Attachment C - Projected Total Transaction Volumes.docx

This is a projected transaction volumes attachment for a Health Care Clearinghouse (HCCH) contract supporting HIPAA insurance identification and verification services for the Department of Veterans Affairs Veterans Health Administration (VHA). The document establishes baseline transaction volumes for the period December 1, 2026 through May 31, 2027, which contractors must be prepared to handle. The projected volumes include 2,500,000 real-time HIPAA 270/271 transactions for standard payers, 1,650,000 for participating payers, and 65,000 for non-participating payers. Additionally, the contractor must support 215,000 customized insurance coverage discovery transactions for found insurance per patient requested and 4,000,000 customized insurance coverage discovery transactions for not-found insurance per patient requested. The document notes that historical data indicates a consistent 5% annual increase in HIPAA 270/271 transaction volumes, though historical data for coverage discovery transactions is not available.

This appendix defines the service capacity and throughput requirements that successful contractors must be capable of delivering throughout the contract period. The transaction volumes are tied to specific Performance Work Statement (PWS) sections, establishing measurable service level expectations across multiple payer categories and transaction types. Contractors responding to solicitation 36C24C27Q0007 should use these projected volumes as the basis for resource planning, infrastructure capacity assessment, and pricing structuring.