J.23.B Government Provided Proposal Assumptions CSR-Handled Telephone Inquiries Tables.docx
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- Solicitation number
- 75FCMC19R0041
About this file
This document contains a table template for offerors responding to solicitation number 75FCMC19R0041 from the Department of Health and Human Services Centers for Medicare and Medicaid Services. The template requires offerors to provide projected volumes of Durable Medical Equipment claims, telephone inquiries, and customer service representative-handled telephone inquiries for the base period of performance and six option years. Offerors must either use the workload estimates provided by CMS or propose adjusted estimates and provide a narrative explanation. Offerors must also complete data for a baseline contract, if used to derive different call-to-claim ratios, and explain any differences from historic performance or CMS projections. The solicitation is for Durable Medical Equipment Medicare Administrative Contractor services for Jurisdiction C, covering 16 states, Puerto Rico and the U.S. Virgin Islands.
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Attachment J.23 B Government Provided Proposal Assumptions CSR-Handled Telephone Inquiries Tables
RFP # 75FCMC19R0041
Provider Customer Service Program (PCSP) CSR-Handled DME Telephone Inquiries Tables
Complete and include the following table for CSR-Handled Telephone Inquiries DME. Offerors that propose to apply the CMS- provided workload estimates for CSR-handled provider telephone inquiries (shown in Row C of each Table below as well as in Attachment J.22, Basis of Estimate, Row 35, Column F) need only complete Row E (CMS has pre-filled Rows A through D) and submit only Rows A through E as part of its proposal. In this case the Offeror must also clearly confirm (in the PCSP section of the proposal) that its technical approach and staffing plan are based on the CMS-provided workload estimates for CSR-handled inquiries. Offerors that propose to adjust (overwrite or derive) the CMS-provided workloads for CSR-handled provider calls must complete Rows E through K and submit the tables in full, Rows A through K, and also provide the required narrative explanation. Further, such Offerors must provide conforming data in the BOE, in keeping with the BOE instructions. Finally, Offerors must align their staffing plans under Tab E to their proposed workloads for CSR-handled provider telephone inquiries.
Table 1 – CSR-Handled DME Telephone Inquiries Workload
| Row |
| Workload/Proposal Element |
| BP |
| OY1 |
| OY2 |
| OY3 |
| OY4 |
| OY5 |
| OY6 |
| a |
| CMS-Projected DME Claims Volume |
(BOE, column E, row 8)
| 13,701,926 |
| 23,769,615 |
| 24,128,665 |
| 24,493,131 |
| 24,863,077 |
| 25,238,611 |
| 25,619,794 |
| b |
| CMS-Projected DME Telephone Inquiries Volume |
(BOE, row 35, column E)
| 548,361 |
| 940,047 |
| 940,047 |
| 940,047 |
| 940,047 |
| 940,047 |
| 940,047 |
| c |
| CMS-Projected DME CSR- Handled Telephone Inquiries Volume |
(BOE, row 35, column F as solicited)
| 174,713 |
| 299,504 |
| 295,011 |
| 290,586 |
| 286,227 |
| 281,934 |
| 277,705 |
| d |
| CMS-Projected Ratio of DME CSR- Handled Calls to Claims |
(row d = row c ÷ row a)
| 0.01275 |
| 0.01260 |
| 0.01222 |
| 0.01186 |
| 0.01151 |
| 0.01117 |
| 0.01083 |
| e |
| Offeror’s Proposed DME CSR- Handled Telephone Inquiries Volume |
(BOE, row 35 Col. F). Add explanation below and in BOE, row 35, Col. N, if change from CMS RFP projection.
| (fill in whether Offeror uses CMS row c or proposes a new CSR volume) |
| (fill in whether Offeror uses CMS row c or proposes a new CSR volume) |
| (fill in whether Offeror uses CMS row c or proposes a new CSR volume) |
| (fill in whether Offeror uses CMS row c or proposes a new CSR volume) |
| (fill in whether Offeror uses CMS row c or proposes a new CSR volume) |
| (fill in whether Offeror uses CMS row c or proposes a new CSR volume) |
| (fill in whether Offeror uses CMS row c or proposes a new CSR volume) |
| f |
| Offeror’s Proposed Ratio of DME CSR-Handled Calls to Claims |
(row f = row e ÷ row a)
| (fill in only if row c and row e differ) |
| (fill in only if row c and row e differ) |
| (fill in only if row c and row e differ) |
| (fill in only if row c and row e differ) |
| (fill in only if row c and row e differ) |
| (fill in only if row c and row e differ) |
| (fill in only if row c and row e differ) |
| Row |
| Offeror’s Baseline Contract: |
<contract name>
(Insert contract name and complete rows g through k below, if rows e and f above differ from rows c and d)
| CY 2016 |
| CY 2017 |
| CY 2018 |
| g |
| CY Total DME Claims Volume (Processed) for Baseline Contract |
| h |
| CY Total DME Telephone Inquiries Volume (All Calls Received at PCC (CSR-handled and IVR- handled) for Baseline Contract |
| i |
| CY Total DME CSR-Handled Telephone Inquiries Volume for Baseline Contract |
| j |
| CY Historic Actual Ratio of DME CSR-Handled Calls to Claims for Baseline Contract |
| k |
| Offeror’s Rationale/Explanation for Changing the CMS-Projected DME CSR Call Volume: |
Provide a narrative response of why Offeror proposes adjustments to CMS-projected DME CSR call volume, i.e., why do rows e and f differ from rows c and d. If applicable, also provide a narrative response of why Offeror proposes a different call-to-claim ratio than it achieves in its own historic contract performance (historic call-to-claim ratio), i.e., why do rows j and f differ.
January 10, 2019 Page 2 of 3
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