Attachment 2 - Performance Work Statement.pdf

INDIAN HEALTH SERVICE - Portland Area

PERFORMANCE WORK STATEMENT

Automated Medical Claims Billing Services

Western Oregon Service Unit and Warm Springs Service Unit Solicitation 75H71326Q00076

1. Purpose and Scope IHS requires continuation of the existing Change Healthcare Assurance Plus web-based medical claims billing service for the Western Oregon Service Unit (WOSU) and Warm Springs Service Unit (WSSU). This is a one-year continuation of the current service; no new implementation, custom development, on-site work, or system conversion is required unless separately quoted and ordered in writing.

The required service is one Assurance Plus subscription for each Service Unit. For pricing purposes, each subscription is based on 1,200 monthly subscription volume. Existing ERA Transactions, Assurance Plus 837 Files Transfer, Assurance Plus Transactions, and related claims, payer-response, status, eligibility, and standard support functions are expected to remain within the current Assurance Plus scope unless the Contractor identifies an exception in its quotation.

2. Facilities and Period of Performance

• WOSU - Chemawa Indian Health Center, 3750 Chemawa Rd. NE, Salem, Oregon 97305.

• WSSU - Warm Springs Health & Wellness Center, PO Box 1209, Warm Springs, Oregon 97761.

Each separate purchase order will cover October 1, 2026 through September 30, 2027, with no options. Services will be provided remotely through the existing web-based service.

3. Contractor Responsibilities

• Keep each facility's existing Assurance Plus subscription and account active and available for routine use during the period of performance.

• Process the ERA transactions, 837 file transfers, Assurance Plus transactions, and related medical claims-billing activity included with each facility's Assurance Plus subscription in accordance with the Contractor's applicable service specifications and existing configuration.

• Maintain the existing account, user, interface, and payer-connectivity configurations needed for continued routine operation. The quotation shall identify any separate transaction, file-transfer, overage, Paper Claims, HC Direct, implementation, transition, or other mandatory or usage-based charge and when it applies. No undisclosed charge is payable.

• Provide the standard customer support included with the service and notify the Government of a material outage or planned change expected to interrupt claims processing.

• Protect PHI in accordance with HIPAA, the applicable Business Associate Agreement, and the privacy, security, and accessibility requirements incorporated into the purchase order.

• Submit a separate monthly invoice for each purchase order showing the service period, monthly Assurance Plus subscription price, and any separately authorized usage-based charge. Each purchase order covers 12 monthly subscription periods.

4. Government Responsibilities

• Maintain authorized users, payer enrollments, and other Government-controlled account information, and transmit complete and accurate data in the formats supported by the service.

• Provide facility and billing contacts and make timely payment for accepted services.

5. Pricing, Deliverables, and Acceptance Attachment 1 contains one Assurance Plus subscription line item for each Service Unit, quantity 12 months, with pricing to be supplied by the Offeror. The 1,200 monthly subscription volume is the pricing basis for each Service Unit. The quotation shall separately disclose any applicable overage, Paper Claims, HC Direct, or other usage-based rate. Each purchase order will incorporate only the prices and rates accepted by the Government; no other charge is payable.

The monthly invoice is the only routine deliverable. No separate implementation plan, transition plan, training, activity report, performance report, or other recurring deliverable is required unless ordered in writing. Services will be accepted when the existing service remains available for routine use, included transactions and file transfers are processed under the applicable service specifications, and the invoice accurately reflects the prices and any separately authorized charges for the correct purchase order.

6. Follow-On Work Any requirement after September 30, 2027 will be addressed under a separate acquisition. No follow-on work is guaranteed.