Exhibit 2 -Financial Spread Sheet.xlsx

XLSX spreadsheet 45 KB Posted

Attached to
Accounts Receivable Services Federal contract opportunity
Solicitation number
75H71324Q00040
Issued by
Department of Health and Human Services Indian Health Service

About this file

This document contains a financial spreadsheet and a federal contract opportunity notice. The financial spreadsheet lists deposit batch data including check amounts, account numbers, and remitter names. The related federal contract opportunity is a sources sought notice from the Department of Health and Human Services Indian Health Service seeking responsible vendors to provide accounts receivable services to Chemawa Indian Health Center. Interested parties must be registered in SAM.gov and complete an ORCA application. Capability statements should include business identification information and a demonstration of the ability to provide the required accounts receivable services. The estimated five-year contract performance period begins in fiscal year 2024. Responses are due by email to the listed point of contact.

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Other files for this federal contract opportunity

Other files attached to Accounts Receivable Services, newest first.
File Type Posted
Attachment 1 - Draft Statement of Work.docx DOCX document
Attachment 2 - IHS-IEE-Representation-Form_Jan-2022.pdf PDF
Exhibit 4- Batch document example (PI-02032021-3)_Redacted.pdf PDF
Exhibit 1 - Insurance Websites.xlsx XLSX spreadsheet
Exhibit 3 - File for low pmt.docx DOCX document

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Text version

Sheet1

MCD$ 127,396.16VAF$ 654.00
PI$ 1,473.49ERROR:#N/A$ 8,043.80ERROR:#N/AERROR:#N/AERROR:#N/A
MCR$ 1,029.65EOB$ 1,448.17
TOTAL$ 140,045.27<----------------->$ 140,045.27DEPOSITBATCH
DateCheck AmountABA/RTAccount NumCheck NumRemitter NameTYPEMATCH INDEXAR ACCOUNT INDEXTICKETNAMEPOSTED
1/2/2418.09B330567651420000139200311613MEDIMPACTERROR:#N/AB33056765142000013ERROR:#N/A652664
1/2/2419.10226007680342000013444444440792473PRIME THERAPEUTIEOB226007680342000013PRIME THERAPEUTICS BCTX652664
1/2/24117.001930238155323070380261174939REGENCE BCBSO -PI1930238155323070380REGENCE OF OREGON FEDERAL652664
1/2/24145.89433044120091000019121000243258580OPTUMRXERROR:#N/A433044120091000019ERROR:#N/A652664
1/2/24186.766930238155111000025154981222REGENCE BCBCOPI6930238155111000025BC BS OF OREGON652664
1/2/24189.1419309519894100103927914187SAMARITAN CHOICEPI193095198941001039SAMARITAN CHOICE PLANS652664
1/2/24553.28B330567651420000139200311010MEDIMPACTERROR:#N/AB33056765142000013ERROR:#N/A652664
1/2/24676.81B330567651420000139200310747MEDIMPACTERROR:#N/AB33056765142000013ERROR:#N/A652664
1/2/241,429.07126007680342000013555555550495709PRIME THERAPEUTIEOB126007680342000013PRIME THERAPEUTICS652664
1/2/246,649.73433044120091000019121000243281943OPTUMRXERROR:#N/A433044120091000019ERROR:#N/A652664
1/2/24654.009101036151101036151VAFA TREAS 310VAF9101036151101036151VA MEDICAL BENEFIT (VMBP)652664
1/2/24$22.00101000187145592435591104922299GEHAPI101000187145592435591GEHA830752
1/2/24$1,029.6571000288229857981290018NAVITUS HEALTH SOLUTIONSMCR7100028822985798D-NAVITUS 610602830752
1/2/24$268.80311002094000848831689790CIGNA DENTALPI3110020940008488CIGNA DENTAL830752
1/2/24$602.0031100209388765341000873399KAISER PERMANENTEPI3110020938876534KAISER CLAIMS830752
1/3/2452,439.749300A1002041001039600176737OR DHS HP MMISMCD9300A1002041001039OREGON MEDICAID653433
1/3/2474,956.429300A1002041001039600176343OR DHS HP MMISMCD9300A1002041001039OREGON MEDICAID653433
1/3/2414.95136273957112438487791006028345AARP SUPPLEMENTAPI1362739571124384877AARP GROUP HEALTH653433
1/3/2436.42900000410881000605105314127GEHAPI900000410881000605GEHA653433
1/3/2436.42900000410881000605105314128GEHAPI900000410881000605GEHA653433

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