TOP_Q A_2_Oct_14.docx

1. REFERENCE: Exhibit A, CDRL A070. The CDRL requires the Contractor to “submit an annual report listing call/inquiry codes and hierarchies (if any) for inquiries received by the call center and/or customer service center, to include a data dictionary defining each code/category.”

Question 1: Does DHA have a common set of inquiry codes that they want the Contractor to report against?

Government Response: No, the government does not have a set of inquiry codes that they want the Contractor to report against.

Question 2: Does DHA want the inquiries made to the BSRs at the MTF TSCs to be included in this report? If so, will DHA allow for a tool to track this to be installed on the government-owned computers?

Government Response: The government does not want the inquiries made to the BSRs at the MTF TSCs to be included in this report. Therefore, there is no need to allow a tool to be installed on the government-owned computers.

2. REFERENCE: Section C.41.2. Section C.41.2 states, “This data includes, but is not limited to, data concerning the provider network, enrollment information, referrals, authorizations, claims processing, program administration, beneficiary and provider satisfaction and services, and incurred cost data.”

Question: Can DHA please specify the types of data that make up “program administration” and “incurred cost data” for the purposes of inclusion in a real time accessible system?

Government Response: Examples of the types of data that would be included in ‘program administration’ are as follows: (1) Travel costs to government meetings; (2) travel costs for site visits outside of the 3 year requirement for credentialing purposes; and (3) provider credentialing information. Examples of ‘incurred cost data’ are as follows: (1) Medical Evacuation data as outlined in CDRL M110; (2) transient care data as outlined in CDRL M310; and (3) any other cost data related to the Overseas Program that is not considered proprietary. Please note that these examples are not all inclusive.

3. REFERENCE: Sections C.12.12. and L.8.6. Section C.12.12. states, “The Contractor shall perform on-site verification during provider certification in the Philippines. The Government may expand this on-site verification requirement to other locations during the life of the contract.” Section L.8.6. states, “Any costs for administrative and support services associated with TRICARE beneficiaries who are not included in CLINs X001, X002, and X003 should be incorporated into the price proposed under CLIN X001.”

Question: Due to the fact that the Philippines Certification process is primarily driven by claims submitted by Standard beneficiaries and not Prime beneficiaries, can the contractor propose assumptions around the number of certifications anticipated and priced? Alternatively, will DHA consider creating a separate CLIN for pricing this effort?

Government Response: The contractors should use the data provided (Data File/Detail Level Claims Data) to make their assumptions regarding the number of certifications anticipated during the life of the contract. The government will not consider creating a separate CLIN for pricing this effort.