6621-Combined Synopsis_A1.docx

A. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued.

B. The Great Plains Area Indian Health Service (IHS) intends to award a firm-fixed price, non-personal service, single award, purchase order to provide subscription access and support for Revenue Cycle Management and providing a Revenue Cycle Automation Process for Third Party Billing (Claims Management & Patient Billing), and Accounts Receivable (Remittance & Payment Management) at the Quentin N Burdick Memorial Health Care Facility, Belcourt, North Dakota in response to RFQ 75H70625Q00224.

C. This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2025-04/2025-06-11.

D. This RFQ is set aside 100% Indian Economic Enterprise (IEE) and the associated NAICS Code is 518210, which has a small business standard of $40 million.

E. The quoted unit pricing must be “all inclusive” (to include but not be limited to travel, lodging, per diem, fringe benefits, federal, state and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable pricing.

Complete the attached Price Schedule for:

F. Subscription access and support for Revenue Cycle Management and providing a Revenue Cycle Automation Process for Third Party Billing (Claims Management & Patient Billing), and Accounts Receivable (Remittance & Payment Management) to be provided for the duration of the contract per the Statement of Work (SOW). SOW is located in the Solicitation Package in the attachment.

G. The period of performance will be twelve (12) months from date of award, with four (4) additional twelve-month option periods, for a total potential period of performance of five (5) years, if all options are exercised.

H. FAR 52.212-1 Instructions to Offerors-Commercial Items and Commercial Services (Sep 2023).

I. Quotes shall be submitted on company letterhead stationery, signed, dated and it shall include:

1. Solicitation number 75H70625Q00244;

2. Closing Date: September 8, 2025 at 12:00 pm CST;

3. Name, address and telephone number of company and email address of contact person;

4. Technical description of the item/service being offered in sufficient detail to evaluate compliance with the requirements of the solicitation. This may include product literature, or other documents, if necessary;

5. Price and any discount;

6. “Remit to” address, if different than mailing address;

7. A completed copy of the representations and certifications at FAR 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the offeror shall complete electronically);

8. Acknowledgment of Solicitation Amendments (if any issued);

9. Past performance information, when included as an evaluation factor, to include recent and relevant contracts for the same or similar items and other references (including contract numbers, points of contact with telephone numbers and other relevant information);

10. A statement specifying the extent of agreement with all terms, conditions, and provisions included in the solicitation. Offerors that fail to furnish required representations or information or reject the terms and conditions of the solicitation may be excluded from consideration.

11. I

Attachments:

· Statement of Work

· Provisions and Clauses incorporated by reference and full text

· Contractor’s Performance Conditions & Responsibilities

Basis of Award is Trade-Offs. Best Value award will be made to the responsible offeror whose quotation is determined to represent the best value to the Government, considering price and non-price factors. The Government will evaluate proposals using a trade-off process. This process permits trade-offs among cost or price and non-cost factors, and allows the Government to accept other than the lowest priced proposal, or other than the lowest priced proposal, or other than the highest technically rated proposal, in order to achieve the best overall value. The following factors will be evaluated: (1) Technical Approach, (2) Qualifications and Experience, (3) Staffing and Key Personnel, (4) Past Performance, and (5) Price; however, price will be evaluated for fairness and reasonableness and will remain a substantial factor in the selection decision.

Best Value Determination: Technical factors (1-4), when combined, are more important that price. However, price will be considered in the overall best value determination and may become the deciding factor if quotations are determined to be technically equal.

Technical Factor 1 – Technical Approach

(a) Solicitation Submittal Requirements:

Proposals, which merely offer a statement to conduct/provide services in accordance with the requirements in the Governments SOW, will not be eligible for award. The offeror must submit an explanation that meet the requirements identified under Technical Requirements; Ability to provide accurate and timely third-party insurance eligibility verification, benefits coordination, and claims submission.

(b) Basis of Evaluation:

This factor will be evaluated as “ACCEPTABLE” if explanation meets the requirements identified under Technical Requirements; Ability to provide accurate and timely third-party insurance eligibility verification, benefits coordination, and claims submission which comply with the requirements outlined above, are submitted. If an explanation of one or more Requirements is not provided, and/or do not comply with the requirements, this factor will receive an “UNACCEPTABLE” rating.

Technical Factor 2 –Experience and Past Performance

(a) Solicitation Submittal Requirements:

Proposals, which merely offer a statement to conduct/provide services in accordance with the requirements in the Governments SOW, will not be eligible for award. The offeror must submit an explanation that identifies the vendor has relevant experience providing third-party verification and claims processing for healthcare organizations, particularly federal health facilities. Provide evidence of measurable outcomes (e.g., improved collections, reduced denials). Provide References and past CPARS (if applicable).

(b) Basis of Evaluation:

This factor will be evaluated as “ACCEPTABLE” if the explanation meets the requirement for qualifications and experience capabilities and responsibilities to meet the following: vendor has relevant experience providing third-party verification and claims processing for healthcare organizations, particularly federal health facilities. Provide evidence of measurable outcomes (e.g., improved collections, reduced denials). Provide References and past CPARS (if applicable), which all comply with the requirements outlined above, are submitted. If an explanation of one or more of the following: vendor has relevant experience providing third-party verification and claims processing for healthcare organizations, particularly federal health facilities. Provide evidence of measurable outcomes (e.g., improved collections, reduced denials). Provide References and past CPARS (if applicable) and/or do not comply with the requirements, this factor will receive an “UNACCEPTABLE” rating.

Relevancy:

For the purposes of this solicitation, a past performance record is relevant if the CPAR business sector is listed as “Services”.

In order to receive an "acceptable" rating for this factor, an Offer's recent and relevant CPARs must NOT include one or more INTERIM and/or FINAL CPARs with a rating of "UNSATISFACTORY" in one or more categories OR one or more INTERIM and/or FINAL CPARs with a rating of "MARGINAL" in two or more categories. If an Offeror has one or more CPARs with a rating of "UNSATISFACTORY" in one or more categories OR one or more CPARs with a rating of "MARGINAL" in two or more categories, the Offeror's past performance will be evaluated as "UNACCEPTABLE".

In the case of an Offeror without a record of recent and relevant past performance or for whom information on past performance is not available or so sparse that no meaningful past performance rating can be reasonably assigned, the Offeror may not be evaluated favorably or unfavorably on past performance. Therefore, the Offeror shall be determined to have unknown past performance. In the context of acceptability/unacceptability, “unknown” shall be considered “acceptable.” An “UNACCEPTABLE” rating for a single factor will result in the Offeror’s entire proposal being rated “UNACCEPTABLE”.

IHS reserves the right to make multiple awards, which is most advantages to the Government. This is a competitive solicitation and the offer your firm submits will be used by IHS to determine, which of the quantities listed within are, “estimate only” and it is not the intent of IHS to be obligated to order the “quantities.”

Technical Factor 3 – Staffing and Key Personnel

(a) Solicitation Submittal Requirements:

Proposals, which merely offer a statement to conduct/provide services in accordance with the requirements in the Governments SOW, will not be eligible for award. The offeror must submit an explanation that meet the requirements identified under Technical Requirements; Qualifications and certifications of staff (e.g., CPC, CCA, or other coding/billing credentials, experience with federal and commercial payers, proposed staffing plan to ensure continuity and timeliness of services.

(b) Basis of Evaluation:

This factor will be evaluated as “ACCEPTABLE” if explanation meets the requirements identified under Technical Requirements; Qualifications and certifications of staff (e.g., CPC, CCA, or other coding/billing credentials, experience with federal and commercial payers, proposed staffing plan to ensure continuity and timeliness of services. If an explanation of one or more Requirements is not provided, and/or do not comply with the requirements, this factor will receive an “UNACCEPTABLE” rating.

Technical Factor 4 – Management Approach

(a) Solicitation Submittal Requirements:

Proposals, which merely offer a statement to conduct/provide services in accordance with the requirements in the Governments SOW, will not be eligible for award. The offeror must submit an explanation that meet the requirements identified under Technical Requirements; Quality assurance and audit processes, data privacy and IT security controls, ability to provide reporting/metrics to IHS on claim status, collections, and denials.

(b) Basis of Evaluation:

This factor will be evaluated as “ACCEPTABLE” if explanation meets the requirements identified under Technical Requirements; Quality assurance and audit processes, data privacy and IT security controls, ability to provide reporting/metrics to IHS on claim status, collections, and denials. If an explanation of one or more Requirements is not provided, and/or do not comply with the requirements, this factor will receive an “UNACCEPTABLE” rating.

Factor 5 – Price

(a) Solicitation Submittal Requirements:

Evaluated for reasonableness and realism.

(b) Basis of Evaluation:

The Government will evaluate price based on the total proposed price calculated as the sum of bid item 0001 Base Year, item 0002 Option Year 1, item 0003 Option Year 2, item 0004 Option Year 3, item 0005 Option Year 4 that includes Contract cost, Subcontractor cost, Overhead and Profit. Analysis will be performed by one or more of the following techniques to ensure a fair and reasonable price:

(i) Comparison of proposed prices received in response to the RFQ.

(ii) Comparison of proposed prices with the IGE.

(iii) Comparison of proposed prices with available historical information.

J. FAR 52.212-3 Offer Representations and Certifications-Commercial Items (May 2024) (DEVIATION FEB 2025). See attachment for full text. The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) of this provision.

K. FAR 52.212-4 Contract Terms and Conditions-Commercial Items (November 2023). Applied to this acquisition and it’s incorporated by reference.

L. FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial Products and Commercial Services (January 2025) (DEVIATION FEB 2025). See attachment for full text.

M. Attached are the additional Federal Acquisition Regulations (FAR) & Health & Human Services Acquisition Regulation (HHSAR) clauses that are applicable.

N. Offers will only be accepted electronically, submit via email to the following:

Quentin N Burdick Memorial Health Care Facility Indian Health Service - Belcourt Service Unit Attn: Farrah Azure, Purchasing Agent 1300 Hospital Loop Belcourt, ND 58316 Email: farrah.azure@ihs.gov

Questions in regard to this solicitation shall be submitted in writing by email no later than Monday, September 8, 2025, 12:00pm CST.

Contractors will need your Unique Entity ID, TIN Number, and be registered with www.sam.gov.

No contract award shall be made to any vendor or provider listed on the OIG Exlusion List http://exlusions.oig.hhs.gov throughout the duration of the contract.

ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm for a period of at least 30 days from the date of receipt by the Government.

Invoice Processing Platform (IPP)

The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system

In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum “Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award resulting from this solicitation will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register- however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov

“Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer”.

Questions:

1. Is there a current incumbent for this contract? If yes, could you please provide the contract details? Yes, No

2. Could you provide the data on the total number of claims submitted in the last year? and How many of these are UB04 and CMS1500 claims within the total submitted claims? We estimate needing 10,000 claims per month some are on a UB04 and CMS-1500

3. Can you share the claim submission volume / percentage broken down by payer? No

4. Does this solicitation include credentialing services (credentialing providers with Medicare and insurance payors)? No

5. Are there any current EDI gateways or tools being used for claim submission and ERA reception? Yes

6. Does RPMS have a billing module to submit and track claims? If not, is there a specific tool being used for claim submission and tracking? Yes

7. How many hours of training are expected for the front-office team per year? we need this info to put the accurate pricing in the proposal. N/A, not exactly sure what they are referring to, the front office team, training?

8. Are we expected to handle patient statements and patient calls as part of the process? No

9. Will medical coding (ICD and CPT codes) be handled by physicians / Providers, or will we need to provide coding services as well? Our inhouse coders do the coding assignments

10. Should we also manage pre-authorizations and referrals? No

11. Are there any claims that go by paper? (not electronic) If so what percentage of total? No

12. In the government’s opinion, how many FTEs are required to manage this process effectively? That’s the vendors responsibility to determine based on the workload and required completion times. Outpatient billing needs to be completed within 6-days of the encounter and inpatient billing needs to be completed within 14-days of the discharge date.

13. What specific parameters or targets will be defined for collections and aging? Billed within 6-14 days depending on whether the service was for inpatient or outpatient, collected within 30 days and if errors occur resubmitted within 45-days but never more than 120-days from encounter date.