75H70926R00002 Q and A.pdf

75H70926R00002 Revenue Enhancement Services

Questions & Answers

1. Q: On the SF 1449, Page 1 the Period of Performance is listed as 10/01/2026 to 09/30/2027. However, for each Item No. the Period of Performance is 11/01/2026 to 09/30/2027. Could the government clarify the Period of Performance for this solicitation?

A: The intended start date is 11/01/2026.

2. Q: For this solicitation can the government confirm that there is no option years included for this solicitation?

A: There are no option years for this requirement.

3. Q: The notice is classified under NAICS 518210, so can you confirm whether the requirement is primarily revenue cycle management work (billing, coding, claims and denials) or system and data support for those functions?

A: Requirement is primarily revenue cycle management work.

4. Q: The SOW states at Section 3.2 that the Government will provide "on-site access" to EHR, while Section 8.2 states that all staff are off-site and do not require physical or network access, and Section 5.1.2 contemplates RPMS access via VPN. Is all work expected to be performed remotely, or will any CLINs require contractor personnel to be physically present at Service Unit locations?

A: No, all work is expected to be performed remotely

5. Q: CLIN 6 prices inpatient coding on an hourly basis, while CLIN 4 prices coding and data entry on a per-visit basis. Is inpatient coding intended to be captured exclusively under CLIN 6, or may inpatient visits also be ordered under CLIN 4? May an offeror propose a per-encounter structure for inpatient coding under the alternative line-item structure provision?

A: Yes, inpatient coding intended to be captured exclusively under CLIN 6. Offerors can propose alternative line-item structures.

6. Q: Section 5.1.6 states that the contractor shall not charge for claims rejected prior to submission and shall correct coding-related denials at no charge. Section 5.4.5 states that the contractor is paid only once per visit regardless of deficiency cycles. Are these no-charge provisions intended to apply across all CLINs, or only to CLIN 2 (Third Party Billing)?

A: One charge for each finalized, completed encounter, both coding and billing.

7. Q: Can the Government provide historical order volumes by CLIN and Service Unit under the predecessor or most recent contract for these services? If not, can the Government provide the estimated annual encounter volume and claim volume that informed the CLIN minimums and maximums?

A: A coding chart is attached for sample purposes. The Government will issue workload volumes, backlog estimates, and audit requirements in each Task Order, that are specific to the requesting site.

8. Q: Please clarify what equipment (GFE), hardware (e.g., laptop), software, remote access, MFA, or other resources will be provided by the Government to support contractor performance.

A: Equipment will not be supplied.

9. Q: Please clarify the required compliance audit frequency, expected audit sample size or percentage, minimum accuracy rate, acceptable error threshold, and any required corrective actions.

A: Audits as requested but typically annually.

10. Q: Please clarify the Government’s expected Quality Assurance requirements, including the required sampling percentage, minimum accuracy rate, error thresholds, corrective-action requirements, and frequency of QA reporting.

A: See Question 38 & 39 as well as Benchmarks in SOW.

11. Q: Given the timing of the Government’s responses to submitted questions, will the Government consider extending the proposal submission deadline to five (5) business days after issuance of the Government’s responses to all submitted questions and any resulting amendment?

A: The government will consider extending the deadline to 9/18

12. Q: Please identify the current incumbent contractor, if applicable, including the incumbent’s contract number, period of performance, and current contract value.

A: Contractor Name: DT Trak Consulting, Inc.

POP: 3/22/2021 – Present Total Contract Value: $3,454,776.11

13. Q: Please provide the current backlog for CLIN 4 and clarify the number or percentage of visits the Contractor is expected to process or clear during the performance period.

A: CLIN 4 workload will be assigned by the facility based on operational needs and will be worked concurrently by Contractor and facility staff. Accordingly, no specific number or percentage of visits is guaranteed or designated for Contractor processing. The Contractor will be responsible for completing the workload assigned by the facility in accordance with the performance requirements of the contract.

14. Q: Please provide the current Accounts Receivable balance that is more than 180 days outstanding and clarify the percentage or dollar amount of the 180+ day AR that the Contractor is expected to address or reduce during the performance period.

A: The 180+ day Accounts Receivable (AR) workload will be assigned by the facility based on operational needs and will be worked concurrently by Contractor and facility staff.

Accordingly, no specific percentage or dollar amount of the 180+ day AR balance is guaranteed or designated for Contractor resolution. The Contractor will be responsible for addressing the AR workload assigned by the facility in accordance with the performance requirements of the contract.

15. Q: Please clarify the expected ramp-up requirements, including the starting backlog, required transition activities, initial workload, and timeframe for the Contractor to reach full production.

A: Workload will be assigned by the facility based on operational needs and will be worked concurrently by Contractor and facility staff. No specific starting backlog or initial workload is guaranteed. The Contractor is responsible for completing all necessary transition and onboarding activities and achieving full production in accordance with the performance requirements and timelines established in the contract.

16. Q: Technical proposal page limit: Does the 10-page limit include cover pages, past performance, resumes, certifications, and the Quality Assurance Plan? May any of these be submitted separately?

A: 10 page limit does not include cover pages, past performance, resumes, certifications, and the Quality Assurance Plan

17. Q: Pricing instructions: What quantities should offerors use to calculate each CLIN’s evaluated total? Please also define “Unit Price” versus “Ceiling Price” and clarify whether the sum of the extended maximum quantities must remain within the $3.8 million contract ceiling.

A: Unit Price is per item/CLIN. Ceiling Price is the maximum quantity multiplied by the unit price.

18. Q: Ordering quantities: Are the listed CLIN minimum quantities estimates only, with the $1,500 contract-wide guaranteed minimum controlling the Government’s minimum ordering obligation?

A: The CLIN minimum quantities are estimates-only, based on what a single service unit would likely need at minimum.

19. Q: Work location and travel: What onsite presence and travel frequency should offerors assume? Should all travel costs be included in the existing CLIN rates?

A: No travel costs. This isn’t intended to be a staffing contract.

20. Q: Workload and acceptance: Is a projected workload distribution available by Service Unit and visit type, including inpatient versus outpatient coding? What turnaround times, quality thresholds, and acceptance criteria will apply?

A: Yes, workload distribution is by Service Unit and Visit type, turnaround time will vary based on quantity. Task Orders will contain the specific information per each request.

21. Q: Section 508: For a services-only proposal using Government systems, what Section 508 documentation must accompany the offer? Is an HHS Product Assessment Template required?

A: Section 508 applies only to contractor-developed deliverables (documents, reports, dashboards). Contractors do not need to submit a Product Assessment Template unless proposing contractor-owned software that will be accessed by Government personnel.

22. Q: What are the annual encounter volumes by service line and by Service Unit?

A: Volume will vary. Inpatient volume is significantly lower than outpatient.

23. Q: What is the annual claims volume by Service Unit, including average and peak monthly volumes?

A: This is average annual encounters per SU.

Fort Peck Service Unit 18369 Fort Belknap Service Unit 75508 Northern Cheyenne Service Unit 86576 Black Feet Service Unit 192674 Crow Service Unit 148975

24. Q: How many providers require coding, billing, and revenue cycle support?

A: Provider numbers fluctuate with hiring and contracted services.

25. Q: What is the current coding, billing, and A/R backlog by Service Unit?

A: At this time, backlog fluctuates from 5-10k across the area.

26. Q: What are the current Accounts Receivable balances, Days in A/R, and aging by payer and Service Unit?

A: Unable to Provide the Answer at this time.

27. Q: What are the current denial inventory, denial volumes, denial dollars, and denial rates?

A: Unable to Provide the Answer at this time.

28. Q: What are the top denial categories and root causes?

A: Timely submission due to backlog.

29. Q: What is the payer mix by Service Unit? Medicare, Medicaid, Commercial, PRC, VA, Self-Pay, and Other Government Programs?

A: Payer mix is typically 50-75% Medicare/Medicaid with VA and Private Insurance less than 25%

30. Q: Please provide current KPI performance metrics; Including Clean Claim Rate, Net

A: Unable to Provide the Answer at this time

31. Q: What is the current RCM staffing model?

A: Not intended to be a staffing contract

32. Q: Which revenue cycle functions are currently performed internally versus externally?

A: All functions are intended to be performed in-house with exception of clearing house functions.

33. Q: How many facilities and locations will be supported and what workload is associated with each location?

A: The Billings Area IHS consists of 5 service units and 5 clinics

34. Q: What turnaround times are required for coding, billing, denials, and A/R activities?

A: When current, coding and billing should be completed within 4 days of the service and 4 days of coding completion. AR activities under 120 days for clean up and follow up.

35. Q: What is the anticipated frequency and duration of onsite support activities?

A: No requirement for onsite activities.

36. Q: Will services be performed remotely, onsite, or through a hybrid model?

A: These services have historically been performed remotely.

37. Q: Should travel costs be included in CLIN pricing or reimbursed separately?

A: No travel costs should be associated

38. Q: What types of compliance audits are anticipated?

A: Provider documentation audits, Coding Audits, Billing Audits for accuracy.

39. Q: How many compliance audits are expected annually by Service Unit? What audit sample sizes are anticipated?

A: Each SU is required to have annual audits conducted. For routine contract oversight, a reasonable starting point is 30–50 randomly selected encounters per coder or coding population per audit period. If the contract is being measured at the vendor level rather than individual coder level, it is generally acceptable to use at least 50–100 encounters per audit period, stratified across relevant encounter types.

40. Q: Will the contractor be responsible for corrective action plans, provider education, remediation support, and follow-up audits?

A: No

41. Q: What clearinghouse, claim scrubbing, eligibility verification, denial management, reporting, and analytics tools currently interface with RPMS?

A: Do not have an exhaustive list of those that interface with RPMS but service units utilize several different vendors such as Tyrula, Inovalon, Change Health etc.

42. Q: What percentage of claims processing is automated versus manual within RPMS, and are there known workflow limitations, interface issues, claim edits, or bottlenecks impacting reimbursement performance?

A: Unable to Provide the Answer

43. Q: Is the contractor expected to utilize Government-furnished RPMS, Third Party Billing, Accounts Receivable, Fee Basis/Financial Processing (FB/FP), and related revenue cycle applications, or will the contractor be expected to provide replacement software solutions?

A: Yes, contractor will use RPMS, TPB, AR systems on the government network.

44. Q: Are there any planned replacements, upgrades, modernizations, migrations, or transitions involving RPMS, Third Party Billing, Accounts Receivable, FB/FP, EHR, or related revenue cycle systems during the period of performance?

A: Not at this time.

45. Q: Will the contractor be required to provide, host, maintain, license, or support any contractor-owned revenue cycle management software, clearinghouse services, claim scrubbing tools, reporting platforms, analytics applications, or business intelligence solutions?

A: Yes. Historically these services have been performed through the contractor-owned revenue cycle management software and platforms.

46. Q: Will the Government provide all required hardware, software licenses, VPN access, remote connectivity, and system access, or will any portion of the infrastructure be contractor furnished?

A: Only accesses to the systems on the government network.

47. Q: Will contractor-furnished software, cloud-hosted applications, or other technology solutions require Security Assessment and Authorization (SA&A), Authority to Operate (ATO), ISSA review, cybersecurity accreditation, or other security approvals?

A: Yes

48. Q: What information assurance, cybersecurity, privacy, training, background investigation, and system access requirements will apply to contractor personnel performing under this contract?

A: All contractors must comply with the requirements for system access, ISSA, Privacy, Cybersecurity etc.

49. Q: Will contractor personnel require access to RPMS, EHR systems, Microsoft 365 environments, financial applications, reporting systems, network resources, or other Government information systems?

A: Yes

50. Q: Is the contractor expected to provide support for the operation, optimization, migration, integration, sustainment, or replacement of Fee Basis/Financial Processing (FB/FP) systems or any successor platform?

A: No