E.3 Business Proposal Template.xlsx
XLSX spreadsheet 113 KB Posted
- Attached to
- National Corrective Coding Initiative (NCCI) Federal contract opportunity
- Solicitation number
- 75FCMC18R0046
About this file
E.3 Business proposal Template
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| E.7__Consent_to_Subcontract.doc | DOC document | |
| amendment_0001_75FCMC18R0046.pdf | ||
| CMS_response_to_solicitation_Questions.xlsx | XLSX spreadsheet | |
| J.1 NCCI.SOW. 2019-2024 .docx | DOCX document | |
| E.6 Virus Detection Certification.doc | DOC document | |
| NCCI Solicitation 75FCMC18R0046.pdf | ||
| J.3 Contractor Business Ethics, Conflict of Interest and Compliance Submission by Offeror-Contractor.docx | DOCX document | |
| E.5 Responsibility Questionnaire.doc | DOC document | |
| E.1 Prime Contractor Proposal Checklist .doc | DOC document | |
| E.2 Subcontractor Proposal Checklist.doc | DOC document | |
| E.4 Past Performance Questionnaire.docx | DOCX document | |
| J.2 Contractor Personal Conflicts of Interest Financial Disclosure.docx | DOCX document |
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Text version
Cost Summary
PROJECT TITLE: NATIONAL CORRECT CODING INTIATIVE PROGRAM 2019-2024
CORRECT CODING INITIATIVE (CCI)
Detailed Price Summary
| Contract Line Item Description | Base Period (CLIN 0001) | Option Year One (CLIN 0002) | Option Year Two (CLIN 0003) | Option Year Three (CLIN 0004) | Option Year Four (CLIN 0005) | 60 Day Transition Period (CLIN 0006) | ||||||||||||||||||
| Hours | Rate | Total | Total Price | Hours | Rate | Total | Total Price | Hours | Rate | Total | Total Price | Hours | Rate | Total | Total Price | Hours | Rate | Total | Total Price | Hours | Rate | Total | Total Price |
| Line Item Subtotal |
| Fringe Benefits |
| Subtotal Line Item & Fringe |
| Overhead |
| Subtotal Line Items, Fringe and Overhead |
| Travel (Sheet labeled Travel) |
| Subcontractor |
| ODCs (Sheet labeled ODCs) |
| Subtotal ODCs |
| Subtotal - All Costs |
| G&A |
| Total Cost |
| Fee/Profit |
| Total Estimated Yearly Values |
| TOTAL ESTIMATED VALUE OF CONTRACT |
| Assumptions: | Percent |
| Inflation Rate Per Year | |
| Fringe Benefits Rate | |
| Overhead Rate | |
| G&A Rate | |
| Fee/Profit Percentage |
&F&D&T
CLIN 0001 Base Year
PROJECT TITLE: NATIONAL CORRECT CODING INTIATIVE PROGRAM 2019-2023
CORRECT CODING INITIATIVE (CCI)
Period of Performance: February, 2019 - February, 2020
| Contract Line Item Description | CLIN 0001AA (Medicare) | Base Year | CLIN 0001AB (Medicaid) | CLIN 0001 Totals | |||||
| Hours | Rate | Total | Hours | Rate | Total | Hours | Total |
| Line Item Subtotal |
| Fringe Benefits |
| Subtotal Line Item & Fringe |
| Overhead |
| Subtotal Line Items, Fringe and Overhead |
Travel (Sheet Labeled Travel below)
| Subcontractor Costs | |
| ODCs (Sheet Labeled ODCs below) | |
| Subtotal ODCs | |
| Subtotal - All Costs | |
| G&A | |
| Total Cost | |
| Fee/Profit | |
| Total Cost (including fee) | |
| Total Period Cost | |
| Assumptions: | Percent |
| Inflation Rate Per Year | |
| Fringe Benefits Rate | |
| Overhead Rate | |
| G&A Rate | |
| Fee/Profit Percentage |
CLIN 0001AA
| Base Year | ||||||||||||||||||||||
| CLIN 0001AA - Medicare | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0001AB
| Base Year | ||||||||||||||||||||||
| CLIN 0001AB - Medicaid | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0002 Option Year 1
PROJECT TITLE: NATIONAL CORRECT CODING INTIATIVE PROGRAM 2019-2023
Period of Performance: February, 2020 - February, 2021
| Contract Line Item Description | CLIN 0002AA (Medicare) | Option Year 1 | CLIN 0002AB (Medicaid) | CLIN 0002 Totals | |||||
| Hours | Rate | Total | Hours | Rate | Total | Hours | Total |
| Line Item Subtotal |
| Fringe Benefits |
| Subtotal Line Item & Fringe |
| Overhead |
| Subtotal Line Items, Fringe and Overhead |
Travel (Sheet Labeled Travel below)
| Subcontractor Costs | |
| ODCs (Sheet Labeled ODCs below) | |
| Subtotal ODCs | |
| Subtotal - All Costs | |
| G&A | |
| Total Cost | |
| Fee/Profit | |
| Total Cost (including fee) | |
| Total Period Cost | |
| Assumptions: | Percent |
| Inflation Rate Per Year | |
| Fringe Benefits Rate | |
| Overhead Rate | |
| G&A Rate | |
| Fee/Profit Percentage |
CLIN 0002AA
| Option Year 1 | ||||||||||||||||||||||
| CLIN 0002AA - Medicare | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0002AB
| Option Year 1 | ||||||||||||||||||||||
| CLIN 0002AB - Medicaid | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0003 Option Year 2
PROJECT TITLE: NATIONAL CORRECT CODING INTIATIVE PROGRAM 2019-2023
Period of Performance: February, 2021 - February, 2022
| Contract Line Item Description | CLIN 0003AA (Medicare) | Option Year 2 | CLIN 0003AB (Medicaid) | CLIN 0003 Totals | |||||
| Hours | Rate | Total | Hours | Rate | Total | Hours | Total |
| Line Item Subtotal |
| Fringe Benefits |
| Subtotal Line Item & Fringe |
| Overhead |
| Subtotal Line Items, Fringe and Overhead |
Travel (Sheet Labeled Travel below)
| Subcontractor Costs | |
| ODCs (Sheet Labeled ODCs below) | |
| Subtotal ODCs | |
| Subtotal - All Costs | |
| G&A | |
| Total Cost | |
| Fee/Profit | |
| Total Cost (including fee) | |
| Total Period Cost | |
| Assumptions: | Percent |
| Inflation Rate Per Year | |
| Fringe Benefits Rate | |
| Overhead Rate | |
| G&A Rate | |
| Fee/Profit Percentage |
CLIN 0003AA
| Option Year 2 | ||||||||||||||||||||||
| CLIN 0003AA - Medicare | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0003AB
| Option Year 2 | ||||||||||||||||||||||
| CLIN 0003AB - Medicaid | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0004 Option Year 3
PROJECT TITLE: NATIONAL CORRECT CODING INTIATIVE PROGRAM 2019-2023
Period of Performance: February, 2022 - February, 2023
| Contract Line Item Description | CLIN 0004AA (Medicare) | Option Year 3 | CLIN 0004AB (Medicaid) | CLIN 0004 Totals | |||||
| Hours | Rate | Total | Hours | Rate | Total | Hours | Total |
| Line Item Subtotal |
| Fringe Benefits |
| Subtotal Line Item & Fringe |
| Overhead |
| Subtotal Line Items, Fringe and Overhead |
Travel (Sheet Labeled Travel below)
| Subcontractor Costs | |
| ODCs (Sheet Labeled ODCs below) | |
| Subtotal ODCs | |
| Subtotal - All Costs | |
| G&A | |
| Total Cost | |
| Fee/Profit | |
| Total Cost (including fee) | |
| Total Period Cost | |
| Assumptions: | Percent |
| Inflation Rate Per Year | |
| Fringe Benefits Rate | |
| Overhead Rate | |
| G&A Rate | |
| Fee/Profit Percentage |
CLIN 0004AA
| Option Year 3 | ||||||||||||||||||||||
| CLIN 0004AA - Medicare | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0004AB
| Option Year 3 | ||||||||||||||||||||||
| CLIN 0004AB - Medicaid | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0005 Option Year 4
PROJECT TITLE: NATIONAL CORRECT CODING INTIATIVE PROGRAM 2019-2023
Period of Performance: February, 2023 - December, 2023
| Contract Line Item Description | CLIN 0005AA (Medicare) | Option Year 4 | CLIN 0005AB (Medicaid) | CLIN 0005 Totals | |||||
| Hours | Rate | Total | Hours | Rate | Total | Hours | Total |
| Line Item Subtotal |
| Fringe Benefits |
| Subtotal Line Item & Fringe |
| Overhead |
| Subtotal Line Items, Fringe and Overhead |
Travel (Sheet Labeled Travel below)
| Subcontractor Costs | |
| ODCs (Sheet Labeled ODCs below) | |
| Subtotal ODCs | |
| Subtotal - All Costs | |
| G&A | |
| Total Cost | |
| Fee/Profit | |
| Total Cost (including fee) | |
| Total Period Cost | |
| Assumptions: | Percent |
| Inflation Rate Per Year | |
| Fringe Benefits Rate | |
| Overhead Rate | |
| G&A Rate | |
| Fee/Profit Percentage |
CLIN 0005AA
| Option Year 4 | ||||||||||||||||||||||
| CLIN 0005AA - Medicare | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0005AB
| Option Year 4 | ||||||||||||||||||||||
| CLIN 0005AB - Medicaid | ||||||||||||||||||||||
| Task Group 1 | Task Group 2 | Task Group 3 | Task Group 4 | Task Group 5 | Task Group 6 | |||||||||||||||||
| Tasks | Total FTEs | Contract Management | Core Operations | Supporting Operations | Preparation of Reports | State and 3rd Party Adoption Coordination | Closeout Operations | GRAND TOTAL | ||||||||||||||
| Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | Hours | Rates | Total | ||
| COST ELEMENTS | ||||||||||||||||||||||
| Direct Labor |
| Total FTE's |
| Subtotal Direct Labor |
Fringe Benefits (at _____%)
Total Direct Labor
| Travel (See separate schedule) |
| SUBCONTRACTORS |
| Subcontractor Name |
| Note: Subcontractors hours above |
| Total Subcontractor |
| Total FTE's- Direct & Subcontract |
| Other Direct Costs (See separate schedule) |
SUBTOTAL ALL DIRECT COSTS
Indirect Costs (at ______ %)
SUBTOTAL COSTS BEFORE FEE
Fee
TOTAL COSTS
CLIN 0006 Transition
PROJECT TITLE: NATIONAL CORRECT CODING INTIATIVE PROGRAM 2019-2023
Period of Performance: December, 2023 - February, 2024
| Contract Line Item Description | CLIN 0006 (Transition) | ||
| Hours | Rate | Total |
| Line Item Subtotal |
| Fringe Benefits |
| Subtotal Line Item & Fringe |
| Overhead |
| Subtotal Line Items, Fringe and Overhead |
Travel (Sheet Labeled Travel below)
| Subcontractor Costs | |
| ODCs (Sheet Labeled ODCs below) | |
| Subtotal ODCs | |
| Subtotal - All Costs | |
| G&A | |
| Total Cost | |
| Fee/Profit | |
| Total Cost (including fee) | |
| Total Period Cost | |
| Assumptions: | Percent |
| Inflation Rate Per Year | |
| Fringe Benefits Rate | |
| Overhead Rate | |
| G&A Rate | |
| Fee/Profit Percentage |
Travel
| TRAVEL | |||||||||||||
| Reason for Trip | From | To | Number of People | Times per PoP | Airfare/Train | Hotel | Number of Nights | Meals & Incidentals Per Diem Per FTR (1st and last day 75%) | Car Rental | Home Airport/train Parking | # Mileage Round Trip | Mileage cost .54 cents | Total |
ODCs
| OTHER DIRECT COSTS | |||||
| Contract Year | Item | Detailed decription and purpose of the item | Quantity | Price | Total Price |
GRAND TOTAL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0
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