PWS #14 Information System Design and Development on pg. 54 vs. D.1 #4 Information System

Design and Development on pg. 77

• Et all Please reconcile the duplicated sections to ensure that only the most relevant and appropriate language is used.

Response: STRIKE the language on pages 48, Section 8 and page 54 Section 14.

Question 3 Attachment, Section: PWS 12.7 Page: 53

RFP Question: Items 12.7 through 12.14 refer to protection of medical research (and might be out of context).

Question: It seems that the paragraph “Ensure, if the work of the Contractor is deemed to meet the definition of research from the HHS Office of Human Research Protections (OHRP) as well as the Common Rule (38 CFR 16), then the Contractor as well as any Sub-Contractors or collaborating institutions shall be covered under Federal Wide Assurances (FWA) or other assurances acceptable to the VA, and the research protocol shall be reviewed and approved by the Contractor’s Institutional Review Board (IRB) of record as well as by IRBs of the collaborating institutions.” should be inserted as item

12.7 to provide context and definitions for the subsequent items.

Response: Language is hereby moved to Section 12.7 of the PWS.

Question 4.

Attachment, Section: PWS 5.17 Page: 46 RFP Question: To support continued operations, the contractor should have data reporting in place to ensure transaction volume, errors, and data is available to research transaction issues.

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Question: Attachment A defines accreditation requirements, not material used for operational support and transaction monitoring. What section did VA intend to refer to here?

Response: STRIKE the following sentence from Section 5.17 of the PWS “Attachment A provides references to material VA and the Contractor utilize for operational support and transaction monitoring”

Question 5.

Attachment, Section: PWS 5.26 Page: 46 RFP Question: VA shall NOT be charged separately for any HIPAA Health Care Eligibility/Benefit Response 270, 271, 835 or 837 transaction as they are considered answers to a successful submission of a HIPAA Health Care Eligibility/Benefit Inquiry 270, 835, or 837 transaction.

Question: While the 271 is accurately described as the “answer to a successful submission of a HIPAA Health Care Eligibility/Benefit Inquiry 270” that description does not apply to the 835 and 837. What is VA’s intent in including these transactions?

Response: STRIKE reference to 835 & 837.

Question 6.

Attachment, Section: PWS 7.11 Page: 48 RFP Question: Currently, the Contractor does not have access to each site's VistA or other EHR/RCM applications designated by VA/VHA system. VA executes appropriate internal code to gather patient names and demographic information which is then transmitted to the Contractor via customized HIPAA transaction. The Contractor shall respond to inquiries with found insurance information via customized HIPAA transaction.

Question: This requirement appears to have been copied from solicitation 36C77620R0008 HCCH HIPAA Insurance Identification and Verification, which included insurance coverage discovery services not mentioned anywhere else in this solicitation. What is VA’s intent in including this?

Response: STRIKE paragraph 7.11 in its entirety.

Question 7.

Attachment, Section: Attachment B QASP Page: 58 RFP Question: Each Contractor is required to submit a QASP thirty (30) calendar days after the Contract award date that outlines how the Contractor plans to provide continued uninterrupted quality of service.

Question: This requirement indicates that the contractor must submit a QASP within 30 days of award.

However, we interpret PWS 17 and 18 (and other language) as meaning that the QASP is provided by the VA to inform contractors about how they will be measured for quality. PWS #17 says the contractor must develop a Quality Control Plan (QCP) and that a template is provided in Attachment B, but there does not seem to be a requirement of the offeror to submit a specific document as part of the offer or post-award, nor does there appear to be a QCP template. Can the government clarify requirements with respect to the QASP and QCP?

Response: STRIKE the language in paragraph 17 of the PWS in its entirety and replace with the following for clarity:

https://gcc01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fword-edit.officeapps.live.com%2Fwe%2Fwordeditorframe.aspx%3Fui%3Den-US%26rs%3Den-US%26wopisrc%3Dhttps%3A%252F%252Femdeon-my.sharepoint.com%252Fpersonal%252Famanda_colwell_changehealthcare_com%252F_vti_bin%252Fwopi.ashx%252Ffiles%252F3c1c50f39354415bb179c5af5f7bfbff%26wdenableroaming%3D1%26mscc%3D1%26wdodb%3D1%26hid%3D7549A29F-0070-B000-B3BC-575D8ABCCDB3%26wdorigin%3DItemsView%26wdhostclicktime%3D1610921707366%26jsapi%3D1%26jsapiver%3Dv1%26newsession%3D1%26corrid%3De854991b-59c3-489f-be38-de4b47986c06%26usid%3De854991b-59c3-489f-be38-de4b47986c06%26sftc%3D1%26instantedit%3D1%26wopicomplete%3D1%26wdredirectionreason%3DUnified_SingleFlush%26rct%3DMedium%26ctp%3DLeastProtected%23_ATTACHMENT_A_%25E2%2580%2593&data=04%7C01%7C%7C948861daf46b46d541a308d8bc9d4eb1%7Ce95f1b23abaf45ee821db7ab251ab3bf%7C0%7C0%7C637466731126509490%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C1000&sdata=OjaRPgd%2BezldCnrla9JDrbab7JTwSBkUWfu0zUf8GvM%3D&reserved=0

17. Quality Assurance. The Contractor shall develop and maintain an effective Quality Assurance Surveillance Plan (QASP)in accordance with their approved Management Oversight Plan (MOP) to ensure services are performed in accordance with the PWS. A SAMPLE template is provided in Section D.3, Attachment B of the PWS.

Question 8.

Attachment, Section: Section B.2 PRICE/COST SCHEDULE (File: 36C7762R0016) & Exhibit A Page: 5-9 RFP Question: Refer to all sections in Section B.2 with POP End: 04-28-2027, with Volume: 1,501,000

- 2,500,000, and Volume 2,501,000 +

Refer to all sections in Exhibit A with POP End: 04-28-2026, with Volume: 1,501,000 - 2,500,000, and Volume 2,501,000 +

Question: Please provide the correct end date. Is it 04-28-2026 OR 04-28-2027?

Please resolve the transaction volume. Shouldn’t volume be revised to reflect consecutive transactions?

Volume: 1,501,000 - 2,500,000 should be changed to 1,500,001 and Volume 2,501,000 + should be changed to 2,500,001?

Response: Section B.2 has been corrected to read: POP Begin: 04-28-2021, POP End: 04/28/2026.

Processing Volume pricing amounts have been corrected. (See attached revised Section B.2, PRICE/COST SCHEDULE and EXHIBIT A).

Question 9.

Attachment, Section: Security Page:

Question: Is there a facility security clearance requirement?

Response: No

Questions 10 – 29 are in general questions, and not assigned to any specific Attachment, Section or page for reference.

Question 10: Can Companies from outside USA apply for this?

Response: No, VA requires a US-based company

Question 11: Would we need to come over there for meetings?

Response: No meetings are anticipated at this time.

Question 12: Can we perform the tasks (related to RFP) outside USA?

(like, from India or Canada) Response: No, tasks must be performed within the USA

Question 13: Regarding FIPS 199, what is the categorization sensitivity level for the system? Low, Moderate, High Response: High.

Question 14: CMMC

a. Will certification be required.

b. If so when and at what level?

Response: This is not referred to in the PWS.

Question 15: Will these transactions be coming from a central business office(s), or from each provider office separately?

Response: Transactions will come from the VA Financial Services Center (FSC).

Question 16: Will enrollment, testing, and reporting be performed with a CBO or with VA provider locations directly? Would the enrollment be conducted with VA Provider directly or coordinated?

Response: Directly

Question 17: How many provider office locations will need to be implemented?

Response: There are currently 247 dispensing pharmacies.

Question 18: Can the VA define the support (high-level tasks) needed from each of the categories listed in the RFP

• Operational Support

• Health Care Analyst Support

• Business Analyst Support

• Technical Development Support

Response: Vendor will determine the level of staffing needed to complete the tasks listed in the RFP.

Question 19: Can the VA describe/define examples of the proprietary transactions mentioned in 3.6.4.1.6?

Response: VA Proprietary file formats are X12 HIPAA Compliant files that provide VA with needed detail to streamline our revenue process

Question 20: If the claims requirement is batch, what is the real-time 837 requirement in 3.6.4.1.7?

Response: STRIKE “HIPAA 837” language from 3.6.4.1.7.

Question 21: What is the expected volume of electronic claims dropped to paper for submission?

Response: Refer to Section B.2 and/or Exhibit A for estimated claim volumes.

Question 22: On page 45, what are “payer appendices”?

Response: Refer to the PWS, Section D of the solicitation, for Attachment D, E and F.

Question 23: Who is the incumbent currently performing this effort?

Response: Change Healthcare

Question 24: What is the expected award date?

Response: Anticpated award date is April 1, 2021

Question 25: What is the expected Period of Performance start date?

Response: The expected start date will be within 30 days of the date of award.

Question 26: What is the estimated volume for 278s?

Response: At this time we do not have any volume for 278s as we are not currently utilizing due to industry readiness.

Question 27: Would an Electronic to Paper Vendor need to either be EHNAC accredited or have an ATO to be compliant?

Response: Yes

Question 28: Are the Pharmacy claims also batch or real-time and batch?

Response: Real-time, refer to Section B.2, PRICE/COST SCHEDULE.

Question 29: Will there be one or more connections from FSC to the HCCH? For example, will both medical and pharmacy transactions be originating from the same location within FSC, and flowing through the same connection?

Response: There will be more than 1 connection from FSC to the HCCH

Question 30 Attachment, Section: 3.6.4.1.1, 3.6.4.1.7

Question: Does the VHA accept 837/835 transactions as both batch and real-time?

If so, can you identify which payers on your list accommodate 835/837 real-time transactions?

Response: VHA sends 837 batch transaction and accepts 835/eMRA. Commercial 835s are not covered in this solicitation. Refer to the list in attachment D.

Question 31 Attachment, Section: 3.10 Question: Please describe the process flow that generates requirement for EOB to be submitted with printed claim for Payers who do not accept electronic 837 claim records. Are electronic EOB’s being submitted to Payers (eMRA via electronic 835 file, re: Section 3.8.4) who can handle electronic 837 files?

Response: If a non-primary payer does not accept electronic 837s; the information from the 837 and primary payer’s 835/eMRA will have to be extracted to submit on paper. Yes, if the payer accepts 837s the CAS segments from the 835/eMRA are sent in 837.

Question 32 Attachment, Section: 3.10 Question: In printing the paper EOB from 837 record and additional data from VA files, what is the meaning of the term “facsimile” EOB?

Response: Exact copy

Question 33 Attachment, Section: 3.10 Question: Is it correct to assume that a printed paper EOB will be on 20# paper with two-sided printing?

Response: This would be a payer preference.

Question 34

Question: Are EOB’s to be printed for every claim printed in Section 3.11?

Response: Only if the payer is the non- primary payer (e-MRA)

Question 35 Attachment, Section: 3.10 Question: Are EOB’s to be printed only for claims in 837 format or will there also be EOB/claims printed from NCPDP records?

Response: 837 format only.

Question 36

Question: What is the volume of EOB’s and volume of EOB pages printed each month for each of the past 12 months?

Response: The VA does not keep track of the paper volume used by the contractor..

Question 37 Attachment, Section: 3.10 Question: What is VA preferred file interface mechanism for providing additional data in order to print the EOB? XML transactional real-time interface or batch file daily interface?

Response: No additional data is provided by VA to print e-MRA. STRIKE the following language in sections 3.10.2: “This requires the addition of data fields to VHA proprietary inbound maps in order to successfully print Medicare EOB’s”.

STRIKE the language in section 3.10.3 in its entirety.

Question 38

Question: What is the index value used from the 837 file to retrieve the supplemental EOB information?

Response: No additional data is provided by VA to print e-MRA. STRIKE the following language in sections 3.10.2:

“This requires the addition of data fields to VHA proprietary inbound maps in order to successfully print Medicare EOB’s”.

STRIKE the language in section 3.10.3 in its entirety.

Question 39 Attachment, Section: 3.11 Question: Are claims to be printed from both 837 records as well as from NCPDP records?

Response: The NCPDP records will not be printed to paper. However, there will be pharmacy claims sent in an 837 format that will need to be printed.

Question 40 Attachment, Section: 3.11 Question: What is the volume of claims and volume of claim pages printed each month for the past 12 months?

Response: Refer to attachment G in the PWS for claim volume. The VA does not keep track of the paper volume used by the contractor.

Question 41 Attachment, Section: 3.11 Question: What is VA preferred file interface mechanism for providing additional data in order to print the claims? XML transactional real-time interface or batch file daily interface?

Response: Batch

Question 42 Attachment, Section: 3.11 Question: Is it the same single index in the 837 that will retrieve the data both for creation of the EOB as well as the printed 837 form?

Response: Section 3.11 does not reference a “same single index”, therefore we are not able to provide a response.

Question 43 Attachment, Section: 3.10 and 3.11 Question: Are all Providers submitting 837 electronic claim records to the FSC? If not, is there any “data conversion” of paper submitted claim records that need to be addressed under this RFP? If so, what is the volume per month?

Response: Are all Providers submitting 837 electronic claim records to the FSC? Yes.

Question 44 Attachment, Section: Attachment D Question: There are no estimated volumes for 277RFAI which implies 275s would be part of scope). If 275s are part of scope, what are the volumes? Solicited vs unsolicited? Volumes for 277RFAI? Are there any attachments coming in through paper?

Response: Attachments (275) are not utilized at this time however, as the industry begins mandating this transaction there is the potential for VHA to begin using it as well. 277RFAI is not mandated in the industry at this time.

Question 45 Attachment, Section: 3.6.5 Question: Will all incoming electronic transactions come from Financial Service center to the clearinghouse? YES Will there be incoming transactions from VHA Providers to Clearinghouse? NO

Question 46: Is any of the work in this RFP currently being performed by one or more contractors? If so, please identify the contract number(s).

Response: Work listed in the RFP is currently being performed by Change Healthcare, contract number

GS-35F-0176X 36C77620N0111.

Question 47: Will this contract replace any work currently being performed under another contract?

Response: Refer to the RFP solicitation for work to be performed in this contract..

Question 48: "Health Care Clearing House II (HCCH II)" Is this the second in a series of HCCH contracts?

Was there an HCCH I? If so, please identify the RFP, awardee and /or contract number.

Response: No, this is a separate requirement..

Question: 49: This is titled: "HIPAA Insurance Identification and Verification" on page 33. Is this correct?

Please clarify.

Response: STRIKE “HIPAA Insurance Identification and Verification from the title”.

Question 50: The 30-day activation plan seems aggressive. We ask that VA consider a 45-60 days start-up schedule.

Response: 30 days will be sufficient

Question 51: Who are the current MAC vendors? Please clarify the "JH and DME" reference.

Response: JH = Novitas, DME = Noridian

Question 52: Are Past Performance references from non-federal clients given equal weight to those from a federal client? If not, please indicate how they compare.

Response: Refer to Section E.4, Evaluation Factors, Evaluation Factor II – Past Performance.

Question 53: "Be advised that the government reserves the right to transmit those questions and answers of a common interest to all prospective Offerors." Does this mean that the government can provide an answer to a question that would not be disclosed to all prospective offerors?

Response: As stated in Section E.2, “Be advised that the government reserves the right to transmit those questions and answers of a common interest to all prospective Offerors..

Question 54: Risk has historically been assessed based on Past Performance Information, and while that seems to be somewhat true here, it seems to be integrated primarily into Technical Evaluation Factor 1.

It seems that risk is effectively being evaluated twice. Please clarify.

Response: For this solicitation, evaluations will be conducted in accordance with the criteria as outlined in Section E.4.

Question 55: Re: CPARS : 1) how many CPARS will be evaluated, and 2) how will the government select the ones it will consider?

Response: The solicitation does not state a specific number of CPARS will be evaluated. Refer to Section E.4, Evaluation Factor II, Past Performance. of the solicitation:

It states in part: “The Government reserves the right to obtain past performance information from any available source and may contact customers other than those identified by the Offeror when evaluating past performance.”.

Question 56: What is the difference between "some credit", "partial credit" and "evaluation credit"? Is one worth more than the other? If so please clarify. Reference SDVOSB/VOSB Involvement Rating (Tables 7 and 8) Response: Refer to the definitions in Table 7 & 8 under Section E.4, Evaluation Factor III describing the definition of the ratings.