Attachment 3- CCN Next Gen Dental Pricing Template.xlsx

XLSX spreadsheet 33 KB Posted

Attached to
Q503--CCN Next Gen - Dental Network
Solicitation number
36C10G26R0004
Issued by

About this file

This document is a Pricing Template for the Department of Veterans Affairs (VA) Community Care Network (CCN) Next Generation Dental Network solicitation (Solicitation Number: 36C10G26R0004). The template outlines multiple Contract Line Item Numbers (CLINs) covering dental services, including dental services at up to 100% of DVAFS rates, waivers of payment rates, non-DVAFS dental services, administrative services, implementation, optional appointment scheduling, software development, and transition services.

The pricing template allows offerors to provide detailed cost proposals across base and nine potential option periods, with specific line items for various service components such as implementation costs per VA facility, appointment scheduling administration, and software development tasks of different complexity levels (extra-small to extra-large). The solicitation is issued by the VA Headquarters and represents a comprehensive dental network services procurement that enables flexible pricing across multiple potential service areas and implementation scenarios.

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Other files

File Type Posted
Attachment 3 - CCN Next Gen - Dental Network Pricing Template v3.xlsx XLSX spreadsheet
36C10G26R0004 0014 CCN Next Gen - Dental Network Amendment.pdf PDF
36C10G26R0004 0013 CCN Next Gen - Dental Network Amendment.pdf PDF
36C10G26R0004 Next Gen Dental Network_Conformed Copy_03232026.pdf PDF
36C10G26R0004 0011 CCN Next Gen - Dental Network Amendment.pdf PDF
Attachment 1 - CCN Next Gen Dental Network PWS_03_13_26 v4.pdf PDF
36C10G26R0004 0010 CCN Next Gen Dental Network Amendment.pdf PDF
Attachment 1 - CCN Next Gen Dental Network PWS_03_05_26 v3.pdf PDF
CCN NG Dental Record of Questions Amendment 0009.pdf PDF
Attachment 2- CCN Next Gen Dental Contractor Manual_02_24_26 v2.pdf PDF
Attachment R - Dental Network Provider Satisfaction Survey_02_24_26 v2.pdf PDF
Attachment Q- Network Adequacy Rate Waiver Form- Dental Network_02_24_26 v3.pdf PDF
36C10G26R0004 0009.pdf PDF
CCN Next Gen - Referrals_Authorizations_SEOCs Overview.mp4 MP4 file
CCN Next Gen - Eligibility_Enrollment Slides.pdf PDF
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CCN Next Gen - Care Coordintion Overview.mp4 MP4 file
CCN NG Dental Record of Questions Amendment 0006.pdf PDF
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36C10G26R0004 0004 CCN Next Gen Dental Amendment.pdf PDF
Attachment C- Performance Requirement Summary- Dental Network _V2.xlsx XLSX spreadsheet
36C10G26R0004 0003 CCN Next Gen Dental Amendment.pdf PDF
Attachment 2- CCN Next Gen Dental Contractor Manual_v1.0.pdf PDF
Next Gen Dental Combined Synopsis_Solicitation_v2.pdf PDF
Attachment 4- Phase I Questionnaire- Dental Network.pdf PDF
Attachment R- Dental Network Provider Satisfaction Survey- Dental Network.xlsx XLSX spreadsheet
Attachment N- Scheduling Return Reason Codes- Dental Network.docx DOCX document
Attachment Mc- 837I CCN Next Gen Companion Guide- Dental Network.pdf PDF
Attachment J- Data Specifications- Dental Network.xlsx XLSX spreadsheet
Attachment C- Performance Requirement Summary- Dental Network.xlsx XLSX spreadsheet
Attachment Q- Network Adequacy Rate Waiver Form- Dental Network.pdf PDF
Attachment Md- 837P CCN Next Gen Companion Guide-Dental Network.pdf PDF
Attachment Ma- EDI 834 Healthcare Provider Information Companion Guide- Dental Network.pdf PDF
Attachment K- VA MOU ISA Template- Dental Network.docx DOCX document
Attachment G- Required Dental Provider Information- Dental Network.docx DOCX document
Attachment F- Network Waiver Request- Dental Network.pdf PDF
Attachment B- Project Risk Register- Dental Network.xlsx XLSX spreadsheet
Next Gen Dental Combined synopsis_solicitation_Final_12.15.2025.docx DOCX document
36C10G26R0004_3.docx DOCX document
Attachment 1- CCN Next Gen Dental Network PWS.docx DOCX document
Attachment O- Dental Volumes by Station- Dental Network.xlsx XLSX spreadsheet
Attachment Me- Pre-Adjudication 277CA Community Care Network Companion Guide- Dental Network.pdf PDF
Attachment Mb- 837D CCN Next Gen Companion Guide- Dental Network.pdf PDF
Attachment I- CCN Veteran Explanation of Benefits EOB Template- Dental Network.docx DOCX document
Attachment H- Eligibility Verification and Enrollment Data Exchange- Dental Network.docx DOCX document
Attachment E- PMR Template- Dental Network.pptx PPTX presentation
Attachment D- MPR Template- Dental Network.docx DOCX document
Attachment Ca- QASP- Dental Network.docx DOCX document
Attachment A- Community Care Network Stakeholders List- Dental Network.docx DOCX document
36C10G26R0004 Next Gen Dental vFINAL 12.14.25_LC.docx DOCX document
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Text version

Pricing Template

Community Care Network Next Generation - Dental
Pricing Schedule

Offeror Name:

Prices per CLIN per year
CLINDESCRIPTIONUNIT/DirectionsBASE PERIODOPTION PERIOD 1OPTION PERIOD 2OPTION PERIOD 3OPTION PERIOD 4OPTION PERIOD 5OPTION PERIOD 6OPTION PERIOD 7OPTION PERIOD 8OPTION PERIOD 9OPTION OF EXTEND SERVICES
CLIN X001Dental ServicesUp to 100% of DVAFS
CLIN X002Waivers of Payment RatesMaximum % above Medicare or VA Fee Schedule Rate
CLIN X003Non-DVAFS Dental Services50% billed charges
CLIN X004Administrative ServicesMonthly Eligible Veteran Population
CLIN X005ImplementationFixed Price Lump Sum
CLIN X006Optional: Appointment Scheduling
CLIN X006AAImplementation for Dental Appointment Scheduling: VA Facility$ total cost of implementation per VA Facility
CLIN X006ABImplementation for Dental Appointment Scheduling: Contractor's Site$ total cost of implementation at Contractor’s site
CLIN X006ACDental Appointment Scheduling Administration$ per Approved Referral for Appointment Scheduling
CLIN X007Optional: Software, Process, and Proof of Concept Development
CLIN X007AAExtra-Small Software Development Task Size$ per software development task
CLIN X007ABSmall Software Development Task Size$ per software development task
CLIN X007ACMedium Software Development Task Size$ per software development task
CLIN X007ADLarge Software Development Task Size$ per software development task
CLIN X007AEExtra Large Software Development Task Size$ per software development task
CLIN X008Transition OutFixed Price Lump Sum

CLIN X002 BOE

CLIN X002 - Waivers of Payment Rates
BOE

Offeror Name:

CLIN X004 BOE

CLIN X004 - Administrative Services
BOE

Offeror Name:

CLIN X005 BOE

CLIN X005 - Implementation
BOE

Offeror Name:

CLIN X006 BOE

CLIN X006 - Optional: Appointment Scheduling
BOE

Offeror Name:

CLIN X007 BOE

CLIN X007 - Optional: Software Development
BOE

Offeror Name:

CLIN X008 BOE

CLIN X008 - Transition Out
BOE

Offeror Name:

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