Revised_Copy_of_Round_3_Questions_and_Answers_for_TPC_24_May_2019.xlsx
XLSX spreadsheet 16 KB Posted
- Solicitation number
- FA805219RFI01
About this file
Revised Copy of Round 3 Questions_and_Answers_for_TPC_24_May_2019
View the file
Other files
| File | Type | Posted |
|---|---|---|
| MTF_TPC_PWS_3_Oct_19_v6.docx | DOCX document | |
| Round_3_Questions_and_Answers_for_TPC_23_May_2019.xlsx | XLSX spreadsheet | |
| Questions_and_Answers_for_TPC_07_May_2019.xlsx | XLSX spreadsheet | |
| MTF_TPC_PWS__Oct_18.docx | DOCX document |
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
Sheet1
REQUEST FOR INFORMATION: Third Party Collections (TPC)
RFI: FA805219RFI01
Final Questions and Answers
Date Received: 21 May 2019 Posted FBO: 24 May 2019 Questions: Answer:
| 1 | 1) Are all 89 positions currently filled at the locations indicated? | No. This is not an FTE-based contract. That number represents the maximum number of people the MTF could accommodate if the vendor chooses to place employees in the field. |
| 2 | 2) Since some of these locations are remote duty assignments, do they get the employees from the very few military spouses; or from the local community? | The vendor can use employees that meet requirements described in the PWS. |
| 3 | 3) What is the current structure; i.e. firm-fixed-price LOE, cost-reimbursement, etc.? | Collection fee based on a percentage of total collections per Region, per MTF. Firm-Fixed-Price type. |
4 Page 3, Section 2.1; and Page 4, Section 2.3: The Contractor shall be paid a negotiated percentage of each dollar collected from third party payers and from the balance-billing of non-beneficiaries that is posted prior to the 151st calendar day after the date of delinquency.
Q: To clarify, does this mean at 181 days (150+30+1) after the placement date?
Q: What happens if the claim is paid after 181 days after the placement date?
a: Does the payment get sent back?
b: Does contractor post the payment but not get paid for collecting the payment?
c: What report would be used to identify payments for which the contractor would receive the negotiated percentage?
d. Complex denial management often requires more than 180 days to complete. What is the incentive to pursue denials management efforts when the payments would be made after the negotiated percentage would no longer be paid to the contractor?
Q1. YES Q2. A. NO B. NO C. Batch Report Summary D. High Dollar claims may be pursued longer with notification and concurrence of COR
5 Page 4, Section 2.2: The Contractor shall provide the MTF with all written documentation received on claims by scanning all hard-copy documents into PDF format and uploading those documents to the GBS.
Q: Where in the GBS?
Q: Will the contractor be receiving documentation from the insurance co via mail or lockbox?
Q1. Ledger posting/EOB-ERA Maintenance Q2. Via Armed Forces Billing and Collection Utilization Solution (ABACUS), which is the Government Billing Solution (GBS)/Recovery/EDI/
6 Page 4, Section 2.2: All encounter data that does not automatically flow to the GBS, contractor will contact the MTF to seek correct billing codes from civilian, military or contracted employee Q: Is there a standard report provided to determine which encounters did not flow over to the GBS?
Q: Or are there standard types of encounters that do not flow over to GBS?
7 Page 7, Section 2.4.5.2: For non-beneficiaries with OHI, the Contractor shall pursue all payments due from third party payers and the patient up to 150 calendar days after the date of delinquency. However, prior to the 151st calendar day of delinquency, the Contractor shall write off all claims that have not been paid in full, IAW Section 2.3.
Q: For non-beneficiaries, the balance at 151st calendar day of delinquency is confusing. Non-beneficiary patients are billed at 31 days (delinquent letter series starts). So if they do not pay the bill (or insurance doesn’t pay), then does this mean at 151 days the bill is written off?
Q: Doesn’t the debt go to CSNG for debt collection and it is not written off?
Q1. NO. Disregard statement. Changes will be made to delete the last sentence in section 2.4.5.2. Q2. YES. that is correct for non-beneficiaries with OHI.
8 Page 8, 2.4.7.2 : The Contractor shall then discern the account information associated with the EOB, annotate that account information or patient identification information on the EOB, and post payments and/or valid write- offs in the GBS within 48 hours of receipt or by close of business (COB) the next business day.
Q: Please clarify, in the same paragraph, it states when the posting of a batch is started, it must be completed the same business day. However, the requirement above states 48 hours will be allowed.
Q1. If within 48 hours of receipt the posting of the batch has started, then it must be completed the same business day.
9 Page 8, Section 2.4.7.5: The Contractor shall verify refund requests are valid and process the draft refund transaction in the GBS within 30 days of notification of cancelled coverage or receipt of the refund request.
Q: Would the government please clarify “notification” and “receipt of the refund request”, does this mean MTF notification or receipt, or notification and or receipt at Government approved location? Requesting clarification of when the 30 days limitation begins, when MTF receives request or when contractor receives request.
Q1. It begins when the contractor receives notification either first hand or from the government.
10 Page 8, 2.4.7.2: Invalid denials shall not be posted in the GBS.
Q: The GBS allows denials to be posted without closing the account. Even with this option, would invalid denials not be posted in the GBS when received in bulk EOBs?
Q1. NO. Disregard statement. PWS will be corrected to delete the statement.
11 Page 15, Section 4.2: It is important to note that remote access to an MTF’s GBS database requires additional approval and is handled on an individual basis by the Defense Health Clinical Systems, an organization unaffiliated with this contract. As such, no more than eight (8) contract employees per region will be provided remote GBS access.
Q: Please clarify, does this mean only 8 users per region for users in the HUB (Government approved location outside of the MTF),
– Or, does this mean 8 users per region for users who sit at the MTF? Q1. Disregard statement. PWS will be corrected to delete the last two sentences of section 4.2.
12 Page 15, Section 4.2: no more than eight (8) contract employees per region will be provided remote GBS access.
Q: Please clarify, only 8 or less employees per region are allowed access to the GBS? Is the GBS referred to in this section CHCS or ABACUS?
Q1. Disregard statement. PWS will be corrected to delete the last two sentences of section 4.2.
13 Page 16, Section 5.2: Two (2) sets of FD-258, FBI Fingerprint Cards for each contract employee.
Q: Are digital fingerprints accepted in lieu of the paper cards?
Q1. Only digital are accepted.
14 NOTE: All Service MTFs, central billing locations, and medical cost recovery program regions will use ABACUS. ABACUS replaced the Third Party Outpatient Collection System (TPOCS), Composite Healthcare System (CHCS) inpatient billing module, and CHCS Medical Services Account modules, previously used in the MHS.
Sheet2
Sheet3
File details come from the government source that posted it.