Answers Bid_Q_A_Cent.Credentialing.xlsx
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- Attached to
- Centralized Credentialing
- Solicitation number
- 40DHHS-S2377
- Issued by
- Churchill County, Nevada
About this file
This document summarizes a request for proposal (RFP) issued by the State of Nevada Department of Health and Human Services (DHHS) for a Centralized Credentialing Vendor (CVO) to provide credentialing services for approximately 42,000 Nevada Medicaid enrolled providers across multiple jurisdictions, including Carson City. The CVO is expected to implement a robust screening and validation process to ensure only qualified and quality providers are enrolled, align enrollment processing times and outcomes, and reduce provider abrasion and administrative burden. The proposed contract term is from March 1, 2024, through February 28, 2028, with the system required to be implemented by December 31, 2024.
The RFP allows for various pricing models, including fixed monthly fees, per provider fees, or per credentialed file fees. DHHS is open to considering the proposed cost method that is in the best interest of the state. The CVO will be required to interface with Nevada's existing Fiscal Agent vendor and adhere to NCQA certification requirements, service level agreements, and liquidated damages provisions. Vendors must submit proposals through the Nevada E-Procurement (NevadaEPro) system by the July 31, 2023, deadline.
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Bid Q&A for Export Report
| Bid Q&A | |||||
| QUESTION_NBR | QUESTION_SUBJECT | QUESTION_TEXT | Who Has It | Date Assigned | ANSWER_TEXT |
| 1 | Off-shore allowed? | Can portions of this be worked by off-shore team? | Vanessa | 7/17/23 | Data and information must be stored on stateside servers. |
| 2 | Off-shore allowed? | Can portions of this be worked by off-shore team? | Vanessa | 7/17/23 | Duplicate |
Data and information must be stored on stateside servers.
| 3 | Cloud hosting | Do you anticipate the system being hosted on state servers? There's a mention in 5.6.6 about Azure, but nothing specific. | Vanessa | 7/17/23 | This would depend on the solutions presented. It is not a requirement it is hosted on state servers. |
| 4 | Turnover and Recreds | Could you please provide an overview of the % turnover and reaccreditations? If the assumption of 42k providers are only needing recreds every 3 years, this would leave a fairly even monthly distribution of 1.2k/monthly. Could you please confirm? | Cynthia | 7/17/23 | If evenly distributed over 36 months, this would be the anticipated number; however, DHCFP is not currently performing credenitialing and cannot confirm the exact number of monthly credentialing/recredentialing requests. |
| 5 | Initials | is there a % / # re: new Initials received on an annual / monthly basis? Is the plan growing the provider base by X % each year? | Cynthia | 7/17/23 |
On average, DHCFP receives approximately 415 initial enrollment applications per month. Initial applications account for roughly 63% of incoming applications. DHCFP does not (currently) recruit providers.
| 6 | Provide credentialing customer support | What are the hours of support and what is the anticipated weekly volume? | Cynthia | 7/17/23 | DHCFP hours of operations are Monday through Friday, 8:00AM to 5:00PM Pacific Time, the vendor shall be available to staff during hours of operation. Estimated volume is unknown at this time. |
| 7 | Develop multi-faceted training, at implementation and ongoing, for system users. | Who would be ?system users? and what would they be doing to the system? | Cynthia | 7/17/23 | DHCFP estimates that representatives from all Managed Care plans as well as DHCFP will have read access to the CVO system. Additionally, in accordance with the CVO proposal, providers may have direct access to the CVO system to review and update credetentialing statuses and documentation. |
| 8 | Cost Schedule | Section 2.4.6. states, ?there are approximately 42,000 Nevada Medicaid enrolled providers? Is that the total number of providers the vendor should plan to load and credential? | Cynthia | 7/17/23 | DHCFP does not have access to NCQA requirements and therefore cannot estimate the number of providers that will need credentialing. The expectation is that the CVO will credential all Nevada Medicaid providers in accordance with NCQA requirements. |
| 9 | Cost Schedule | There are various worksheets within the Cost Schedule Excel file. For worksheets x 1.4, x 1.5, x 1.6, x 1.7 which include Potential Changes and Optional Services. It is not possible for the bidder to price a Potential Change or an Optional Service without knowing the specifics. We would like to leave worksheets x 1.4, x 1.5, x 1.6, x 1.7 blank and fill-in worksheet x 1.8 which will list Personnel Rates. These rates can be applied to any change request and/or optional service to determine the cost once the specifics are understood and the number of hours are established. Does this approach work? If not, would you please give guidance on how bidders are to price Potential Changes and Optional Services without knowing what they are? | Vanessa | 7/17/23 | No Potential Changes or Optional Services were noted, no value is required in these sections. |
| 10 | Appendix X | Centralized Credentialing Service Level Agreement ID #1 and #2 the Damages are assessed ?per day? but it would seem ?per occurrence? would be appropriate for these two items, is that correct? | Cynthia | 7/17/23 | Damage assessment is accurate as described. Per day for #1 and Per day/per occurance for #2 |
| 11 | Project Management - 8.2.3 and 8.2.5 | On page 7, the RFP states "A draft Project Management Plan shall be included with the proposal" but then on pge 8 the RFP states "The draft Project Management Plan shall be submitted within 10 business days of the contract effective date." Please clarify as to when to submit the draft Project Management Plan. | Vanessa | 7/17/23 | At proposal the state expects to see a high-level Project Management Plan. A detailed draft Project Management Plan is expected 10 days of the contract. |
| 12 | Liquidated Damages - 10.1.5 | Centralized Credentialing Vendor shall provide technical support by phone and online in accordance with DHCFP?s regular business hours for the duration of the contract. What are the criteria used to define "failure to provide technical support"? | Cynthia | 7/17/23 | Vendor is expected to meet all service level agreements |
| 13 | Liquidated Damages - 10.1.5 | Centralized Credentialing Vendor shall respond to all received telephone, email communications, and written correspondence from stakeholders within two (2) business days of receipt of the inquiry. What are the criteria used to define "failure to comply"? | Cynthia | 7/17/23 | Vendor is expected to track and report on all service level agreements |
| 14 | 10.3.3 - Requirements Matrix Site Visits | Perform site-visits of certain providers as required by NCQA requirements, State and Federal regulations, and as needed in response to recipient complaints or quality of care concerns. What is the expected annual volume of site visits required for moderate risk providers and are they expected to be performed in person or virtually? | Cynthia | 7/17/23 | DHCFP does not have access to NCQA requirements and, therefore, cannot estimate the number of providers that will need credentialing. Site visits are expected to be performed in person, with exceptions only in cases of out-of-state providers; however, a written process which meets all federal and state requirements would be evaluated. |
| 15 | 10.3.3 - Requirements Matrix Call Center | Provide a Customer Support Call Center to assist providers in the credentialing and re-credentialing process. The Customer Support Call Center will also be utilized by stakeholders for process or technical assistance. What is the expected monthly call volume? | Cynthia | 7/17/23 | Call Center is intended to support stakeholders. At this time we cannot estimate the call volume as we believe volume will depend on the transparency, efficiency and effectiveness of the CVO's process. |
| 16 | 15.2 G Other Informational Material | Should vendors include sections 10.3.2 through 10.3.4 in 15.2 G Other Informational Material? If not, where would the State like to see this information (sections 10.3.2 through 10.3.4) in the response? | Contracts | 7/17/23 | Include as attachments with the Technical Proposal. |
| 17 | 6.4.1 Change Management Plan | Where would the State like vendors to include 6.4.2 CM Plan in their responses? | Cynthia | 7/17/23 | If the vendor has a CM Plan, provide a copy. If there are additional comments, add them to the System Requriments Technical Questioannaire (Add a row within Change Management). |
| 18 | 2.4.6 - Project Background | here are approximately 42,000 Nevada Medicaid enrolled providers and currently 59 active Provider Types. What percentage of newly enrolling providers require credentialing? | Cynthia, Cathy | 7/17/23 | DHCFP does not have access to NCQA requirements and therefore cannot estimate the number of providers that will need credentialing. |
| 19 | 3.1 Concurrent Impacts | DHHS will be supporting COVID Unwind activities, particularly in the MMIS as the COVID-19 Public Health Emergency concludes. What impact do these unwind activities have, if any, on credentialing activities? | Vanessa | 7/17/23 | Some DHCFP staff may be working on the COVID-19 Unwinding and/or the other concurrent projects and this project at the same time. This shouldn't have any impacts to credentialing. |
| 20 | 2.6.4.A Goals | Implementing a robust screening and validation process to ensure only qualified and quality providers are enrolled in the program. What is included in the definition of screening? Is this screening peformed by the Fiscal Agent today? Is there a distinction between screening and credentialing? | Cynthia | 7/17/23 | Provider credentialing is a more robust process of establishing that providers have proper qualifications to perform their jobs and are eligible to participate in insurance networks. This process has commonalities with screening and validation performed by the contracted Fiscal Agent, but is separate. The primary purpose of screening is to become an approved provider to receive reimbursement for services. |
| 21 | 10.3.5 Cost Schedule | The Cost Proposal Instruction tab (and other tabs) contain items marked in red XXX. In additon, there are comments stating "Purchasing to complete". Will the State provide an updated Cost Schedule with these items completed? | Ryan | 7/17/23 | See revised cost schedule under Attachments Tab. |
| 22 | State Environment | Section 5.6.6: Please explain the implication of "B2B between Azure Public and the FedRAMP high is not supported by Microsoft in the State Environment." Is the State dictating Azure integration? | IT | 7/17/23 | No, the State is informing you of it's limitations so your proposals my be adjusted accordingly. |
| 23 | Data Transmition | Section 14.3: In a situation where XaaS supplier triggers an incident, for example State provided IaaS, how will the situation be handled? | IT | 7/17/23 | The expectation would be for the entity that triggerred the incident to immediately report the incident to all impacted parties and follow an appropriate incident response plan. |
| 24 | Qualification | In Section 2.4.7, it describes that the vendor will need to work with Nevada's existing Fiscal Agent (FA) vendor. Is the contracted FA eligible to bid on this opportunity? | Ryan | 7/17/23 | Information requested does not materially impact a vendor's ability to propose. All submissions through nevadaepro.com are subject to the same review. |
| 25 | Timeline | Section 11.2: Would the STate consider extending the deadline for proposal submissions and opening to August 26th, allowing vendors a full six weeks to prepare responses after answers to questions are received? | Vanessa | 7/17/23 | No, the State needs to adhere to the timeline to ensure there's sufficient time for implemenentation. |
| 26 | Timeline | Section 11.2: If the estimated Contract start date is 1/1/2024, what is DHCFP expectation for the implementation time frame? | Vanessa | 7/17/23 | The system must be implemented by 12/31/2024. |
| 27 | NCQA certification | Section 10.2.3: Would DHCFP consider NCQA certification 60 days prior to start of operations? | Cynthia | 7/17/23 | No. |
| 28 | RFP 2.4.6 | Please provide a list of provider types. | Cynthia | 7/17/23 | Provider types and specialties can be found in the Provider Enrollment Handbook on the Nevada Medicaid website: https://medicaid.nv.gov/Downloads/provider/NV_Provider_Enrollment_Information_Booklet.pdf |
| 29 | RFP 2.4.6 | Please provide the historical number of participating providers for the last 5 years. | Cynthia | 7/17/23 | State Fiscal Year - July through June |
2018: 29,595 2019: 31,909 2020: 36,576 2021: 39,025 2022: 40,364 2023: 43,683
| 30 | RFP 2.4.6 | Approximately how many providers participate with the MCEs vs solely FFS? | Cynthia | 7/17/23 | All Nevada Medicaid providers must first enroll with FFS before they can contract with an MCE. As of June 2023, approximately 67% of Nevada Medicaid providers service FFS only (this data is based on provider self-disclosure at the time of enrollment). |
| 31 | RFP 2.4.6 | Please provide the number of new providers that applied per month for the last 2 years. | Cynthia | 7/17/23 | On average, DHCFP receives approximately 415 initial enrollment applications per month. |
| 32 | RFP 2.4.6 | Please provide the projected re-validation schedule for the existing provider count, showing the number of projected re-validations per month. | Cynthia | 7/17/23 | On average, DHCFP receives approximately 145 revalidation applications per month. |
| 33 | RFP 2.4.7 | What data transactions/interfaces will the Contractor need to conduct with the Fiscal Agent? | Cynthia | 7/17/23 | The CVO will interface with the Fiscal Agent to receive collected enrollment and credentialing documenation as well as provider demographic and eligibility data. |
| 34 | RFP 2.6.2 | Please identify any responsibilities the CVO will have related to provider enrollment processing or confirm there are none. | Cynthia | 7/17/23 | The CVO will play an integral role in enrollment in that an enrollment application will not be approved until credentialing is complete. DHCFP currently does not envision the CVO will perform enrollment activities. |
| 35 | RFP 2.6.2 | Will provider enrollment staff screen applications for complete information prior to the applications being made available to the CVO? | Cynthia | 7/17/23 | That is the current vision however DHCFP would look to the vendor to provide a solution of how the screening and credentialing process could be completed in parallel. |
| 36 | RFP 2.6.2 | What are the CVO?s requirements as it relates to ACA required verifications for an initial enrollment? | Cynthia | 7/17/23 | The CVO is limited to responsiblities related to credentialing in accordance with NCQA requirements. |
| 37 | RFP 2.6.2 | What are the CVO?s requirements as it relates to ACA required re-validations? | Cynthia | 7/17/23 | The CVO is limited to responsiblities related to credentialing in accordance with NCQA requirements. |
| 38 | RFP 2.6.2 | What are the CVO?s requirements as it relates to ACA required screening and monitoring? | Cynthia | 7/17/23 | The CVO is limited to responsiblities related to credentialing in accordance with NCQA requirements. |
| 39 | RFP 2.6.2 | What are the CVO?s requirements as it relates to ACA required site visits for medium to high risk providers? | Cynthia | 7/17/23 | Site visits are currently being performed by DHCFP staff in accordance with ACA. DHCFP would look to the vendor to propose a solution for incorporating NCQA required site visits as part of the credentialing process. |
| 40 | RFP 2.6.2 | How many providers are medium to high risk? | Cynthia | 7/17/23 | The expectation is that the CVO will determine which providers are medium to high risk based upon NCQA requirements. |
| 41 | RFP 2.6.2 | Please define ?develop and support a Credentialing Committee.? Will the CVO determine membership for the committee? Please confirm the Contractor will not participate on the Credentialing Committee. | Cynthia | 7/17/23 | The CVO will collaborate with DHCFP to determine committee membership consistetn with NCQA requirements. The CVO may have a representative as part of their solution to support the CVO committee and decision making. |
| 42 | RFP 2.6.3.B | Please provide more details regarding the interface responsibilities. What data will the CVO share? What transaction methods will be used? What data will the CVO receive? | Cynthia | 7/17/23 | The CVO will interface with the Fiscal Agent to receive collected enrollment and credentialing documenation as well as provider demographic and eligibility data. |
| 43 | RFP 3.1 | Please provide a brief description of DHCFP?s timelines associated with the PHE unwind. | Cynthia | 7/17/23 | System (MMIS) activities will be completed by 9/2024, these system changes should not have any impacts to credentialing. |
| 44 | RFP 3.1 | How did provider enrollment change during the COVID pandemic? Is the Contractor expected to experience any spikes in workload associated with the PHE unwind? | Cynthia | 7/17/23 | There were no significant changes to provider enrollment during the pandemic. DHCFP does not anticipate provider enrollment spikes in workload as a result of the PHE unwind. |
| 45 | RFP 4.1 | Will all document exchanges with providers take place within the MMIS system, including follow up document requests made by the CVO, or will providers be interacting with the CVO?s system? | Cynthia | 7/17/23 | Initial documentation intake will take place within the provider portal of the MMIS. The DHCFP would look to the vendor to propose a solution for direct provider interactions based on past experience and best practices. |
| 46 | RFP 5.6.2 | Please identify the estimated number of users of the CVO?s system, and the different levels of functionality they will require. | Cynthia | 7/17/23 | DHCFP estimates that representatives from all Managed Care plans as well as DHCFP will have read access to the CVO system. Additionally, in accordance with the CVO proposal, providers may have direct access to the CVO system to review and update credetentialing statuses and documentation. |
| 47 | RFP 5.6.6 | What is the purpose of including this statement in the RFP? | Cynthia | 7/17/23 | The State is informing you of it's limitations so your proposals may be adjusted accordingly. |
| 48 | RFP 6.4.1 | In what document/section is the bidder to submit the CM Plan as part of their proposal? | 7/17/23 | As a separate attachment along with the other required documents listed in the RFP. | |
| 49 | RFP 9.1 | Is the State requesting a fixed monthly fee for services, as opposed to a per provider fee, or a per credentialed file fee? | Cynthia | 7/17/23 | The DHCFP is open to all proposed pricing options. The proprosed cost method will be considered if it is in the best interest of the state. |
| 50 | RFP 11 | Does the State have a desired or required ?go-live? date for services, or is it for the CVO to propose what it believes is best for the project? | Cynthia | 7/17/23 | The system must be implemented by 12/31/2024. |
| 51 | RFP 14.6.9 | This section references a Help Desk Manager ? is this the same position as the Call Center Manager referenced in 8.2.11? | Vanessa | 7/17/23 | Yes. |
| 52 | RFP 14 | May one person fulfill more than one position? | Vanessa | 7/17/23 | Not in key positions defined in the contract. |
| 53 | RFP 15.1.4 & 15.5 | Please clarify the contradicting statements of ?should flag confidential? in 15.1.4 and ?should not flag confidential? in 15.5. | Ryan | Cost Proposals are NOT confidential. Vendor financials can be. | |
| 54 | Terms and Conditions 1.6 | Please provide more details regarding the requirements of Section 1.6 with respect to Section 15.3 of the RFP. Does this requirement mean that the vendor is to provide one full, complete copy of their response (with confidential information included and marked as proprietary) part of the proposal submission? This file would then be flagged as confidential in NevadaEPro. If not, please provide more details. | Ryan | It is the Vendor's responsibility to identify trade secret and proprietary in formation. All submitted Vendor proposals become public documents once a contract has been awarded. Vendors must provide a redacted version for public release. | |
| 55 | Scope of Work, 1.10 | Please provide more details regarding the Contractor?s responsibilities related to CMS certification. | Vanessa | 7/17/23 | The vendor is expected to help the State complete all required evidence documents, gather the required evidence to support the criteria, provide slides to support the operational readiness and final certification reviews, and anwer any questions from CMS pertaning to a sucessful system certification. |
| 56 | Scope of Work, 1.10 | Please provide more details regarding the DHCFP?s responsibilities related to CMS certification. | Vanessa | 7/17/23 | The vendor is expected to help the State complete all required evidence documents, gather the required evidence to support the criteria, provide slides to support the operational readiness and final certification reviews, and anwer any questions from CMS pertaning to a sucessful system certification. |
| 57 | 10.1.5 ? Liquidated Damages | Would the State consider an overall limit on damages based on a percentage of the monthly invoice ? for example 10%? | Contracts | 7/17/23 | Damage assessment should be contained within the Proposal for consideration. |
| 58 | 10.1.5 ? Liquidated Damages | There is a damage associated with CMS certification that indicates it is measured ?per-employee? ? please clarify this measurement. | Vanessa | 7/17/23 | During CMS Certification for each employee that is not replaced within 7 days of the termination date of any key personnel member, unless the States grants an exception to the requirement, will result in the CMS certification damages. |
| 59 | 10.2.3 ? SLAs | Is the State aware of any specific dates that impact SLA #4? | Vanessa | 7/17/23 | The system must be implemented by 12/31/2024. |
| 60 | 10.3.3 ? RTM | For item 5, are ACA required site visits for medium and high risk providers included in scope for the CVO, or only NCQA required site visits? If the former, please provide the number conducted per month. | Cynthia | 7/17/23 | Site visits are currently being performed by DHCFP staff in accordance with ACA. DHCFP would look to the vendor to propose a solution for incorporating NCQA required site visits as part of the credentialing process. |
| 61 | Cost Proposal | Please clarify the use of the term ?partial? for years one and five. | Cynthia | 7/17/23 | The State Fiscal Year is July 1st thru June 30th of the following year. State Fiscal Year 2023 is 07/01/2022-06/30/2023. The partial years are for timeframes that do not include a full state fiscal year. If the contract runs from 03/01/2024-02/28/2028. There would be a partial year from 3/1/24-06/30/24 and a partial year from 7/1/27-02/28/28. |
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Comment:
@Timothy Ryan 62 Cost Proposal Because of the potential cost, would the State prefer a separate line item for the site visit requirement in the M&O sheet? If not, where should it be included? Cynthia 7/17/23 This would be fine.
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Comment:
Ryan, I have a travel question on this regarding Per diem GSA.
| 63 | Cost Proposal | Please clarify what is to be included in cost sheets 1.4 and 1.5, and what assumptions bidders should make to ensure comparability across bids. | Cynthia / Margaret | 7/17/23 | No Potential Changes or Optional Services were noted, no value is required in these sections. |
| 64 | Scope of Work 1.3.3 | Please provide clarification as to what each task level should be associated with the 5-page response limit. For example, does the 5-page limit apply to addressing all the requirements in Section 1.4 (i.e., 1.4.1-1.4.7) or does the 5-page limit apply to addressing all the requirements of Section 1.4.1 and the vendor then has another 5 pages to respond to all of the requirements in Section 1.4.2, etc.? | Cynthia | 7/19/23 | Ignore this limitation. |
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Comment:
Ryan does the Scope need to be updated to reflect this on 1.3.3.
65 Cloud Hosting Questionnaire Is the requirement for Identity Management referring to Active Directory? If not, please provide more details.
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Comment:
@Nate Topchi Reply:
| Done | Nate | 7/17/23 | Ideally but not nessesarily. A system that has SSO integration with Windows AD/SAML is preferred. |
| 66 | Credentialing Committee Staffing | Reference: Attachment 10.3.3 Requirements Matrix; Functional Requirement #10 Facilitate a Credentialing Committee. |
Have the participants for the Credentialing Committee already been identified, or is the vendor expected to recruit and/or staff any positions on the Credentialing Committee?
| Is it the state?s expectations that the vendor propose the size and make-up of the committee? | Cynthia | 7/17/23 | The CVO will collaborate with DHCFP to determine committee membership consistent with NCQA requirements. The CVO may have a representative as part of their solution to support the CVO committee and decision making. |
| 67 | Liquidated Damages - ARPA Funding timeframes | Attachment 10.1.5 Liquidated Damages; Row 19 - Implement Centralized Credentialing Solution capabilities and services to comply with American Rescue Plan Act (ARPA) grant funding timeframes. |
| Can the state confirm that ARPA grant funding is still available, and provide the appropriate federal government / program reference? (Is this a funding grant available through CMS or some other agency?) | Fiscal/Contracts | 7/17/23 | Yes a portion of this project is funded by ARPA. However program reference does not apply to a single project and may not be relevant to this request. |
| 68 | Data Migration | Reference: Attachment 10.3.3 Requirements Matrix; System Technical Services Requirement #16 Data Migration |
| It is our understanding that the state does not currently follow a standardize credentialing process, and therefore does not have historical credentialing data to be migrated. Is there historical credentialing data that the state anticipates migrating? If so, is that history coming from the state or from the participating Managed Care Entities, or both? | Cynthia | 7/17/23 | DHCFP does not house any historical credentialing data and does not anticipate migrating these data at this time. |
| 69 | Databases used for Screening Purposes | Reference: Attachment 10.3.3 Requirements Matrix; Functional Requirement #2 ? comparison of information to databases |
CMS Provider Screening requirements include using many of these same databases for provider enrollment decisions.
| Should the CVO vendor assume that some of these activities are already managed by the Fiscal Agent? If so, is it the state?s expectations that the Fiscal Agent, or the CVO, or both vendors handle moving forward? | Cynthia | 7/17/23 | The expectation is that the CVO performs all credentialing acitivities in accordance with NCQA requirements. |
| 70 | Performance of Site Visits | Reference: Attachment 10.3.3 Requirements Matrix; Functional Requirement #5 Perform Site Visits |
CMS Provider Screening requirements specify situations where Site Visits are required for Medicaid Provider Enrollment.
| Should the CVO vendor assume that some of these Site Visit activities are already managed by the Fiscal Agent? If so, is it the state?s expectations that the Fiscal Agent, or the CVO, or both vendors handle moving forward? | Cynthia | 7/17/23 | Site visits are currently being performed by DHCFP staff in accordance with ACA. DHCFP would look to the vendor to propose a solution for incorporating NCQA required site visits as part of the credentialing process. |
| 71 | Relationship between Credentialing and Provider Enrollment Processes | Reference: General Comment |
This procurement indicates the state is pursuing a direct relationship with a CVO. Similarly, the state has a direct relationship with the Fiscal Agent performing end-to-end provider enrollment processing. It is assumed that the Fiscal Agent may already support a "provider call center" to address general enrollment questions. An optimal delivery model might reuse that existing call center channel, but route the call / ticket to the CVO vendor.
| Can vendors put forward an approach where some requirements are coordinated through a business process relationship between the CVO and the Fiscal Agent? | Cynthia | 7/17/23 | Yes, the DHCFP would consider an approach that integrates/coordinates wtih existing services. |
| 72 | Credentialing Appeals Process | Reference: Attachment 10.3.3 Requirements Matrix; Functional Requirement #11 Appeals Process |
Does the Fiscal Agent already support an Appeals Process for the end-to-end Provider Enrollment process?
| Is it the state?s expectation that the CVO support a separate Appeals process (specific to credentialing), or would it consider integrating credentialing Appeals process into any existing Fiscal Agent enrollment appeals services? | Cynthia | 7/17/23 | The Fiscal Agent supports the appeals process for provider enrollment. The CVO would be expected to support an appeals process with the DHCFP as it directly relates to credentialing decisions. |
| 73 | Customer Support Call Center | Reference: Attachment 10.3.3 Requirements Matrix; Functional Requirement #16 Customer Support Call Center |
Does the Fiscal Agent already support a Call Center to providers for assistance in the end-to-end Provider Enrollment process?
| Is it the state?s expectation that the CVO support a separate Call Center (specific to credentialing), or would it consider incorporating the credentialing Call Center process into the existing Fiscal Agent provider call center services? | Cynthia | 7/17/23 | Yes the DHCFP would consider an approach that integrates/coordinates wtih existing services. |
| 74 | Key Staff Roles | Reference: RFP, 8.2.11B Required Positions and 14.6 Vendor Staff Resumes. |
While the state indicates that vendors can propose an implementation project plan and methodology, it also specifies roles and qualifications for Key Staff. These "positions" may not directly align with a vendor's existing (standard methodology).
Are vendors able to propose alternate staffing methodologies and roles, provided that all key tasks are addressed? Or is the state requiring vendors to follow the staffing roles as outlined? Contracts 7/17/23 Vendors may propose alternate staffing methodologies / roles provided all key roles / qualifications / tasks are addressed.
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Comment:
Margaret and Vanessa can we chat on this one.
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@Timothy Ryan tc={90DC4C51-C491-4A2F-954D-60AF09841E6F}: [Threaded comment]
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Comment:
Ryan, I have a travel question on this regarding Per diem GSA.
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@Nate Topchi Reply:
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Comment:
Ryan does the Scope need to be updated to reflect this on 1.3.3. 75 Pricing - CVO Personnel Rates Reference: RFP 9.5.7 CVO Personnel Rates
The state should understand that not all CVOs price services on hourly rates, preferring instead to price according to "credentialing applications completed" or "per provider" methodologies. Does the state have recommendations for how vendors should try to "translate" from standard pricing models into the requested hourly models?
| Would the state allow vendors to submit alternative pricing models that are not "hourly rate" based? | Contracts | 7/17/23 | The DHCFP is open to all proposed pricing options extremely detailed. The proprosed cost method will be considered if it is in the best interest of the state. |
| 76 | Integration with interChange MMIS (1) | Reference: RFP 5.6.3 |
| Does the state have a separate project budget for any system integration costs associated with changes needed on the interChange MMIS to support the credentialing data? | Vanessa | 7/17/23 | No. |
| 77 | Integration with interChange MMIS (2) | Reference: RFP 5.6.3 |
| If vendors have existing integrations with Gainwell interChange MMIS, will that impact technical or cost scoring? | Cynthia | 7/17/23 | Scoring is not discussed prior to evaluation. |
| 78 | Relationship between Credentialing and Provider Enrollment Processes (2) | Reference: RFP 2.6.4 |
This RFP is stating objectives like "Aligning enrollment processing times and outcomes" and "reduce provider abrasion and administrative burden" which seems to be references to an "end-to-end enrollment process" where credentialing is a subprocess.
Does the state envision the credentialing work happening as a subprocess within the end-to-end Medicaid Provider Enrollment and revalidation process? Or does the state envision the credentialing process happening separate / parallel to the Provider Enrollment process? Consider that if credentialing is treated as a subprocess, then there is a higher level of coordination between the CVO and the Fiscal Agent than is explicitly stated within the requirements. Cynthia 7/17/23 The current vision is that credentialing would be a sub-process, however DHCFP would look to the Contractor to provide a solution of how the enrollment and credentialing process could be completed in parallel.
File details come from the government source that posted it. Updated .