MARKET RESEARCH QUESTIONNAIRE_.pdf

U.S. Department of Justice Federal Bureau of Prisons

Administration Division

Field Acquisition Office 346 Marine Forces Drive

Grand Prairie, Texas 75051

MARKET RESEARCH QUESTIONNAIRE

MEDICAL BILLING ADJUDICATOR SERVICES

FEDERAL CORRECTIONAL COMPLEX (FCC) BUTNER, NORTH CAROLINA

The Federal Bureau of Prisons (FBOP) is conducting market research in compliance with Federal Acquisition Regulation, Part 10. The service is for the provision of Medical Billing Adjudicator services.

The services will be provided at the Federal Correctional Complex (hereinafter referred to as FCC) Butner, North Carolina. The physical address is 3000 Old 75 Hwy, Butner, NC 27509. The contract year shall consist of a 12 month base year with four 12 month option years for renewal. The Government contemplates awarding an indefinite-delivery/ requirements type contract with firm fixed unit prices. The estimated quantity for the base year and each option year is 1,440 sessions. The NAICS Code is 561320.

The size standard is $30 million.

A draft copy of the Statement of Work is attached to this questionnaire. Additional details is forthcoming in the solicitation. A Government solicitation document to provide these services is being developed, and a BPA may or may not result. Market research is being conducted to determine interest and capability of potential sources for this requirement. The information gathered from the market research will be vital in the formation and set aside status of the solicitation. All information submitted in response to this announcement is voluntary the Government will not pay for information requested nor will it compensate any respondent for any cost incurred in developing information provided to the Government.

Please answer the following questions:

1. The North American Industrial Classification System (NAICS) code for Temporary Help

Services is 561320, which sets the small business size standard at $30 million (below $30 million in gross revenues is considered small, above $30 million in gross revenues is considered large).

Based on this standard, what is your business size, small or other than small (large)?

Small Other than Small

2. Is your business or employee certified to practice in the state of North Carolina?

Yes No

3. Can your firm provide the service as either a prime contractor or as a subcontractor?

Prime Subcontractor

4. If you are a small business, what level of subcontracting, if any, would your firm utilize? Services (except construction) require at least 50 percent of the cost of contract performance incurred for personnel shall be expended for employees of the concern.

5. Which type of form does your business use to report earned income on the individual performing the services?

W2 1099

6. Is your firm eligible for participation in one of the following small business programs? If so, please indicate the program.

8(a) Program HUBZone Certified Business Women-Owned Small Business Service-Disabled Veteran-Owned Small Business

7. Can your firm provide firm fixed unit prices for future contract years (for example: a contract consist of a 12 month base year with four 12 month option years, equaling a total of five years)?

Please indicate the maximum number of years you can provide firm-fixed unit prices.

5 years 4 years 3 years 2 years 1 year only

8. The Federal Acquisition Regulations requires the following insurances policies: Workers’

Compensation and Employer’s liability not less than $100,000; and General Liability no less than $500,000 per occurrence; and Automobile Liability of at least $200,000 person, $500,000 per occurrence for bodily injury, and $20,000 per occurrence for property damage. Are these rates and requirements consistent with regulatory requirements in North Carolina?

Yes No If no, what are the standard rates per insurance?

9. **Are privacy provisions/clauses “customarily” included in solicitations of this type of requirement?

10. **Are Medical Billing Adjudicator services “customarily available” in commercial practice/marketplace?

11. Does your firm have access to the internet to download solicitation materials?

12. How many calendar days does your firm need to prepare a proposal resulting from this solicitation?

7 days 10 days 15 days 30 days

13. Is your firm able to provide the personnel, furnish all equipment, tests and anything else needed to conduct the Medical Billing Adjudicator services?

14. Is your company registered in System for Award Management (SAM)?

Yes No DUNS

All potential offerors are advised if a solicitation is issued it will include the clause at FAR 52.212-4 Commercial Items, paragraph (t) SAM. This clause requires all contractors doing business with the Federal Government after September 30, 2003, to be registered in the SAM database. If your company is not registered in SAM, registration can be completed at https://www.sam.gov.

15. If awarded a contract, how many calendar days following an award would it take your firm to begin providing services to the institution?

Please note that all individuals providing services at the institutions must undergo a security clearance investigation. This investigation may take 30 calendar days or longer to complete.

Calendar days

16. Does your firm have qualified employees with experience in a correctional setting?

17. Which of the following best describes your organization?

Non-Profit Faith-Based Corporation LLC

18. Please indicate any General Services Administration Federal Supply Schedule (FSS) contract number(s) your firm has been awarded in association with the aforementioned services and their respective expiration date(s).

FSS number(s): Expiration date(s):

19. Please furnish the following information in reference to your firm:

Name:

Address:

Point of Contact:

Telephone Number:

E-mail Address:

I am extremely appreciative of the time you have taken to complete this questionnaire. Please submit your market research questionnaire to llwheeler@bop.gov in pdf format no later than Thursday, January 28, 2021, at 10:00 a.m. Central Time (CT). Please feel free to contact me at

(972) 352-4536 if you have any questions.

https://www.sam.gov/ mailto:llwheeler@bop.gov

Sincerely, LaQueta Wheeler

LaQueta Wheeler, Contracting Officer Federal Bureau of Prisons U.S. Armed Forces Reserve Institution Field Acquisition Office 346 Marine Forces Drive Grand Prairie, TX 75051

NOTE: The resulting solicitation will be distributed solely through Beta.Sam.gov. Hard copies of the solicitation will not be available. The website provides downloading instructions to obtain all documents relating to the solicitation. All future information concerning this acquisition, including the pre-solicitation notices, solicitation, and any subsequent amendments, will be distributed solely through the website. Interested parties are responsible for monitoring the website to ensure they have the most up-to-date information about the acquisition.

Federal Bureau of Prisons Medical Billing Adjudication Services

Statement of Work

SUBJECT: The contractor will provide medical billing, coding review, and verification of medical invoices received at the Federal Correctional Complex, hereinafter referred to as the FCC, located in Butner, North Carolina.

PLACE OF PERFORMANCE: Medical Administration Offices, Federal Medical Center (FMC), Old NC Highway 75, Butner, NC 27509.

PERIOD OF PERFORMANCE: The resulting contract will be for a base and 4 year contract.

SCHEDULE: The work schedule will normally consist of 30 sessions per week, with a session being defined as one-hour in length. Although the exact times of performance will be decided by the Health Services Administrator (HSA) after contract award, it is anticipated the contractor will provide eight sessions per day, five days a week, Monday-Friday, 7:30 a.m. to 4:00 p.m., excluding federal holidays. The schedule will include a ½ hour unpaid lunch break.

The contractor may not work more than thirty (30) hours per week during the same work week, unless a waiver to exceed that amount is approved and funding is available. Any change in the schedule or adjustments in sessions will require prior approval by the Contracting Officer's Representative (COR.)

Due to the nature of the correctional setting, delays in performance of work may be experienced. Such delays may include, but are not limited to, inclement weather, electrical or mechanical problems, or other security concerns. When a contract employee reports to the institution, but is unable to perform services due to such delays, the contractor will be paid for two sessions. Normally, any remaining sessions for that day will be suspended and the contractor will be free to leave. The contractor will not be paid for any remaining unperformed sessions. However, if the institution requests that the contractor remain at the institution for eventual performance, the contractor will be paid for each session.

The contractor shall not supervise inmates or BOP staff, participate in inmate accountability, purchase supplies or equipment, sign for or pick up supplies or equipment, formulate policies or procedures, attend meetings, staff recalls, or staff functions.

EQUIPMENT AND SUPPLIES: All equipment and supplies required to effect contract performance will be furnished by the FCC and remain the property of the U.S. Government.

SCOPE OF WORK: The manner and method of performance are the sole responsibility and within the sole discretion of the contractor, provided, the contractor performs the services in accordance with standards and practices consistent with those in the community. Services will be provided in the method as considered normal in the local community.

2 Years of experience in a healthcare or insurance environment. Requires strong analytical, organizational and customer service skills. Strong oral and written communication skills.

Proficient in database software.

The service is a BPA arrangement and not a personnel appointment. The service does not constitute an employer/employee relationship. These services will be unsupervised by the Government, but will be monitored by the COR. The contractor shall provide the following services:

1. Utilizing automated records of ingress and egress for each facility at the FCC, the contractor shall verify time worked for other contract staff providing services at the FCC. If the time sheet presented for verification is correct, the contractor shall sign the time sheet to indicate correctness and give it to the COR for final review and signature approving payment. If the time sheet submitted for verification cannot be certified as correct, the contractor shall return the time sheet to the COR with a written determination detailing why the time sheet cannot be certified as correct.

2. Utilizing Medicare National Correct Coding Initiative (NCCI) coding principles, the contractor shall verify that invoices for medical care to inmates provided by contracted medical services providers are coded appropriately based upon the care documented in the inmates’ medical records. The contractor shall also verify the services provided were consistent with the reason for the inmate’s referral to the medical services provider. If the invoice presented for payment is determined to have been coded appropriately, the contractor shall indicate by signature on the invoice that a coding review has identified no inconsistencies.

When inconsistencies in invoice coding prevent the contractor from certifying the accuracy of the invoice, the invoice shall be returned to the COR with a written determination detailing why the invoice cannot be certified as correct.

3. Utilizing Medicare Part A and Part B payment regulations and payment recommendations from a third party adjudicator, the contractor shall verify that invoices for the provision of medical care to inmates which have been determined to have been properly coded (see 2. above) are also billed appropriately in accordance with the contracted terms and conditions of the contract under which the medical services were provided. If the invoice presented for payment is determined to have been billed appropriately, the contractor shall indicate by signature on the invoice that a billing review has identified no inconsistencies. If the invoice presented for payment cannot be determined to have been billed appropriately, the invoice shall be returned to the COR with a written determination detailing why the invoice cannot be certified as correct.

4. Utilizing contracted rates provided by the Government, the contractor shall verify that invoices for services performed at the FCC by other contracted medical services providers are accurately billed based upon the inclusion of approved/verified time sheets, the application of correct unit prices to the number of hours billed, and the overall total calculation. If the invoice presented for payment is determined to have been billed appropriately, the contractor shall indicate by signature on the invoice that a billing review has identified no inconsistencies. If the invoice presented for payment cannot be determined to have been billed appropriately, the invoice shall be returned to the COR with a written determination detailing why the invoice cannot be certified as correct.

5. Utilizing knowledge of Medicare coding and billing standards and procedures, contractor shall investigate all inconsistencies in invoices identified by third party adjudicator. If invoices have been determined as coded and billed correctly, the contractor shall contact the third party adjudicator to update their records and indicate by signature on the invoice that a billing review has identified no inconsistencies.

If invoices have been determined as coded and billed incorrectly, contractor shall return the invoice to the COR with a written determination detailing why the invoice cannot be certified as correct and then notify the medical contractor of inconsistencies per Medicare coding and billing standards and procedures. If the medical contractor disagrees with inconsistency notifications, contractor shall review additional documentation from medical contractor and when appropriate forward to necessary BOP staff for further payment direction.

6. Other duties will include, but are not limited to: filing, composing memoranda, maintaining suspense files, data entry, and preparation of cost analysis, financial obligations reconciliations, budget and expenditures tracking.

In the performance of all services under this contract, the contractor shall maintain patient confidentiality in accordance with the Privacy Act of 1974 and ensure security of all information and data. Any requests for information relating to an inmate’s medical care shall be referred to the COR for proper disposition.

The contractor shall have access to the following automated resources to perform the tasks identified in this Statement of Work: PGBA systems, IPPS PC Pricer, WordPerfect, and internet access. The contractor shall have access to the following resources: current ICD-9 CM volumes 1 & 2 and CPT code books. The contractor shall verify invoices for services billed under the Medicare Outpatient Prospective Payment System through manual calculations as needed and comparison to payment recommendation from third party adjudicator.

SPECIAL QUALIFICATIONS REQUIRED: The contractor shall have a thorough knowledge of Medicare payment principles, to include but not be limited to: Medicare Inpatient Prospective Payment System, Medicare Outpatient Prospective Payment System, Medicare Ambulatory Surgical Center Payment Rates, Medicare Part B Physician Fee Schedule, Medicare Anesthesia Physician Services, Medicare Clinical Laboratory Fee Schedule, and Medicare Drugs and Biological Payment Amounts.

The individual providing these services shall possess a verifiable experience of at least one year and at a minimum, a certificate in one of the following:

Registered Health Information Administrator (RHIA) Registered Health Information Technician (RHIT) Certified Coding Specialist (CCS) Certified Coding Assistant (CCA) Certified Professional Coder (CPC)

The individual selected to perform these services must be able to pass a drug screening and law enforcement agency background check to include credit checks.

Contractor’s Invoice: The contractor will provide a monthly billing statement that accurately reflects the days of each visit, the number of sessions for each visit and the total dollar amount due for that month’s services. Payment is based on an end product or the accomplishment of specific results.

Institution Security: The contractor agrees to adhere to all regulations prescribed by the institution for safety, custody, and conduct of inmates. The contractor shall attend institution orientation training, which will last approximately four hours, prior to performing any services under this contract. The time and date for this orientation training will be decided after contract award.

Additionally, the contractor may be required to attend, on an annual basis, security related refresher training. Reimbursement to the contractor for the time spent in the institution orientation or other specific security related training will be at the contract rate, prorated hourly. The contractor may, at any time, be removed from the institution at the discretion of the CEO.

The manner and method of performance are the sole responsibility and within the sole discretion of the contractor, provided the contractor performs the services in accordance with standards and practices consistent with those in the community. The contractor will not be subject to Government supervision, except for security related matters. However, contractor performance shall be monitored.

Services will be provided in the method as considered normal in the local community. These services will be unsupervised by the Government, but will be monitored by the Contracting Officer's representative (COR).