2_TCRS_Section_B_CLIN_Descriptions_11-4-2016.pdf

SECTION B, SUPPLIES OR SERVICES AND PRICES/COSTS

CONTRACT LINE ITEM NUMBER (CLIN) DESCRIPTIONS

TCRS HT9402-17-R-0002, Section B

TRICARE Claims Review Services (TCRS) Contract Line Item Number (CLIN) Descriptions

CLIN DESCRIPTION:

0001 Transition-In. (Section C, paragraph 6.3.1). This CLIN establishes a firm-fixed-price

(FFP) in whole dollars with no cents for transition-in tasks. This amount shall include all costs and profit anticipated in the performance of transition-in tasks to accomplish the requirements in the contract, including review testing, security, (Physical, Personnel and NIST) certifications and shall not include any costs associated with any other CLIN. Unit of issue: Lot (LO)

0002 Deliverables (DD Forms 1423-1, Contract Data Requirements List (CDRLS)) Not separately priced (NSP). Unit of issue: Lot (LO)

Managed Care Support Contracts (MCSCs) Quarterly Compliance Reviews.

(Section C, paragraph, 6.4) This CLIN establishes a fixed price in whole dollars, with no cents, per each claim reviewed per quarterly MCSC compliance review completed.

The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Estimated number of claims reviewed per quarter is 4,800 or 19,200 per option period. Unit of issue: Each (EA).

TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC) Quarterly Compliance Reviews (Section C, paragraph 6.4) This CLIN establishes a fixed price in whole dollars, with no cents, per each claim reviewed per quarterly TDEFIC compliance review completed. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Estimated number of claims reviewed per quarter is 2,200 or 8,800 per option period. Unit of issue: Each (EA)

TRICARE Overseas Program (TOP) Quarterly Compliance Reviews (Section C, paragraph 6.4) This CLIN establishes a fixed price in whole dollars, with no cents, per each claim reviewed per quarterly TOP compliance review completed The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Estimated number of claims reviewed per quarter is 1,875 or 7,500 per option period. Unit of issue: Each (EA)

TRICARE Pharmacy Program (TPharm) Quarterly Compliance Reviews (Section C, paragraph 6.4). This CLIN establishes a fixed price in whole dollars, with no cents, per each claim reviewed per quarterly compliance review completed for the TPharm contract. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Estimated claim volume per quarter is 2,800 or 11,200 per option period. Unit of issue: Each (EA)

Active Duty Dental Program (ADDP) Semiannual Compliance Reviews. (Section C, paragraph 6.4.2). This CLIN establishes a fixed price in whole dollars, with no cents, per each claim reviewed per semiannual compliance review completed for the ADDP contract. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Estimated claim volume per semiannual review is 1,250 or 2,500 per option period. Unit of issue: Each (EA)

MCSCs Annual Health Care Cost Audits. (Section C, paragraph 6.4.2.1). This CLIN establishes a fixed price in whole dollars, with no cents, per each claim reviewed per annual MCSC review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Estimated claim volumes per MCSC annual review is between 5,000 to 7,500 or 10,000 to 15,000 per

SECTION B, SUPPLIES OR SERVICES AND PRICES/COSTS

CONTRACT LINE ITEM NUMBER (CLIN) DESCRIPTIONS

TCRS HT9402-17-R-0002, Section B

CLIN DESCRIPTION:

option period. Unit of issue: Each (EA)

Focus Studies. (Section C, paragraph 6.5.1). This CLIN establishes a fix price in whole dollars, with no cents, per claim reviewed per focused study. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Individual task order (See Section G). Estimated six studies per year. Estimated claim volume per study will vary. However, the estimated claim volume per focus study is 2,500 or 15,000 per option year. Unit of issue: Each

(EA)

Medical Record Reviews. (Section C, paragraph 6.5.2) This CLIN establishes a fixed price in whole dollars, with no cents, per medical record review. The contractor shall furnish all necessary labor and materials to perform the services to meet the requirements in the contract. Individual task order (See Section G). Estimated record volume per medical record review will very. However, the estimated record volume per medical record review is 6,000 or 36,000 records per option period. Unit of issue:

Each (EA)

Transition-out. (Section C, paragraph 6.3.2). This CLIN establishes a FFP in whole dollars, with no cents, for transition-out for all necessary labor and materials to perform the services to meet the requirements in the contract. Although priced for each option period, transition-out shall occur only once during the life of the contract. The transition-out period will run concurrently with the last exercised option period of the contract. Unit of issue: Lot (LO)

Deliverables. (DD Forms 1423-1, CDRLS) Not separately priced (NSP). Unit of issue:

Lot (LO)