National Clinical Documentation Imaging QA.pdf

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National Clinical Documentation Imaging

Questions and Answers

Q: We are a company capable of scanning and indexing millions of pages a day. Are you interested in learning about pricing on a per-page model with centralized operations?

A: We are not interested in modifying the current pricing model at this time.

Q: Is this process currently being fulfilled by VA employees or is it outsourced to a contractor?

A: This process is currently being fulfilled by a combination of VA employees and Contractor Support.

Q: Is this being done by VA employees and if so, is this only for the overflow work?

A: This depends on the needs of the site. This process is currently being fulfilled by a combination of VA employees and Contractor Support.

Q: Who currently owns the scanning equipment being used for this process?

A: VA owns IT network resources used to access EHR and index imported images remotely--most work is performed off-site using contractor’s personally owned equipment. If/when work is performed on-site at a VA facility, equipment is usually owned by VA unless vendor brings their own equipment and accesses the VA network via secure access gateway.

Q: Can you share the forward-looking budget/estimated cost for this project?

A: No, we cannot provide details pertaining to the government cost estimate.

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Q: Would the VA consider having a centralized offsite scanning facility in which the documents are sent by overnight courier for processing.

A: No.

Q: If this is primality overflow RFP, would the VA consider sending all work to a single contractor offsite? If so, could volumes be estimated.

Q: If the VA is amendable to 100% offsite, would the VA consider paying courier charges for transportation or would that need to be billed into the numbers.

A: N/A

Q: When a document set is indexed, is it always indexed as a single document or do document sets including multiple document types? In example 1.3.2.d.ii (Example #2 page 8), would this always be index when a document set is indexed, is it always indexed as a single document or do document sets including multiple document types? In example 1.3.2.d.ii (Example #2 page 8), would this always be indexed as a single document, or could this document set contain multiple documents within it?

as a single document or could this document set contain multiple documents within it?

A: The example referenced describes an example of a single document set that is indexed as one electronic file. There may be situations where a packet of received inpatient documentation requires individual documents to be separated. This will be based on facility needs and outlined in local task order requirements, standard operating procedures (SOPs), and policies.

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Q: Can you provide the average number of documents in a set as well as the maximum number of documents in a set?

A: We currently do not have an average minimum or maximum. This is a national requirement, therefore the number of documents per set could vary depending on the workload at each individual site.

Q: What travel was required in the past 12 months, and what was the cost

A: We cannot not provide information pertaining to cost. However, travel requirements and cost could vary depending on the needs for each facility task order.

Q: If the kickoff is March 1st, when would the vendor be expected to be provide the services?

A: The March Kickoff meeting is only an estimated start. The start date will be based on the length of the evaluation process. At the earliest, depending on background investigations, services can be expected to begin within 30 days after contract award.

Q: Is this a virtual meeting or onsite?

A: The kickoff meeting will take place in a virtual environment in a pre-determined virtual platform.

Q: Would the indexing piece only be considered as part of the award?

A. No, indexing is simply part of the contractor roles and responsibilities associated with the records requirements. Upon award, contractors will be expected to process document sets In Accordance With (IAW) the Performance Work Statement (PWS).

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Q: Can you elaborate on the capabilities for importing the documents into the imaging software? Is this manual or does an integration exist?

A: Paper documents are converted to an electronic format manually, and the electronic files are manually imported and indexed in the record.

Q: When reviewing for duplicates, is this based upon indexing names or a complete review of all document sets against corresponding file?

A: The process of reviewing for duplicate documentation involves a combination of comparing indexing field information (date of service, Specialty, facility, etc.) and the actual scanned document in the EHR.

Q: Does each facility have their own distinct indexing value?

A: Indexing values are based on standard indexing values available in the software but may be applied differently based on site-specific requirements.

Q: Is there anything in additional to the traditional background screen process?

Q: Does the current scanning import utility help to produce the invoice?

A: VA Software has reporting capabilities that display number of images and page count of scanned/imported documents that can be used by administrators.

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Q: The instructions require us to submit PPQs (Attachment 7). Can the Government allow us to submit CPARS along with the Proposal, in lieu of PPQs? Can the PPQs be waived-off, for those who can submit CPARS with the Proposal?

A: We will expect to receive PPQs that support your proposal past performance narratives. You can submit your CPARs as additional support information, but we will be accessing CPARs has part of our evaluation process.

Q: The Para B.1. listed four Proposal Volumes and instructed to submit these four separate volumes.

A. Correct, the volumes must be separate, but can be submitted all within the same email.

Q: This table under the row for Volume III: Past Performance, mentions the Past Performance Questionnaire to be as Attachment 8. Whereas the Solicitation Package includes the PPQ form as Attachment 7. Can the Government please confirm?

A: Past Performance Questionnaire is Attachment 7.

Q: Can we know the tentative start date of the Base Period of Performance?

A: We anticipate the period of performance for these services to start in the March or April time frame.

Q: We understand this Blanket Purchase Agreement shall be a multi-Award contract, that stands awarded to more than One Offeror. Is this correct?

A: The Government contemplates a single award Firm-Fixed-Price Blanket Purchase Agreement.

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Q: Requesting the Government to let us know the Ceiling value / Funds approved for the BPA Contract.

A: The ceiling value will be determined based on the proposed pricing and the established Independent Government Estimate (IGCE).

Q: Unit of Measure SE – Since the number of images in each SE varies from 5-20 Images as per section 1.3.2, we recommend using the standard convention of pricing by per Image rather than by per SE or Document Set? This would also be the most effective unit for invoicing the Government.

A: An image consists of one captured electronic image file, regardless of the number of pages (i.e., an image=document set).

Q: Is there an incumbent currently performing services under this requirement? If yes, can you provide the contractor’s name and contract details?

A: We currently have a contractor performing this service. The incumbent contractor is Integrated Solution and Services Inc.

Q: Is the Government satisfied with Incumbent’s performance and are they eligible to re-compete on this requirement?

A: We welcome all interested and qualified vendors to submit a proposal.

Q: Can you provide an estimate of how many Incumbent employees are currently supporting this effort?

A: No. This information is not tracked, nor available.

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Q: Can we recommend VA to use Multiple BPA instead of Single BPA so the agency has more flexibility and bargaining power because it would be more competitive at Task order level?

A: No, at this point we contemplate only making a single award.

Q: Can we request a 2-week extension to incorporate responses from the Q&A and also for any follow-up questions if required?

A. The closing date of the solicitation will be extended to Monday, 02/27/2023 by 1400EST.

Q: “STAT scanning/importing shall be a separate production CLIN document type and will only include electronic documents processed off-site” – If STAT only includes processing of electronic documents off-site (Importing and Indexing), would Clin 0001 and 0002 need to be revised to remove STAT since it includes Prep/Scan?

A: No. Inclusion of STAT documents under CLINS XX1 and XX2 indicates that separate pricing is not authorized when STAT documents are processed on-site.

Q: CLIN 1001 and 1002 – Can you elaborate if anything additional would be required to perform E2E services when compared to CLIN 0001 and 0002?

A: The tasks are the same, the location (on-site or remote) would differ between the CLINs. See NOTE column for CLINs.

Q: Approximately how many people currently perform his function? Can this also be broken down by full time and part time?

A: Each VHA facility will have varying levels of resources assigned to the scanning/importing process.

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Q: Approximately how many locations are documents scanned in?

A: All VHA facilities scan/import documents. Refer to PWS.

Q: What is the maximum number of documents sets expected to be taken in a day?

A: The amount of document sets will vary depending on the site location and workload.

Q: Can the government confirm that the due date for proposals is on a Sunday?

A: The closing date of the solicitation will be extended to Monday, 02/27/2023

Q: This paragraph states "The scanning process will be completed by contract staff using VA software and procedures. No automation or image enhancement software will be used other than VA applications." But section 1.3.2a states "Converting paper records to an electronic format... [can] be accomplished using standard national imaging software..." and section 2.1.2 states "The Contractor shall provide any specialized management, labor, resources, computer software, equipment needed..."

Can the Government clarify if the Contractor is able to propose their own software for this effort, or clarify which VA software we must use?

A: The “scanning process” is completed using VHA software. This currently includes VistA Imaging and Oracle Cerner Enterprise Document Management applications. Computer software referred to under Contractor’s responsibilities will not be provided by the Government, such as software used internally by the vendor in day-to-day operations, and not required for scanning/importing information into the VHA EHR. VHA is not considering alternative software solutions for scanning/importing images into the EHR.

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Q: Bullet G in section 1.3 states "Transportation or shipping... offsite... is not part of the BPA." However, section 1.6 states that "… work may be performed… partially at the Contractor's primary facility, and partially at other locations or facilities..."

and section 1.6.1 states "The principal place of performance for services provided in the task order PWS is projected to be at the Vendor's site." If the work is determined, at the TO level, to be performed at VA facilities, will the government providing scanning equipment to complete the scanning function?

A: If work is performed on-site at a VAMC, VHA will provide equipment.

Q: Can the Government please provide an estimate of the annual workload of scanning, importing, and indexing for this RFP? Can the Government provide a report of the volume of work by location over the past several years?

A: The Government is unable to provide an estimate of the annual workload since the workload at each facility varies. We are providing historical quantities in the pricing schedule pertaining to the work volume associated with these services.

Q: Does the Government have an estimate of the impact of the PACT Act on the estimated workload?

A: Not at this time.

Q: Does the Government have an estimate of how the scanning and importing workloads are received by percentage, i.e., electronic vice paper?

A: The Government does not have an estimate pertaining to how workload is received. Additionally, the format in which workload is received could vary by site location.

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Q: Is there an incumbent performing these responsibilities today, or recently? If so, can the Government indicate which company(ies) that is?

A: Yes, the incumbent contractor is Integrated Solution and Services Inc.

Q: The RFP states "The scanning process will be completed by contract staff using VA software and procedures. No automation or image enhancement software will be used other than VA applications." Please confirm that the government will provide all equipment and supplies including all software, computers, and required scanning equipment for performance under the corresponding Task Order.

A: The Government will provide required scanning/importing software. If work is performed on-site at a VAMC, the Government will supply equipment and supplies as needed. Generally, work performed off-site will need to be supported using vendor’s resources (equipment, supplies, internet access, etc.).

Exceptions include equipment required for personnel authentication (PIV cards, e-Tokens, etc.) when accessing VA networks or facilities.

Q: Please explain when Attachment 1: Invoice Inquiry Tracker should be used.

A: Attachment 1 is to be used if there are issues relating to the submitted invoice.

Q: Please confirm that the cover of the proposal volumes is exempt from the layout requirements on page 54, Section 2- Proposal Files.

A: The cover page for each proposal volume is exempt from the layout requirements.

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Q: Given reference to the Service Contract Labor Act on page 45, please provide a Wage Determination physical location for use in preparing our pricing.

A: Physical location (for on-site work) will be based on local task order. Remote work will be based on location of employee.

Q: Attachment 3: Product Price Cost Schedule only allows pricing by set; however, the solicitation specifically asks offerors to explain the most effective "unit" for invoicing the government, which could be per page, file, or set. Does the VA intend to use the document set as its unit, or should offerors propose the most effective unit?

A: The Government intends on pricing by set.

Q: Attachment 3 column "Description" lists several different combinations of services. Is the purpose of these combinations to allow Task Orders for individual physical sites to choose their preferred combination of on-site and off-site work?

A: Yes

Q: On page 8, Section 1.3.2 (d) and page 57, Section i. Volume I: Technical, #10, it is stated that a document set has a variable amount of pages. However, Attachment 3 column J- "Quantity" uses a set as a unit of measurement. Please clarify the definition of a document set.

A: A paper or electronic document set contains a Veteran’s documents associated with a specific clinical visit/encounter/hospital stay or administrative form. It may contain a variable number of pages.

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Q: Please provide clarification of the definition of the "Quantity" and "Unit of Measure" columns in Attachment 3. Are they page, file, document set, or something else?

A: Column J is providing historical quantities in the pricing schedule pertaining to the work volume associated with these services. Unit of Measure for scanning would be document sets, not pages.

Q: Please provide the list of possible fields of index for each document set?

A. Typically, document sets will need to be indexed using the following fields. Depending on capture configuration selected, some information is pre-defined.

• ORIGIN

• DOCUMENT IMAGE DATE

• DOCUMENT IMAGE TYPE

• SPECIALTY

• PROCEDURE/EVENT

• IMAGE DESCRIPTION

Additional information can be located at:

https://www.va.gov/vdl/documents/Clinical/Vista_Imaging_Sys/MAG_Captur e_User_Manual.pdf

Q: "Are the quantities provided in Attachment 3 for 1) evaluation purposes only, 2) estimates of actual work to be done, 3) minimums, or 4) something else? On page 58, it also says that we are to write to whether we are capable of processing up to 3,000,000 documents per year, implying that these numbers may be low."

A: We are providing annual historical quantities in the pricing schedule pertaining to the work volume associated with these services. These quantities are for evaluation purposes only. This pricing schedule will establish the unit pricing for CLIN.

https://www.va.gov/vdl/documents/Clinical/Vista_Imaging_Sys/MAG_Capture_User_Manual.pdf https://www.va.gov/vdl/documents/Clinical/Vista_Imaging_Sys/MAG_Capture_User_Manual.pdf

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Q: Please explain when Attachment 8: QSR Reporting Tool should be used.

A: Attachment 8 should be used by the awardee when submitting Quarterly Sales Report to the Strategic Acquisition Center.

Q: Please confirm that offerors should only submit FAR 52.212-3(b) if offeror's Representations and Certifications are available electronically through SAM.

A: “The Offeror shall complete only paragraph (b) of this provision if the Offeror has completed the annual representations and certification electronically in the System for Award Management (SAM) accessed through https://www.sam.gov.If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (v) of this provision.”

Q: On page 56, the RFP states "No pricing information is to be provided in the Technical Volume." However, page 68 states "The evaluation of the management and staffing plan will consider the offeror's ability to manage and balance technical performance, time constraints, cost factors and the management of personnel." How should we meet the evaluation requirement without referencing price?

A: The Technical Volume should be free of pricing information associated with scanning, indexing, and importing functions, travel or any information belonging in Attachment #3 or belonging to the Pricing Volume. There should be no in depth or elaborate discussions surrounding price in this section.

https://www.sam.gov/

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Q: In section 2.4.1-Contractor Responsibilities, as well as page 56 which states “Do not include staffing for positions that do not directly perform the direct project management or technical lead of the contract." Since this solicitation results in a BPA with no committed or specified Task Orders, there would be no staffing at award time other than the PM that is directly performing on the contract. As such, who is to be included in the organizational chart in order to meet the evaluation criteria?

A: All unit pricing should include the contractors proposed labor to include all labor that they think will be needed to meet this requirement.

Q: Page 18 states "Contractor shall provide at least one Technical Lead for each task order. If work is conducted on-site, the Technical Lead must be physically located at the task order facility during business hours." Does each Task Order always correspond to a single physical location?

A: TOs are issued per facility. Physical location of scanning operations will be determined by the customers needs and outlined in the TO.

Q: How many Task Orders are contemplated under this contract?

A: We are unable to estimate the number of task orders for this requirement due to the many locations and varying workloads per site.

Q: Please provide a list of all physical locations that this BPA may cover.

A: This BPA will cover all Department of Veteran Affairs Hospitals in the United States that might need this service.

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Q: We are required to include to our experience specifically with Health Care and Electronic Health Records. Please explain how the weighing of health care specific experience vs. size/scale/complexity of other experiences the same type of work doing would be weighed in the evaluation.

A: There is not an actual weight given to health care specific experience. We are using your experiences and past performance to judge the risks of your company being able to perform the services.

Q: Attachment 7: Past Performance Questionnaire states "The Department of Veterans Affairs is currently in the process of awarding a competitive enterprise-wide strategic contract for Standard Manual Wheelchairs and Accessories for in home use." Please verify that this is a mistake and provide a new Past Performance Questionnaire that corresponds to work under this solicitation.

A: Attachment 7 will be corrected and replaced with a Past Performance Questionnaire that is in alignment with the solicitation.

Q: In this evaluation factor, the government states “Relative Experience: The contractor shall provide information to facilitate the Government’s consideration of relative experience…... The Government is most interested in examples of real work with actual results of the contractor in performing requirements similar to those of this solicitation in terms of size, scope, and complexity. The Government is more interested in the quality and similarity of the experience examples to the requirement than the quantity of examples. The contractor shall provide a name and contact information of a reference that can substantiate the work performed, if necessary.”

As past performance is a separate volume, please confirm that the examples with contact names and information are not to be submitted in the Technical Volume and that this is not an evaluation factor of the technical volume.

A: Point of Contacts/Names and any references related to previous projects should be included in the past performance volume and need not to be included in the Technical Volume as they are not evaluation factors of the Technical Volume.

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Q: In this evaluation factor, the government states “Relative Experience: The contractor shall provide information to facilitate the Government’s consideration of relative experience…... The Government is most interested in examples of real work with actual results of the contractor in performing requirements similar to those of this solicitation in terms of size, scope, and complexity. The Government is more interested in the quality and similarity of the experience examples to the requirement than the quantity of examples. The contractor shall provide a name and contact information of a reference that can substantiate the work performed, if necessary.”

As past performance is a separate volume, please confirm that the examples with contact names and information are not to be submitted in the Technical Volume and that this is not an evaluation factor of the technical volume.

A: The Past Performance Narratives detail examples of work should be provided in the technical volume. Provide the name and contact information of individuals that can verify this information in the Past Performance Questionnaires (Phone numbers, Contract/BPA Numbers, Gov’t Agency etc.).

Q: "Page 15, Section 2.2 (h) states ""For paper records, Contractor shall perform the following items: remove staples, ensure document is flat, ensure pages are sequenced in order, ensure all pages are present, document is not torn and if so, repair it, ensure all pages are for the correct patient, document is authenticated (i.e., signed), etc."" Historically, what percentage of your documents require this type of intervention before scanning?"

A: All documents require a review/prep prior to scanning.

Q: Please change the due date of the solicitation to Tuesday 02/21/2023 given than the current due date Sunday 02/19/2023, and Monday 02/20/2023 is a Federal Holiday.

A: The closing date of the solicitation will be extended to Monday, 02/27/2023