Exhibit 2 -Financial Spread Sheet.xlsx
XLSX spreadsheet 45 KB Posted
- Attached to
- Accounts Receivable Services Federal contract opportunity
- Solicitation number
- 75H71324Q00040
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
| File | Type | Posted |
|---|---|---|
| Attachment 1 - Draft Statement of Work.docx | DOCX document | |
| Attachment 2 - IHS-IEE-Representation-Form_Jan-2022.pdf | ||
| Exhibit 4- Batch document example (PI-02032021-3)_Redacted.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 | $ 127,396.16 | VAF | $ 654.00 | ||||||||
| PI | $ 1,473.49 | ERROR:#N/A | $ 8,043.80 | ERROR:#N/A | ERROR:#N/A | ERROR:#N/A | |||||
| MCR | $ 1,029.65 | EOB | $ 1,448.17 | ||||||||
| TOTAL | $ 140,045.27 | <------ | -----------> | $ 140,045.27 | DEPOSIT | BATCH | |||||
| Date | Check Amount | ABA/RT | Account Num | Check Num | Remitter Name | TYPE | MATCH INDEX | AR ACCOUNT INDEX | TICKET | NAME | POSTED |
| 1/2/24 | 18.09 | B330567651 | 42000013 | 9200311613 | MEDIMPACT | ERROR:#N/A | B33056765142000013 | ERROR:#N/A | 652664 | ||
| 1/2/24 | 19.10 | 2260076803 | 42000013 | 444444440792473 | PRIME THERAPEUTI | EOB | 226007680342000013 | PRIME THERAPEUTICS BCTX | 652664 | ||
| 1/2/24 | 117.00 | 1930238155 | 323070380 | 261174939 | REGENCE BCBSO - | PI | 1930238155323070380 | REGENCE OF OREGON FEDERAL | 652664 | ||
| 1/2/24 | 145.89 | 4330441200 | 91000019 | 121000243258580 | OPTUMRX | ERROR:#N/A | 433044120091000019 | ERROR:#N/A | 652664 | ||
| 1/2/24 | 186.76 | 6930238155 | 111000025 | 154981222 | REGENCE BCBCO | PI | 6930238155111000025 | BC BS OF OREGON | 652664 | ||
| 1/2/24 | 189.14 | 1930951989 | 41001039 | 27914187 | SAMARITAN CHOICE | PI | 193095198941001039 | SAMARITAN CHOICE PLANS | 652664 | ||
| 1/2/24 | 553.28 | B330567651 | 42000013 | 9200311010 | MEDIMPACT | ERROR:#N/A | B33056765142000013 | ERROR:#N/A | 652664 | ||
| 1/2/24 | 676.81 | B330567651 | 42000013 | 9200310747 | MEDIMPACT | ERROR:#N/A | B33056765142000013 | ERROR:#N/A | 652664 | ||
| 1/2/24 | 1,429.07 | 1260076803 | 42000013 | 555555550495709 | PRIME THERAPEUTI | EOB | 126007680342000013 | PRIME THERAPEUTICS | 652664 | ||
| 1/2/24 | 6,649.73 | 4330441200 | 91000019 | 121000243281943 | OPTUMRX | ERROR:#N/A | 433044120091000019 | ERROR:#N/A | 652664 | ||
| 1/2/24 | 654.00 | 9101036151 | 101036151 | VAFA TREAS 310 | VAF | 9101036151101036151 | VA MEDICAL BENEFIT (VMBP) | 652664 | |||
| 1/2/24 | $22.00 | 101000187 | 145592435591 | 104922299 | GEHA | PI | 101000187145592435591 | GEHA | 830752 | ||
| 1/2/24 | $1,029.65 | 71000288 | 22985798 | 1290018 | NAVITUS HEALTH SOLUTIONS | MCR | 7100028822985798 | D-NAVITUS 610602 | 830752 | ||
| 1/2/24 | $268.80 | 31100209 | 40008488 | 31689790 | CIGNA DENTAL | PI | 3110020940008488 | CIGNA DENTAL | 830752 | ||
| 1/2/24 | $602.00 | 31100209 | 38876534 | 1000873399 | KAISER PERMANENTE | PI | 3110020938876534 | KAISER CLAIMS | 830752 | ||
| 1/3/24 | 52,439.74 | 9300A10020 | 41001039 | 600176737 | OR DHS HP MMIS | MCD | 9300A1002041001039 | OREGON MEDICAID | 653433 | ||
| 1/3/24 | 74,956.42 | 9300A10020 | 41001039 | 600176343 | OR DHS HP MMIS | MCD | 9300A1002041001039 | OREGON MEDICAID | 653433 | ||
| 1/3/24 | 14.95 | 1362739571 | 124384877 | 91006028345 | AARP SUPPLEMENTA | PI | 1362739571124384877 | AARP GROUP HEALTH | 653433 | ||
| 1/3/24 | 36.42 | 9000004108 | 81000605 | 105314127 | GEHA | PI | 900000410881000605 | GEHA | 653433 | ||
| 1/3/24 | 36.42 | 9000004108 | 81000605 | 105314128 | GEHA | PI | 900000410881000605 | GEHA | 653433 |
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