Exhibit 2 - Financial Spread Sheet.xlsx

XLSX spreadsheet 45 KB Posted

Attached to
Accounts Receivable Services Federal contract opportunity
Solicitation number
75H71324Q00040
Issued by
Department of Health and Human Services Indian Health Service

About this file

This document includes a solicitation for accounts receivable services and a related federal contract opportunity. The solicitation seeks quotes for accounts receivable services to be provided to the Department of Health and Human Services Indian Health Service. Services include posting medical, dental, optometry, behavioral health and pharmacy payments from insurance companies into the agency's patient accounting system. Quotes are due by April 8, 2024. The performance period is one base year with four one-year options, from an estimated award date of April 15, 2024 through April 14, 2025. Evaluation will be based on price and demonstrated prior experience in areas such as ICD-10 and CPT coding, explaining insurance payment adjustments, and accounts receivable processes. The set-aside is for Indian Small Business Economic Enterprise.

The solicitation provides the NAICS code, attachments including the statement of work and wage determination, and instructions for submitting quotes. The federal agency is the Department of Health and Human Services Indian Health Service. The solicitation number is 75H71324Q00040.

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Other files for this federal contract opportunity

Other files attached to Accounts Receivable Services, newest first.
File Type Posted
ATTACHMENT 7 - FY 2023 WORKLOAD.pdf PDF
ATTACHMENT 6 - Q-A 75H71324Q00040 REVISED 04042024.docx DOCX document
ATTACHMENT 6 - Q-A 75H71324Q00040.docx DOCX document
Exhibit 3 - File for low pmt.docx DOCX document
Exhibit 1 - Insurance Websites.xlsx XLSX spreadsheet
ATTACHMENT 4 - WAGE DETERMINATION.pdf PDF
ATTACHMENT 5 - IHS IEE REPRESENTATION FORM.pdf PDF
Exhibit 4 - Batch document example (PI-02032021-3)_Redacted.pdf PDF
ATTACHMENT 3 - BUSINESS ASSOCIATE AGREEMENT.pdf PDF
ATTACHMENT 2 - STATEMENT OF WORK.docx DOCX document
ATTACHMENT 1 - SCHEDULE OF ITEMS.xlsx XLSX spreadsheet
Show all 11

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Text version

Sheet1

MCD$ 127,396.16VAF$ 654.00
PI$ 1,473.49ERROR:#N/A$ 8,043.80ERROR:#N/AERROR:#N/AERROR:#N/A
MCR$ 1,029.65EOB$ 1,448.17
TOTAL$ 140,045.27<----------------->$ 140,045.27DEPOSITBATCH
DateCheck AmountABA/RTAccount NumCheck NumRemitter NameTYPEMATCH INDEXAR ACCOUNT INDEXTICKETNAMEPOSTED
1/2/2418.09B330567651420000139200311613MEDIMPACTERROR:#N/AB33056765142000013ERROR:#N/A652664
1/2/2419.10226007680342000013444444440792473PRIME THERAPEUTIEOB226007680342000013PRIME THERAPEUTICS BCTX652664
1/2/24117.001930238155323070380261174939REGENCE BCBSO -PI1930238155323070380REGENCE OF OREGON FEDERAL652664
1/2/24145.89433044120091000019121000243258580OPTUMRXERROR:#N/A433044120091000019ERROR:#N/A652664
1/2/24186.766930238155111000025154981222REGENCE BCBCOPI6930238155111000025BC BS OF OREGON652664
1/2/24189.1419309519894100103927914187SAMARITAN CHOICEPI193095198941001039SAMARITAN CHOICE PLANS652664
1/2/24553.28B330567651420000139200311010MEDIMPACTERROR:#N/AB33056765142000013ERROR:#N/A652664
1/2/24676.81B330567651420000139200310747MEDIMPACTERROR:#N/AB33056765142000013ERROR:#N/A652664
1/2/241,429.07126007680342000013555555550495709PRIME THERAPEUTIEOB126007680342000013PRIME THERAPEUTICS652664
1/2/246,649.73433044120091000019121000243281943OPTUMRXERROR:#N/A433044120091000019ERROR:#N/A652664
1/2/24654.009101036151101036151VAFA TREAS 310VAF9101036151101036151VA MEDICAL BENEFIT (VMBP)652664
1/2/24$22.00101000187145592435591104922299GEHAPI101000187145592435591GEHA830752
1/2/24$1,029.6571000288229857981290018NAVITUS HEALTH SOLUTIONSMCR7100028822985798D-NAVITUS 610602830752
1/2/24$268.80311002094000848831689790CIGNA DENTALPI3110020940008488CIGNA DENTAL830752
1/2/24$602.0031100209388765341000873399KAISER PERMANENTEPI3110020938876534KAISER CLAIMS830752
1/3/2452,439.749300A1002041001039600176737OR DHS HP MMISMCD9300A1002041001039OREGON MEDICAID653433
1/3/2474,956.429300A1002041001039600176343OR DHS HP MMISMCD9300A1002041001039OREGON MEDICAID653433
1/3/2414.95136273957112438487791006028345AARP SUPPLEMENTAPI1362739571124384877AARP GROUP HEALTH653433
1/3/2436.42900000410881000605105314127GEHAPI900000410881000605GEHA653433
1/3/2436.42900000410881000605105314128GEHAPI900000410881000605GEHA653433

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