ATTACHMENT NO. 2 - STATEMENT OF WORK.pdf

ACCOUNT RECEIVABLE (A/R) TECHNICIAN SERVICES

STATEMENT OF WORK (SOW)

I. Objective

Accounts Receivable Technician Services at Western Oregon Service Unit, Chemawa Indian Health Center

II. Background

Chemawa Indian Health Center is a Service Unit within the Indian Health Service that bills Medicaid, Medicare, Private Insurance, and Veterans Administration. The Account Receivable technician posts payments from the various billing sources.

III. Scope

The Contractor shall provide Account Receivable (A/R) Technician and A/R Technician duties include posting payments and working with Chemawa’s business office staff to assure proper payment is received as required under IHCIA, at Title 25, U.S.C.162e(a). The Contractor will utilize RPMS (Resource Patient Management System), Easyprint, Adobe, various secure share folders, and various insurer/clearinghouse websites to assist with Accounts Receivable services for Western Oregon Service Unit, Chemawa Indian Health Center.

IV. Specific Tasks

A - Reviews 3rd Party / EOB (Explanation of Benefits), posts to Account Receivable System

1. Review payments from remittances and EOB's for accuracy.

2. Places EOB in designated file if it reflects payment is denied or paid lower % due to “out of network".

3. Post from Remittance Advice within 72 work hours from receiving supporting documentation.

4. Messages accounts to reflect to/from credits when credit involves multiple accounts utilizing New Standard Adjustment Reason Codes.

5. Post Beneficiary Medical Program payments same day Portland Area sends payment information;

Files BMP documents.

6. Notifies Business Office Manager (BOM) and supplies documents if a payment needs to be refunded or transferred.

7. Create Collection Batch within two work days after all information is obtained following IHS's batching requirements; file after posting.

8. Batch "No Pays" after Voucher Examiner reviews and confirms legal denials. Post accordingly and file.

B - Electronic Remittance Advice (ERA) and EOB Retrieval

• Assure the EOBs and Electronic Funds Transfer are retrieved from Change Healthcare, Novasphere, PNC portal, and web sites daily.

C - Maintain Accounts Receivable System

1. Monitor previous Batch Statistical Report collection batches for open balances to resolve possible issues.

2. When no EOB is received: Reviews BSL to reconcile all un-posted batches. Send report to BOM via email by 5th business day of new month. “Example: August unposted payments-report sent to BOM by September’s 5th business day”.

3. Resolve all un-posted payments by end of following month. Using example above: All August payments must be posted by last day of September.

V. Required Knowledge

1. Knowledge of the accounting methods, procedures, and techniques to conduct difficult and responsible analysis and determinations within RPMS to validate transactions and to perform research to resolve inconsistencies.

2. The contractor will have knowledge of automated patient accounting system, point of sale system, and third-party billing system to reconcile errors that require an understanding of nonstandard procedures related to patient accounts. The contractor will have a general working knowledge of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10) and Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) coding terms.

3. Experience with IHS (Indian Health Service), EHR (Electronic Health Record) and RPMS.

4. The Contractor will comply with all Federal Regulations and comply with the Indian Health

Services Third Party Resource and Internal Control Policy, The Debt Collection Policy, and the Indian Health Services Statistical and Reporting Systems for all Departments.

5. Knowledge of Indian Health Services policies and regulations on alternate resources as they relate to Medicare, Medicare Advantage, Supplement Insurance, Medicaid and other private insurance payers.

VI. Performance monitoring (if applicable)

Business Office Manager will run reports and monitor the accuracy and compliance to time sensitive duties which is mandated by Indian Health Service Revenue Operating Manual (ROM).

VII. Security Requirements

The Contractor shall comply with industry standards, applicable to Indian Health Service (IHS) Rules and Regulations, State and Federal Law, including but not limited to the OIG (Office of Inspector General) recommendations on compliance programs and HIPAA (Health Information Portability Accountability Act)

VIII. Government-Furnished Equipment (GFE)/Government-Furnished Information (GFI).

The Government does not anticipate a need for contractor furnished equipment.

IX. Place of Performance Services under this contract will be performed for:

Western Oregon Service Unit Chemawa Indian Health Center 3750 Chemawa Rd NE Salem, OR 97305-1198

All Accounts Receivable services are to be completed off-site, remotely with VPN network access by the contractor.

X. Period of Performance

The period of performance shall be from August 1, 2022 through December 31, 2022 (Start date is estimate or time of award). Services will not be provided on federally recognized holidays.

The general business hours of the Clinic are as follows:

Monday – Friday, 8 a.m. to 5 p.m.

The contractor shall work closely with Chemawa’s Business Office staff; As a result, contractor’s work hours should align with the clinic’s hours.

The contractor shall submit the work schedule one month in advance.

XI. Contracting Officer’s Representative (COR)

The following individual or their designee shall serve as the Project Officer/Supervisor government representative under this contract for the facilities listed:

Name: Judith Patterson (Adams), COR

Address: Western Oregon Service Unit Chemawa Indian Health Center 3750 Chemawa Rd NE Salem, OR 97305-1198

Phone: 503-304-7628 E-mail: X.X@ihs.gov

The COR’s responsibilities will be to coordinate with the contractor the technical aspects of this service and the review of performance hereunder. The COR does not have the authority to change or alter the order amount, terms or conditions, of the contract.

XII. Invoicing

Invoices shall be uploaded/submitted monthly to Invoice Processing Platform (IPP) for COR’s review and acceptance.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury's Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL).

The IPP website address is: https://www.ipp.gov

If you require IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov

The following information must be included on the invoice as a minimum:

• Purchase Order/Contract Number, Task order number (if applicable)

• Contractor’s Name and Address,

• Contractor’s Identification Number,

• Dates of service,

• Quantity of services, unit cost, and total amount due.

Invoices shall align with contractor’s submitted schedule.

Invoices shall be submitted only for services actually completed at time of invoice submission. Payment is also subject to the registration requirements in accordance with clause, 52.204-7 System Award Management (SAM).

XIII. Payment Schedule

1. The unit price awarded is the contract price for services and covers all related costs to provide required services. The unit price paid shall constitute full compensation for providing all services remotely which includes the following cost examples: applicable federal / state / local / sales / income taxes, travel, lodging, training, license requirements. The Service Wage Act applies to this contract.

2. Hourly rates: Payment for services received and approved shall be paid at an hourly rate calculated using the actual number of hours services are accepted by the Government (rounded to the nearest ¼ hour).

3. The Government is obligated only to the extent of authorized purchases actually made and received under this contract.