CSP018879_LDC016_Contract_Rev.pdf
PDF 124 KB Posted
- Attached to
- Competitive Selection OH|CSP018879
- Contract number
- CSP018879
- Issued by
- Ohio
About this file
This document is a Mandatory Use Contract issued by the State of Ohio's Department of Administrative Services (DAS), General Services Division, for Claims Processing Management. The contract (CSP018879) is awarded to CorrectCare – Integrated Health, located in Lexington, Kentucky, and is available to the Ohio Department of Rehabilitation and Correction and the Department of Youth Services. The contract was awarded following a Request for Proposal (RFP No. SRC0000011937) that was opened on 09/27/23 and has an effective period from 01/01/24 to 06/30/26.
The contract establishes a per-claim processing fee of $17.00 for offenders, which will only be charged for claims that have been processed. The scope involves claims processing management, with specific technical requirements including electronic data interchange (EDI) claim submissions, secure file transfer protocol (SFTP) data exchanges, and patient eligibility verification. The contractor is required to maintain professional liability insurance with limits of $3,000,000 per occurrence and $5,000,000 aggregate. Payment terms are set at Net 30, and the state makes no guarantee of purchase volume. The contract includes provisions for claims submission, data handling, and processing without requiring utilization management, with all payment vouchers to be issued through the Ohio Administrative Knowledge System (OAKS).
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| File | Type | Posted |
|---|---|---|
| CSP018879_LDC016_A1.pdf |
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Text version
Index No.: LDC016
Eff. Date: 01/01/24
STATE OF OHIO
DEPARTMENT OF ADMINISTRATIVE SERVICES
GENERAL SERVICES DIVISION
OFFICE OF PROCUREMENT SERVICES
4200 SURFACE ROAD, COLUMBUS, OH 43228-1395
MANDATORY USE CONTRACT FOR: CLAIMS PROCESSING MANAGEMENT
CONTRACT NUMBER: CSP018879 EFFECTIVE DATES: 01/01/24 TO 06/30/26
The Department of Administrative Services has accepted Proposals submitted in response to Request for Proposal (RFP) No.
SRC0000011937 that opened on 09/27/23. The evaluation of the Proposal responses has been completed. The Offeror listed herein has been determined to be the highest ranking Offeror and has been awarded a Contract for the services listed. The respective Proposal response including, Contract Terms & Conditions, any Proposal amendment, special Contract Terms & Conditions, specifications, pricing schedules and any attachments incorporated by reference and accepted by DAS become a part of this Services Contract.
This Requirements Contract is effective beginning and ending on the dates noted above unless, prior to the expiration date, the Contract is renewed, terminated, or cancelled in accordance with the Contract Terms and Conditions.
This Requirements Contract is available to the Department of Rehabilitation and Correction and the Department of Youth Services as applicable.
The agency is eligible to make purchases of the contracted services in any amount and at any time as determined by the agency. The State makes no representation or guarantee that department will purchase the volume of services as advertised in the Request for Proposal.
This Requirements Contract and any Amendments thereto are available from the DAS Web site at the following address:
https://procure.ohio.gov/
MUTUALLY AGREED UPON CLARIFICATIONS / MODIFICATIONS
1.) All Providers will send applicable patient claims directly to CorrectCare Integrated Health (CCIH) either via an EDI
Clearinghouse or via the United States Postal Service.
2.) For Adult information, Ohio extracts the required minimal set of patient data from its OMS system and then CCIH securely picks up the file from Ohio’s SFTP server in the DMZ. CCIH then ingests and uses the data to determine a patient's eligibility for care.
3.) When submitting INF02 files for claims payments, CCIH will post the files to an SFTP server located in OMB’s DMZ.
When picking up INF03 files for payment receipts, CCIH will pick up the applicable file(s) from an SFTP located in OMB’s DMZ and then ingest this information into its claims processing system.
4.) Utilization Management is not required by CCIH for this RFP. Additionally, the State of Ohio will issue all payment vouchers though the Ohio Administrative Knowledge System (OAKS). The State will not be funding a Claims Payment Bank Account for the benefit of ODRC/DYS.
5.) Professional Liability (Errors and Omissions) Insurance appropriate to the Contractor’s profession, with limits not less than $3,000,000 per occurrence or claim, $5,000,000 aggregate.
COST SUMMARY FORM
Claims Processing Management
CSP018879
UNSPSC CATEGORY CODE: 84131608
Description
Price Per
Offender Claim Processing Fee $ 17.00 / Claim
The fee shall only be charged for offenders where claims have been processed.
All costs must be in U.S. Dollars.
The State will not be responsible for any costs not identified.
There will be no additional reimbursement for travel or other related expenses.
Eff. Date: 01/16/24
CONTRACTOR INDEX
CONTRACTOR AND TERMS: BID CONTRACT NO.: CSP018879
0000057673 CorrectCare – Integrated Health DELIVERY: As Specified 1218 S. Broadway, Suite 250 Lexington, KY 40504 TERMS: Net 30
CONTRACTOR'S CONTACT: Jeff Lytle *Telephone: (859) 225 – 7999 ext. 411166 Fax: (859) 226 - 0554
E-Mail: jlytle@correctcare.com
* Indicates updated Contractor contact information.
mailto:jlytle@correctcare.com
Eff. Date: 01/16/24
SUMMARY OF AMENDMENTS
Amendment Number
Effective Date Description
1 01/16/24 This amendment is issued to update the Contractor’s contact information and to add the Summary of Amendments page.
| CONTRACT FOR: CLAIMS PROCESSING MANAGEMENT |
| CONTRACTOR INDEX |
| SUMMARY OF AMENDMENTS |
File details come from the government source that posted it. Updated .