Exhibit_L_-_Medical_Discount_Pricing_File_(3_TABS_TO_COMPLETE,_DO_NOT_SUBMIT)_FINAL.xlsx
XLSX spreadsheet 46 KB Posted
- Solicitation number
- 25-P-115TF
- Issued by
- Volusia County, Florida
About this file
Exhibit L is a comprehensive medical discount pricing file for Volusia County Government's self-funded group health plan administrative services contract, covering medical claims re-pricing for facility, ancillary, and professional services from January 1, 2024, to December 31, 2024. The Request for Proposals (RFP) seeks a contractor to provide administrative services only (ASO) for the county's health plan, which includes benefits for employees, retirees, and COBRA participants. The contract term is initially five years with a potential subsequent five-year renewal, contingent on mutual agreement and county council approval, with an intended effective date of January 1, 2027.
The pricing file details medical service categories with 100% discount rates across multiple healthcare facilities, including inpatient, emergency room, outpatient, and urgent care services from providers like AdventHealth and Orlando Health. The total billed amount for these services is $57,780,293, with ancillary services (radiology, laboratory, durable medical equipment) totaling $6,782,836 and professional services amounting to $14,548,822. All service categories show a consistent 100% discount rate, and the document is marked as confidential with instructions not to submit the pricing information with the proposal. The county intends to award a single contract to the most suitable respondent, covering comprehensive health plan administrative services.
View the file
Other files
Show all 20
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Facility Health Plan Administrative Services
| Facility Services |
| Incurred: 01/01/2024 - 12/31/2024 |
| Paid: 01/01/2024 - 02/28/2025 |
MEDICAL CLAIMS RE-PRICING - CONFIDENTIAL - DO NOT SUBMIT THIS INFORMATION WITH YOUR PROPOSAL
FACILITY PRICING
| Inpatient | Inpatient | |||
| Facility | Billed Amount | Admits | Allowed Amount | Discount % |
| ADVENTHEALTH DAYTONA BCH | $4,369,379 | 119 | 100% | |
| ADVENTHEALTH ORLANDO | $2,948,491 | 46 | 100% | |
| ORLANDO HLTH INC | $2,448,630 | 40 | 100% | |
| HCA FL LK MONROE HSP | $1,891,906 | 10 | 100% | |
| ADVENTHEALTH FISH MEML | $1,853,715 | 40 | 100% |
| All Others | $7,114,607 | 130 | 100% | |
| Total Facility Inpatient | $20,626,729 | 385 | $0 | 100% |
| Emergency Room | ER | |||
| Facility | ER Billed Amount | ER Visits | Allowed Amount | Discount % |
| ADVENTHEALTH DAYTONA BCH | $3,413,883 | 487 | 100% | |
| ADVENTHEALTH DELAND | $1,742,518 | 222 | 100% | |
| ADVENTHEALTH FISH MEML | $1,690,557 | 229 | 100% | |
| HALIFAX MED CTR | $1,271,872 | 158 | 100% | |
| ADVENTHEALTH NEW SMYRNA | $767,344 | 99 | 100% |
| All Others | $2,720,435 | 446 | 100% | |
| Total | $11,606,609 | 1,641 | $0 | 100% |
| Outpatient | Outpatient | |||
| Facility | Outpatient Billed Amount | Outpatient Visits | Allowed Amount | Discount % |
| ADVENTHEALTH DAYTONA BCH | $2,638,455 | 604 | 100% | |
| ADVENTHEALTH DELAND | $2,230,357 | 757 | 100% | |
| ADVENTHEALTH NEW SMYRNA | $1,590,987 | 348 | 100% | |
| ADVENTHEALTH FISH MEML | $983,250 | 273 | 100% | |
| ADVENTHEALTH ORLANDO | $784,396 | 126 | 100% |
| All Others | $16,563,583 | 5,187 | 100% | |
| Total | $24,791,027 | 7,295 | $0 | 100% |
| Urgent Care | Urgent Care | |||
| Facility | Billed Amount | Visits | Allowed Amount | Discount % |
| All Urgent Care Facilities | $755,927 | 2,283 | 100% | |
| Total | $755,927 | 2,283 | $0 | 100% |
| Total Billed Amount | $57,780,293 | Please transfer your Company's aggregate allowed amount and tabulated average discount to Exhibit B, Section 8, Item 2. |
| Total Allowed Amount | $0 | |
| Average Discount | 100.00% |
&"Arial,Bold"25-P-115TF &"Arial,Bold"Exhibit L - Medical Discount Pricing File (Facility)
&"Arial,Regular"Page &P of &N
Ancillary Health Plan Administrative Services
| Ancillary |
| Incurred: 01/01/2024 - 12/31/2024 |
| Paid: 01/01/2024 - 02/28/2025 |
MEDICAL CLAIMS RE-PRICING - CONFIDENTIAL - DO NOT SUBMIT THIS INFORMATION WITH YOUR PROPOSAL
ANCILLARY PRICING
Ancillary Type Billed Amount Visits Allowed Amount Discount %
| Radiology | Radiology | |||
| All Radiology | $991,676 | 3,326 | 100% |
| Laboratory | Laboratory | |||
| All Laboratory | $5,439,822 | 8,138 | 100% |
| Durable Medical Equipment | Durable Medical Equipment | |||
| All DME | $351,339 | 915 | 100% |
| Total Billed Amount | $6,782,836 | Please transfer your Company's aggregate allowed amount and tabulated average discount to Exhibit B, Section 8, Item 2. |
| Total Allowed Amount | $0 | |
| Average Discount | 100.00% |
&"Arial,Bold"25-P-115TF &"Arial,Bold"Exhibit L - Medical Discount Pricing File (Ancillary)
&"Arial,Regular"Page &P of &N
Professional Health Plan Administrative Services
| Professional Services |
| Incurred: 01/01/2024 - 12/31/2024 |
| Paid: 01/01/2024 - 02/28/2025 |
MEDICAL CLAIMS RE-PRICING - CONFIDENTIAL - DO NOT SUBMIT THIS INFORMATION WITH YOUR PROPOSAL
PROFESSIONAL PRICING
| Primary Care & Specialist | PCP & Specialist | |||
| Physicians | Billed Amount | Visits | Allowed Amount | Discount % |
| Primary Care Office Visits | $1,975,485 | 6,597 | 100% | |
| Specialty Care Office Visits | $9,500,378 | 16,490 | 100% |
Subtotal Primary Care & Specialist $11,475,864 23,087 $0 100%
| Ancillary Professional | Ancillary Professional | |||
| Ancillary Professional Type | Billed Amount | Visits | Allowed Amount | Discount % |
| Anesthesiology | $408,025 | 210 | 100% | |
| Emergency Medicine | $2,316,731 | 1,549 | 100% | |
| Pathology | $348,203 | 832 | 100% |
Subtotal Ancillary Professional $3,072,959 2,591 $0 100%
| Total Billed Amount | $14,548,822 | Please transfer your Company's aggregate allowed amount and tabulated average discount to Exhibit B, Section 8, Item 2. |
| Total Allowed Amount | $0 | |
| Average Discount | 100.00% |
&"Arial,Bold"25-P-115TF &"Arial,Bold"Exhibit L - Medical Discount Pricing File (Professional)
&"Arial,Bold"Page &P of &N
File details come from the government source that posted it. Updated .