Appendix H.docx
DOCX document 37 KB Posted
- Solicitation number
- RFSQ-BHS-FY23-0108
- Issued by
- Santa Clara County, California
About this file
This is an Electronic Health Record (EHR) Status Questionnaire from the County of Santa Clara Behavioral Health Services Department for the Substance Use Residential Withdrawal Management Services RFSQ-BHS-FY23-0108. The questionnaire requires offerors to provide comprehensive information regarding their EHR capabilities and intended implementation approach. Key requirements include demonstration of EHR vendor and platform identification, compatibility with Netsmart's myAvatar system through FHIR API for Provider Connect Enterprise (PCE) implementation, and capability to produce 837 billing files. Offerors must disclose whether they are existing County-contracted providers and whether myAvatar is already in use, as responses to these questions determine which subsequent questions must be completed.
The questionnaire requires offerors to select their preferred implementation type from four options: PCE (requiring approximately 3-4 months of preparation), PCNX with 837 billing (2 months), PCNX with non-837 billing using Fast Service Entry (6 weeks), or PCNX without billing setup for data collection only (4 weeks). Offerors must confirm they have sufficient resources to complete their selected implementation prior to contract start and provide a detailed implementation plan with County support through weekly go-live preparation meetings. All responses must be submitted with the bid response and are subject to rejection if omissions, inaccuracies, or misstatements are identified. Contact information for EHR-related communications must be provided, and all statements must be submitted under penalty of perjury with authorized representative signature.
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Other files
| File | Type | Posted |
|---|---|---|
| Appendix E (With Local Preference).docx | DOCX document | |
| Addendum 2.pdf | ||
| Appendix C.docx | DOCX document | |
| Appendix G.docx | DOCX document | |
| Attachment E.pdf | ||
| Appendix A.docx | DOCX document | |
| Appendix J.docx | DOCX document | |
| Solicitation_Document.pdf | ||
| Appendix E (Without Local Preference).docx | DOCX document | |
| Attachment A.pdf | ||
| Appendix F.docx | DOCX document | |
| Appendix B.docx | DOCX document | |
| Attachment B.pdf | ||
| Addendum 5.pdf | ||
| Addendum 1.pdf | ||
| Addendum 4.pdf | ||
| Addendum 3.pdf | ||
| Attachment D.pdf | ||
| Appendix I.xlsx | XLSX spreadsheet | |
| Solicitation_Document_1.pdf | ||
| Appendix D.docx | DOCX document | |
| Attachment C.pdf | ||
| RFSQ-BHS-FY23-0108.pdf |
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Text version
APPENDIX H
County of Santa Clara – Behavioral Health Services Department RFSQ-BHS-FY23-0108: Substance Use Residential Withdrawal Management Services
OFFEROR’S ELECTRONIC HEALTH RECORD (EHR) STATUS
All EHR information requested in the form shall be furnished by Offeror and shall be submitted with the response. Statements shall be complete, accurate, and in the form requested. Any omissions, inaccuracies, or misstatements may be cause for the rejection of a response in whole or part.
1. Is Offeror an existing County-contracted Provider (CCP)?
YES ☐ NO ☐
Does Offeror already have a contract(s) with the County of Santa Clara in which myAvatar is already being used?
YES ☐ NO ☐
If both responses indicate “Yes”, please complete Questions 2-7.
If either response includes “No”, please complete Questions 2-4 and 8-10.
2. Please provide the name of the organization’s EHR vendor and platform (ex. Netsmart, myAvatar):
3. Does Offeror’s EHR have the capability of being certified with Netsmart’s myAvatar system through Fast Healthcare Interoperability Resources Application Programing Interface (FHIR API) allowing the implementation type of Provider Connect Enterprise (PCE)? The Offeror Electronic Health Record (EHR) would need to be compatible with FHIR if client data is to be electronically exchanged with the County of Santa Clara. The Offeror’s EHR vendor is responsible to assess the ability of their EHR to be compatible with FHIR and can reference the PCE Companion Guide (on the County’s partner site) that outlines the requirements necessary for integration.
YES ☐ NO ☐
4. Does Offeror’s EHR have the capability to produce 837[footnoteRef:2] billing files or manages an active contract with an additional vendor to produce 837 billing files on the organization’s behalf? [2: 837 billings files are electronic files that contain client and individual claim information. These are standard claim files and are comprised of individual claims that are then submitted electronically to be processed.]
5. What implementation of myAvatar is being used?
☐ Provider Connect Enterprise (PCE) ☐ Provider Connect NX (PCNX) with 837 billing ☐ Provider Connect NX (PCNX) with non-837 billing, using Fast Service Entry ☐ Provider Connect NX (PCNX) without a billing setup, completing forms solely for data collection
6. Based off your understanding of the organization’s current myAvatar implementation type, will Offeror’s staff need a different (more enhanced) implementation type if awarded a contract for the services listed in this eRFP?
If yes, please provide a reason and proceed to question 7. If no, proceed to question 10.
7. Given the lengths of time provided below, does the organization have enough resources to complete the need for a different (more enhanced) implementation type chosen in question 6 prior to the start of the contract?
☐ PCE: roughly 3-4 months of prep ☐ PCNX with 837 billing: roughly 2 months of prep ☐ PCNX with non-837 billing: roughly 6 weeks of prep ☐ PCNX without a billing setup, roughly 4 weeks of prep
YES ☐ NO ☐
8. Based off your understanding of the eRFP parameters and your EHR capabilities, what type of implementation of myAvatar would best suit the organization?
☐ Provider Connect Enterprise (PCE) ☐ Provider Connect NX (PCNX) with 837 billing ☐ Provider Connect NX (PCNX) with non-837 billing, using Fast Service Entry ☐ Provider Connect NX (PCNX) without a billing setup, completing forms solely for data collection
9. Given the lengths of time provided below, would Offeror’s staff have enough resources to complete the selected implementation chosen in question 8 prior to the start of the contract?
☐ PCE: roughly 3-4 months of prep ☐ PCNX with 837 billing: roughly 2 months of prep ☐ PCNX with non-837 billing: roughly 6 weeks of prep ☐ PCNX without a billing setup, roughly 4 weeks of prep
10. With the County’s support in weekly go-live prep meetings, please describe the organization’s plan to implement myAvatar.
11. Please confirm the contact(s) the County shall contact for EHR related communications:
| NAME |
| TITLE |
The undersigned hereby declares under penalty of perjury that all statements, answers and representations made in this questionnaire are true and accurate, including all supplementary statements hereto attached. In the case of a corporate Offeror, the signature of one duly authorized representative is sufficient.
Signature
(Please print or type name)
Title
Signature
(Please print or type name)
Title
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