ADDP4 Response to Questions (20260924).pdf

ADDP4 Pre-Solicitation Exchanges with Industry: PWS Industry Feedback

Draft PWS Section Number (i.e.

C.X.X)

Page # Comment, Question, or Discussion related information: Government Response

C.2, C.2.1 2 Would DHA be willing to clarify whether there are locations, either CONUS or OCONUS, where the current Contractor cannot meet access standards and could require a mobile dentistry solution to improve access?

To assist offerors in designing targeted provider networks and identifying underserved areas, the Government will provide a comprehensive ADSM population location report. While offerors are expected to establish robust networks to meet access standards, the Government may annually direct the deployment of mobile dental units to specific remote or underserved locations. In these instances, DHA will define the exact location, duration, and minimum appointment thresholds required to support readiness, which the Contractor shall execute.

C.4.4 4 Is it possible for DHA to confirm how network access and adequacy standards for non-remote ADSMs will be calculated? Will they be determined based on the ADSM's assigned DTF rather than their place of residence (e.g., "within 15 driving miles of ADSM DTF referred care…")?

In accordance with draft PWS C.4.4.1, network adequacy distance is calculated as driving miles from the ADSM's assigned DTF (for referred care) or from the place of residence (for remote ADSMs) to the provider structure's fixed location.

C.4.4 4 Would DHA be willing to provide the volume of services performed by non-network providers on an annual basis? Non-network provider service volume is provided in the ADDP4 Data Release Offerors should review PWS network utilization requirements.

C.4.4 4 Is DHA's expectation that the Contractor will be attesting to appointment AQLs, or will the Contractor be required to conduct ongoing monitoring and reporting according to defined criteria?

The Contractor is required to conduct ongoing monitoring, reporting, and attestation against defined performance standards. Financial audits will be performed semi-annually by DHA.

C.4.4.2.4 5 While the number of periodontists in the US is stable, they are predominantly practice in urban areas which makes the access standard outlined in the PWS challenging for any offeror to meet. Given this concern, we recommend the Government consider revising to 75%.

Provider standards are based on nationwide metrics to ensure consistent access. The recommendation to revise the standard to 75% is taken under advisement; any changes will be reflected in the final solicitation.

C.4.5.1.1 6 Does the AQL referenced in C.4.5.1.1 apply to standard network directory updates? Yes, the AQL applies to standard network directory updates.

C.4.5.2 6 How frequently does DHA expect the Contractor to conduct an audit of the provider directory for accuracy? Directory audit frequency requirements are under development. Feedback on industry-standard auditing frequencies is welcome and will be considered.

C.4.5.2 6 Please clarify if the government has specific requirements for the directory audit or if offerors can define how they will meet the audit requirement.

Directory audit requirements are being finalized. Detailed technical specifications and instructions will be provided in the final solicitation.

C.4.6 6 Given that TOPDs will be utilized by other Contractors in other Programs (as referenced in J-3a 6.0) represting significant redundancy is program execution, would DHA consider validating licensure requirements for TOPDs on behalf of the Contractor?

No. The Contractor is solely responsible for validating TRICARE Overseas Preferred Dentist (TOPD) licensure. DHA does not validate credentials on behalf of contractors.

C.4.6 6 Can the DHA confirm the recredentailing requirement every 3 years as detailed in J-3b 4.2. Confirmed. Recredentialing is required every three years, as specified in Program Operations for OCONUS [identified as J-3b 4.2 in the draft PWS] Section 4.2. Note that this reference may be subject to change in the final solicitation.

C.4.6 6 Would DHA consider providing aggregated, de-identified claims or utilization data to support offeror analysis of provider access and continuity risks during transition?

Historical volume and utilization data is provided in the ADDP4 Data Release.

C.4.6.1.1 6 Does the AQL referenced in C.4.6.1.1 indicate that the Contractor must contract with 95% of OCONUS providers identified by the DHA COR throughout each option period, or 100% of new providers identified throughout each option period?

In accordance with draft PWS C.4.6.1.1, the Contractor must complete agreements with 95% of the existing TOPD providers identified by the COR prior to Option Period 1, and 95% of any new providers identified by the Government during each option period.

C.4.7 7 Is DHA willing to elaborate on how the "utilization rate" related to TOPD providers is defined? Utilization rate is defined by the volume of claims, procedure codes, or patients seen during the applicable Option Period.

C.4.7 7 Would the DHA consider providing the volume of services TOPDs currently perform today? TOPD service volume and utilization metrics are included in the ADDP4 Data Release.

C.4.8 7 Will the types of OCONUS dental practice reviews detailed in C.4.8 be addressed through any other DHA contract?

Will the ADDP4 Contractor be the sole entity responsible for reviewing dental practices?

The ADDP4 Contractor is solely responsible for compliance reviews under this contract. Providers may be subject to independent reviews under other DHA contracts; however, no contractor reviews on behalf of another.

C.4.8 7 Would the DHA consider specifying what a TOPD dental practice review entails? TOPD practice reviews assess key standards, including English language proficiency, cleanliness, sterilization, and credentialing. Guidelines will be in the final solicitation.

C.4.8 7 Please clarify the difference between OCONUS dental practices and TOPD practices and the associated requirements. Please define what review means in this context.

TOPD practices are contracted OCONUS clinics that process claims and collect cost-shares without up-front billing. Non-TOPD clinics are uncontracted dental practices with standard administrative processes.

C.4.9 7 Would DHA be willing to provide the number of CONUS referrals and authorizations current Contractor receives on an annual basis (as referenced in J-3a 4.2)?

CONUS referral and authorization volumes are included in the ADDP4 Data Release.

C.4.9 7 Would DHA be willing to provide the number of OCONUS referrals and authorizations the current Contractor receives on an annual basis (as referenced in J-3b 7.3)?

OCONUS referral and authorization volumes are included in the ADDP4 Data Release.

C.4.9.1 7 Would DHA be willing to provide the volume of appointments the current Contractor schedules monthly and annually? If possible, segmented by phone, online, and app scheduling modes (as referenced in J-3a 14.3).

Historical appointment volumes are shared in the ADDP4 Data Release.

C.4.9.1 7 Would the DHA be willing to disclose the average call time for a customer service center appointment scheduling interaction?

Average customer service and scheduling handle times information is not available.

C.4.9.1 7 Can the DHA confirm that the Contractor is expected to schedule international appointments for OCONUS services? Confirmed. The Contractor is required to schedule OCONUS dental appointments upon request.

C.4.9.1 7 Would the DHA be willing to provide the volume of OCONUS appointments the current Contractor is managing on an annual basis?

OCONUS appointment volume data is included in the ADDP4 Data Release.

C.4.9.1.1 7 C.4.9.1.1 and C.4.9.1.2. appear to be in conflict with one another. Can DHA please clarify the minimum percentage of appointments that shall be scheduled within five business days of a request?

The Performance Work Statement will be corrected to resolve the typographical conflict: 90% of routine appointments shall be scheduled within two business days of a request, and 98% shall be scheduled within five business days, as specified in forthcoming updated PWS.

C.4.11 9 Would DHA consider providing historical appeal volumes that the Contractor is managing annually (as referenced in J-3a 13.1)?

Yes. Historical appeal volumes are provided in the ADDP4 Data Release.

C.4.12 9 Would DHA consider providing the number of grievances that the current contractor manages annually (as referenced in J-3a 13.2)?

Yes. Historical grievance volumes are provided in the ADDP4 Data Release.

C.4.13.1.2 10 Would the DHA consider providing the volume of inbound customer service calls the current Contractor manages annually (as referenced in J-3a 14.1)?

Yes. Annual inbound customer service call volumes are provided in the ADDP4 Data Release.

C.4.13.1.2 10 Would the DHA consider providing the average volume of inbound OCONUS customer service calls the current Contractor manages daily?

Yes. Monthly OCONUS customer service call volumes are provided in the ADDP4 Data Release.

C.4.13.1.2 10 Would the DHA consider providing the average handle time the current Contractor experiences with managing customer service calls?

Customer service handle times information is not available.

C.4.13.1.4 10 Would the DHA consider providing the first call resolution rate the current Contractor experiences with managing customer service calls?

Yes. Historical customer service first call resolution rates will be provided if available by the final solicitation.

C.4.14 10 Please consider further clarifying expectations for "promoting the value of utilizing diagnostic and preventive services". Will this requirement include direct member education campaigns?

This requirement will be executed through the approved Education Plan, which includes direct member education, DTF-focused outreach, and various annual publications.

C.4.15 10 Is DHA willing to detail any frequency requirements related to the requirement to "inform and educate ADSMs, providers, and Military Dental Treatment Facilities staff about the program benefits", or the requirement to emphasize the benefit of diagnostic and preventive services to ADSMs?

This requirement will be executed through the approved Education Plan, which includes direct member education, DTF-focused outreach, and various annual publications.

C.4.16 11 Would the DHA work with the Contractor to define outcome measures and will they differentiate between non-remote/remote and individual vs. population health outcome measures?

DHA is willing to collaborate with the Contractor to refine outcome measures, including segmentations for remote/non-remote and individual/population health.

C.4.21 13 Please provide technical specifications required for any interfaces. Additionally, please clarify "other applicable" systems. This open ended requirement is difficult for offerors to solution and price.

DEERS technical specifications will be provided. The Government will coordinate with DMDC to ensure documentation is released at least 30 days prior to required integration.

C.4.21, C.4.22 13 Is DHA willing to provide a timeline for when these requirements will be released so that bidders can accurately assess the time and resources necessary to achieve this interface for solicitation submission? Please note that significant changes to requirements between the draft and final solicitation have a large affect on timely solicitation submission.

Integration timelines and technical requirements will be outlined in the Draft solicitation to ensure adequate preparation prior to final solicitation submission.

C.5.1.3 13 Please clarify whether or not all subcontractors, including small business, will need to be CMMC Level 2 certified.

Will DHA provide flexibility on small businesses subcontractors following the CMMC requirements?

Per DFARS 252.204-7021 and 32 CFR 170.23, CMMC Level 2 requirements flow down to all subcontractors handling Federal Contract Information (FCI) or Controlled Unclassified Information (CUI). No exemptions are available for small businesses.

C.5.4.1 15 Would DHA consider providing counts of current ADSMs by eligibility type and by zip code and/or associated DTF? Yes. ADSM population counts by eligibility type, zip code, and DTF are provided in the ADDP4 Data Release.

C.5.4.2 15 Will DHA please elaborate on the criteria that will be used to determine which of a carrier’s employees must be required to have common access cards and SF-86 background investigations?

Common Access Cards (CAC) and SF-86 background investigations are required for all personnel accessing, processing, or transmitting government data, as detailed in the TRICARE Systems Manual

(TSM).

C.5.4.2 15 Would the DHA be willing to disclose the application software that must be purchased and maintained to access

DEERS?

Required DEERS interface and database access software specifications will be provided in the final solicitation.

C.5.4.3 15 Would DHA be willing to elaborate regarding the AQLs for turnaround times for printing/mailing welcome packets? The printing and mailing turnaround times and associated AQLs will be specified in the final Performance Work Statement (PWS).

C.5.4.3 15 Would DHA be willing to consider electronic welcome packet distribution, or have the requirement adhere to the beneficiaries preferred communication method?

Although the standard requirement under draft PWS C.5.4.3 is to print and mail welcome packets, the Government is considering allowing electronic delivery (via email) based on beneficiary preference. Any such updates will be reflected in the final solicitation.

C.5.4.3 15 How many communications to beneficiaries, disaggregated by USPS mail, email, SMS text modes of communication, does the current Contractor send annually?

Newsletters are sent via email. The handbook, brochure, newsletters and claim forms, among other items are made available online for downloads. This information is not tracked.

C.5.4.3. 15 Is the requirement to print and mail welcome packets to each beneficiary or household enrolled applicable to

ADDP?

If welcome packets are applicable, can these materials be provided electronically?

Welcome packet requirements are applicable to the ADDP. Distribution details, including authorized electronic alternatives, will be defined in the PWS and final solicitation.

C.5.5.3 16 Commercial dental insurance companies are generally not required by law to report adverse events by dental providers. Further, dentists may not know of adverse events as patients generally enter the health system (i.e.

health provider, emergency room) versus returning to a treating dentist in the scenarios provided, making it difficult to report on these adverse events. Given that the ADDP contractor would not have relationships with hospitals and emergency rooms, would this information come from the ADSM or the managed care support contractor?

Contractors must immediately report any adverse events to DHA upon notification. While notifications typically originate from the ADSM, MTF, or military command, the Contractor must encourage network providers to report incidents directly and establish communications protocols with other TRICARE contractors.

C.5.5.3.1 16 Please provide more information regarding the required timeline for reporting adverse events to the TRICARE Dental Program Branch Chief and the COR after the event has been reported to the Contractor by network providers?

Adverse events must be reported to the TRICARE Dental Program Branch Chief and the COR immediately (as soon as possible) upon the Contractor becoming aware of the issue.

C.6.1.1, C.6.1.2 17 Please confirm the file formats that must be transmitted to DHA systems (e.g., MDR, M2) for claims payment and encounters.

File formats for claims and encounters are specified in the TRICARE Systems Manual (TSM) and will be detailed in the final solicitation.

C.6.1.1 17 C.6.1.1 speaks to transmitting and receiving claims and other data to/from the MDR and M2 repositories. Would DHA be willing to provide additional clarity regarding these systems so that bids can be as accurate as possible?

Detailed interface and data transmission specifications for the MDR and M2 repositories are provided in the TRICARE Systems Manual (TSM) and the final solicitation.

The Government does not restrict proposed business structures, provided they comply with all solicitation and regulatory requirements.

DTF staff manually update the dental EHR based on treatment documentation from the Contractor's secure, proprietary portal. Full electronic health record interoperability remains a pending long-term DoD objective.

Past Performance evaluations will consider CPARS and performance history over the past three years from both federal and non-federal sources. Criteria will be defined in Section M of the solicitation.

Past Performance evaluation and rating methodologies will be fully defined in Section M of the solicitation.

Representative utilization, procedure code counts, and zip-code network data are provided in the ADDP4 Data Release.

Enrollment and demographic data is included in the ADDP4 Data Release to facilitate geographic network analysis.

General Comments/Questions:

4.) Would DHA be willing to provide insight on how Past Performance will be rated, and will this information be released before the final solicitation is posted?

5.) When can bidders anticipate that DHA will provide current utilization, procedure code counts, and provider network counts by zip codes?

6.) When will DHA be releasing enrollment data so that bidders can prepare a thorough geographic analysis of the provider network to ensure adequate access?

1.) Given the critical importance of an Offeror determining an appropriate bidding legal entity and ensuring that entity is in compliance with the ADDP4 solicitation requirements, it is respectfully requested that information regarding the allowable structures for Offerors bidding ADDP4 be made available as soon as practically possible.

2.) Would DHA be willing to elaborate on how network providers can assist in ensuring that military patients’ dental records kept at the DTF remain current? Specifically, what portals or methods exist to facilitate the retrieval of dental records from network providers? And is there a feasible pathway to integrate this data into the DoD Electronic Health Record (EHR) to achieve full interoperability?

3.) Is it possible for DHA to provide information as to what Past Performance will be accepted in terms of relevancy, recency, complexity, and magnitude?

The contract may require operational flexibility and development for future integrations.7.) How will the role of the DHA Enterprise Wide Care Coordination Center for referral management and the appointment making functionality noted on SAM.gov interact on a operational basis with the referral management and appointment making requirements under the ADDP4 PWS?

ADDP4 Pre-Solicitation Exchanges with Industry: Industry Questions to DHA

Question Government Response Does DHA anticipate the addition of reservists to the ADDP beneficiary population?

DHA currently has no information indicating this change. Incorporating reservists would require a congressional mandate.

Can DHA provide any IT specification requirements for record exchange during market research?

General ADP/IT security requirements are prescribed in the TRICARE Systems Manual 7950.4-M (April 2021).

Specific Interface Control Documents (ICDs) will be referenced in the contract or provided post-award if available.

Will CMMC Level 2 complaince be required at the time of award or by the start of dental care delivery?

A valid CMMC Level 2 status (conditional or final) is required at contract award. Any conditional award POA&Ms must be resolved within 180 calendar days of the initial assessment to achieve final certification.

What are the biggest challenges within the ADDP3 program today, and what are the key outcomes you would like to see for ADDP4?

Key ADDP3 challenges include provider administrative burden, DTF staffing constraints, specialty care access, and rapid deployment support. ADDP4 aims to streamline processes, enhance DTF support, expand specialty networks, and improve readiness logistics.

Would DHA consider providing the Dental Treatment Facilities (DTF) geographies that are experiencing access to care issues?

There are currently no persistent, systemic access-to-care issues across DTF geographies. Access challenges are sporadic, localized, and driven entirely by regional private-sector provider capacity.

Where does DHA see the greatest opportunity to improve the ADSM experience?

Greatest opportunities lie in improving DTF referral accuracy, enhancing provider compliance with referrals, and streamlining dental records management.

What program components are working well in ADDP3 today that DHA would like to retain in ADDP4?

DHA intends to retain successful elements of ADDP3, specifically robust OCONUS network access and comprehensive contractor-led DTF dental coding education.

How should offerors think about designing access solutions for geographies, specialties, or markets where traditional network adequacy metrics may not fully capture the ADSM experience, particularly where additional layers of access could reduce travel burden or appointment friction, but may require tradeoffs with total program cost?

Network access and operational readiness are paramount. While costs must remain fair and reasonable, solutions that minimize ADSM travel time and duty disruption are highly preferred.

When considering network design and access strategies, how does DHA view the relative importance of provider access, clinical quality, member experience, and overall program affordability?

Clinical quality and member access are the highest priorities to ensure mission readiness. Affordability is highly important but secondary to meeting clinical and readiness requirements.

Are there specific clinical quality, adverse event, or provider performance issues from ADDP3 that DHA would like offerors to address more directly in ADDP4?

Offerors must address expedited reporting of adverse events, proactive monitoring of provider clinical and infection control compliance, and collaboration with government dental reviewers (Dental Service Point of Contacts/DSPOCs) to address performance trends.

Given the ADDP3 network challenges in Pensacola, Kirkland, and Corpus Christi etc., what types of innovation would DHA consider most impactful over the life of the contract?

The Government has no record of persistent network challenges in these specific areas. Innovation that enhances network stability and access across all regions is welcome.

Offerors will need volume and utilization data from the current programs to establish a fair price and ensure fair competition. When will DHA be releasing volume and utilization data for offerors’ review, and what will these files include?

Historical volume and utilization data—including procedure codes, DTF-referred, remote, OCONUS, and Foreign Military data—are included in the ADDP4 Data Release.

How is DHA thinking about balancing cost competitiveness with other critical program outcomes such as provider access, network adequacy, member experience, readiness, and operational performance when evaluating offerors for ADDP4?

The acquisition will utilize a best-value tradeoff source selection process in accordance with FAR Part 15, DFARS Part 215, and the DoD Source Selection Procedures (August 20, 2022). The Source Selection Authority (SSA) will evaluate technical, past performance, small business, and price factors to determine the proposal offering the best overall value, reserving the right to award to a higher-priced, technically superior offeror if justified.

Will DHA include price realism and/or price reasonableness FAR clauses in the solicitation?

The Government does not plan to evaluate proposals for cost or price realism. Total proposed prices will be evaluated for reasonableness based on adequate competition.

As a commercial item contract designation will significantly affect the evaluation of staffing, technical capability, price realism, and performance risk for offerers, can DHA please clarify whether ADDP4 will be procured as a commercial item contract?

The ADDP4 acquisition is designated as non-commercial.

If a commercial item contract is pursued for ADDP4, would DHA consider sharing the rationale for this approach?

Not applicable; the contract is designated as non-commercial.

When will the contractor need CMMC Level 2—at time of bid submission, contract award, or some point between award and start of health care delivery?

CMMC Level 2 compliance is required at the time of contract award.

How should bidders balance CMMC requirements and small business requirements given the costs associated with CMMC certification?

The Government cannot provide business strategy advice. Offerors must determine their own commercial and subcontracting approaches to meet both CMMC and small business requirements.

How does DHA envision evaluating large-scale federal and commercial healthcare administration experience, particularly when an offeror's relevant performance history includes contracts or engagements for which a CPAR evaluation may not exist?

Past Performance evaluations will not be restricted to CPARS. The Government will also consider past performance questionnaires, proposal narratives, and other available performance databases.

How will DHA evaluate relevant commercial experience relative to federal contract experience?

Relevancy criteria, including federal versus commercial experience, will be defined in Section M of the solicitation.

Are there particular functional areas where DHA believes past performance recency, relevance, or scale will be especially important?

All past performance evaluation criteria, including specific functional focus areas, will be detailed in the final solicitation.

How does DHA envision fostering innovation throughout the life of the ADDP4 contract, and are there particular areas, such as dental/medical integration, telehealth, digital engagement, or operational automation, where DHA believes innovative solutions could meaningfully enhance program performance and the member experience?

The contract will include mechanisms to permit the proposal and incorporation of beneficial new technologies and processes. Continuous collaboration between the Contractor and Government will drive ongoing innovation.

How does DHA view the balance between cost efficiency, operational performance, and program innovation in proposal evaluation?

Evaluation factors, subfactors, and their relative order of importance will be fully detailed in Section M of the solicitation.

If any, which operational processes would DHA like to modernize within the ADDP4 contract?

DHA seeks to modernize and streamline communication, referral tracking, and information exchange between the Contractor, network providers, and DTFs.

Does DHA view augmented intelligence as a benefit or a risk to the program?

DHA views augmented intelligence as a technology with potential benefits for automation and efficiency, as well as operational risks that must be managed.

Are there specific areas where DHA would welcome automation or augmented intelligence?

DHA is open to automation solutions that enhance communication and referral workflows. Specific proposals will be reviewed with the Government post-award.

Would DHA consider including a CLIN in the contract that would allow the contractor to incorporate value-based care reimbursement methodologies as pilot programs over the life of the contract?

No, a CLIN for value-based care pilot programs is not anticipated.

Given the dynamic movement of ADSMs across global locations, how should offerors think about building and sustaining OCONUS provider networks that can rapidly scale to meet changing demand, and are there anticipated changes to OCONUS access, contracting, or pricing requirements that DHA would like offerors to consider in ADDP4?

The Contractor must build relationships based on OCONUS ADSM population data and remain agile to expand the network as directed. To ensure continuity, historical TRICARE Overseas Preferred Dentist (TOPD) lists will be shared post-award.

If any, are there specific countries, regions, or provider specialties where DHA has experienced persistent access challenges?

The primary OCONUS challenges are rapid, short-notice deployments that require expedited provider development. These case-by-case events are managed in response to global operations.

Does DHA anticipate changes to TOPD participation, provider contracting, or reimbursement methodologies that offerors should consider?

No changes to TOPD participation, contracting, or reimbursement methodologies are currently anticipated.

Would DHA consider the opportunity to consolidate ADDP4 OCONUS activities, such as office reviews and credentialing, with other overseas TRICARE contracts?

No. ADDP4 OCONUS activities will remain independent and will not be consolidated with other TRICARE contracts.

How are retroactive eligibility determinations handled when a self-referred claim was initially denied due to lack of eligibility?

Retroactive eligibility disputes are rare and are resolved in accordance with the established appeals process.

How are retroactive authorization requests handled when a self-referred claim exceeded the amount limits ($750.00)?

Retroactive authorization requests exceeding the $750 threshold are managed through the contract's appeals process.

Can DHA clarify the calculation logic for completed procedures from DTF referrals as stated in section C.4.9.1.8 - C.4.9.1.9 in the PWS?

The Contractor must ensure that at least 90% of referred cases are seen by the designated specialist. Note that certain specialized procedures (e.g., endodontics, oral surgery) may be performed by qualified general dentists within the network.

Can DHA confirm whether referral and authorization intake is expected to occur directly within the contractor’s tracking tool by DTF, DSPOC, and DHA users, or whether any portion of that intake must be received through a separate external interface or file transmission?

Confirmed. The Contractor must provide a secure portal accessible by DTF, DSPOC, DHA users, and network providers to process and communicate referrals. The tool must remain flexible to evolve with future DHA technical and EHR requirements.

Can DHA confirm whether dental explanation of benefit delivery to providers can be electronic or based on provider communication preference?

DHA prefers electronic Explanation of Benefits delivery, but the system must accommodate provider communication preferences. Specific communication parameters will be finalized prior to award.

Average total annual claim volume segmented by electronic, mail, and fax submission.

This performance/utilization data is included in the ADDP4 Data Release.

Volume of services performed by non-network providers on an annual basis

This performance/utilization data is included in the ADDP4 Data Release.

Historical denial and pended claim volume resulting from remote ADSM self-referrals

This information is not available.

Utilization / Network Data Current volume of ADSMs by eligibility type, county or zip code, and associated DTF

This performance/utilization data is included in the ADDP4 Data Release.

Historical and expected service CONUS ADSM volume by CDT code This performance/utilization data is included in the ADDP4 Data Release.

Historical and expected OCONUS service volume by CDT code This performance/utilization data is included in the ADDP4 Data Release.

Care Management Data Average CONUS referral and authorization volume on a daily, monthly and/or annual basis

Referral data is not available. The authorization data is included in the ADDP4 Data Release.

Average OCONUS referral and authorization volume on a daily, monthly and/or annual basis

Referral data is not available. The authorization data is included in the ADDP4 Data Release.

Retroactive authorization volume on a monthly and annual basis Historical retroactive authorization volume is minimal to none.

Average CONUS appointment volume scheduled monthly and annually, segmented by phone, online, and scheduling modules

This performance/utilization data is included in the ADDP4 Data Release.

Average OCONUS appointment volume scheduled monthly and annually, segmented by phone, online, and scheduling modules

This performance/utilization data is included in the ADDP4 Data Release.

Customer Service Data Average daily, monthly, and annual CONUS inbound call volumes handled by an agent versus IVR including call volumes for Saturday and Sunday calls

This information is not available.

Average daily, monthly, and annual OCONUS inbound call volumes handled by an agent versus IVR including call volumes for Saturday and Sunday calls

This information is not available.

Average CONUS customer service handle time This information is not available.

Average OCONUS customer service handle time This information is not available.

Average handle times for CONUS appointment scheduling calls This information is not available.

Average handle times for OCONUS appointment scheduling calls This information is not available.

Average CONUS customer service first call resolution rate This performance/utilization data is included in the ADDP4 Data Release.

Average OCONUS customer service first call resolution rate This performance/utilization data is included in the ADDP4 Data Release.

Average annual appeal volumes This performance/utilization data is included in the ADDP4 Data Release.

Average annual grievance volumes This performance/utilization data is included in the ADDP4 Data Release.

Volumes of communications to beneficiaries disaggregated by USPS mail, email, SMS text modes of communication

This performance/utilization data is included in the ADDP4 Data Release.

Eligibility Data

Average percentage of remote enrollment from DEERS auto-enrollment and manual enrollment or updates handled by a contractor, DSPOC, or DTF

Approximately 200 to 250 remote enrollment or eligibility update transactions are processed monthly via DMDC auto-enrollment or manual entry by the Contractor. No enrollment actions are performed by DSPOC or DTF personnel. Historical transaction volumes are subject to fluctuation based on operational deployments and mission requirements.

Average monthly enrollment mismatches from DEERS that the current contractor internally resolves

Minimal to none.

Volume of retroactive eligibility determinations received on a monthly and annual basis

Retroactive eligibility determinations are minimal to none.

DISCLAIMER: ADDP4 PRE-SOLICITATION Q&A

1. Informational and Non-Binding Status

This Question and Answer (Q&A) document is issued solely for informational and planning purposes in accordance with RFO FAR 15.101. It does not constitute a Request for Proposals (RFP), a promise to issue an RFP, or a commitment by the Government to contract for any supply or service. These preliminary responses do not amend, modify, or supplement any draft or final solicitation.

2. Final RFP Controls Absolutely

Only the final, formal RFP (and any subsequent written amendments issued by the Contracting Officer) shall govern this procurement. In the event of any conflict, discrepancy, or inconsistency between this pre-solicitation Q&A and the final RFP, the final RFP shall control absolutely.

3. No Government Liability

The Government is not liable for any costs incurred by interested parties in reviewing this document or preparing potential proposals. Reliance on this preliminary information is at the offeror's sole risk. Prospective offerors are responsible for independently monitoring SAM.gov for the final RFP and official amendments.