Public_Health_Lab_Billing_System.pdf

DEPARTMENT OF GENERAL SERVICES

Central Services Division

REQUEST FOR INFORMATION (RFI)

208-1018-25

For

PUBLIC HEALTH LAB BILLING SYSTEM

RELEASE DATE: November 1, 2024

RESPONSE DUE: December 3, 2024, 5:00 pm

SUBMIT PROPOSAL TO: RFI COORDINATOR

Solano County digitally via OpenGov Solano County

Portal website at:

https://procurement.opengov.com/portal/solanocounty

Karen Poole

Phone: (707) 784-6321 kdpoole@solanocounty.com

Any proposer participating in this solicitation is required to have a vendor application on file with the

County. This application may be downloaded from the Solano County website at www.solanocounty.com . Include the application with your proposal. The County will post any changes and information relating to this RFI digitally via OpenGov. Proposers are responsible for frequently checking OpenGov at https://procurement.opengov.com/portal/solanocounty for any changes or information relating to this RFI.

“Smoking is not permitted in County Buildings or around Solano County campuses. Thank you in advance for your compliance.”

MEGAN M. GREVE

Director

MMGreve@SolanoCounty.com

(707) 784-7900

DUSTIN D. LENO

Assistant Director ddleno@solanocounty.com

(707) 784-7900

LORRAINE TANG

Support Services Manager lctang@solanocounty.com

(707) 784-3426

675 Texas Street, Suite 2500

Fairfield, CA 94533-6342

Fax (707) 784-6320 www.solanocounty.com https://procurement.opengov.com/portal/solanocounty http://www.solanocounty.com/ mailto:MMGreve@SolanoCounty.com mailto:ddleno@solanocounty.com mailto:lctang@solanocounty.com http://www.solanocounty.com/

Solano County

REQUEST FOR INFORMATION

Public Health Lab Billing System

TABLE OF CONTENTS

1. Purpose

2. Background

3. Statement of Objective

4. General Respondent Requirements

5. Electronic Submittal

6. General Requirements and Information

Attachments:

A - Data Flow Diagram As-Ia LabBilSys

B - As-Is Business Diagram

C - Agency_Reference_Form

D - SAAS Requirement Questionaire

Request For Information #208-1018-25 Title: Public Health Lab Billing System

1. Purpose

The Purpose

1.1. Purpose

The County of Solano, Health and Social Services, hereinafter referred to as the County, is soliciting informational responses to Public Health Lab Billing System.

Using information gathered from responses to this RFI, the County of Solano may issue a Request for

Information (RFI) to bidders interested in providing services to the County. Nothing in this document shall be construed as obligating the County to issue an RFI. The County reserves the right to award a contract based on this RFI.

Please note that, responding to this RFI, will not give any advantage to any organization or individual in any subsequent competition. Responses may be used by the County without restriction or limitation, therefore proprietary information should not be sent.

Responses should not exceed ten (10) pages and should focus on addressing the objectives and illustrative results requested in the Statement of Objective (SOO). Additional information limited to the offeror’s corporate and organizational capability statement to carry out their approach and case studies supporting the strategies in the approach may be included as an annex.

Please do not submit applications, proposals, resumes and promotional material as they will be discarded.

1.2. Scope of Work

The scope of this project involves replacing the current laboratory billing system for the Solano County Public

Health Laboratory with a secure, modern, full-cycle revenue billing solution that enhances operational efficiency, ensures regulatory compliance, and improves reporting and accountability. The vendor selected will provide a fully hosted Software as a Solution that integrates seamlessly with the existing Orchard Harvest Lab

Information Management System (LIMS) and meets the specific needs outlined below.

1.3. Key Project Objectives

• Replace Current Billing Application: Implement a secure, state-of-the-art billing system that addresses privacy concerns and mitigates the risk of malware or data breaches.

• Enhance Data Privacy and Security: The new billing system must prioritize robust security protocols to safeguard sensitive health information in accordance with HIPAA standards.

• Improve Operational Efficiency: The solution should enhance workflow and productivity for lab staff by providing a full-cycle revenue management system, including automated billing, claims processing, and payment tracking.

• Ensure CLIA Compliance: The solution must comply with Clinical Laboratory Improvement

Amendments (CLIA) standards to ensure ongoing certification of the Public Health Laboratory for human specimen testing.

• Advanced Reporting and Analytics: The system should offer advanced data reporting and analytical capabilities, providing actionable insights into billing operations and trends.

• Increase Transparency and Accountability: Tools must be provided for clear audit reporting and tracking, ensuring transparency in billing processes and financial operations.

• Procure a SaaS Solution: The County seeks a SaaS-based lab billing system that can be securely hosted, easily maintained, and meets the specified technical and functional requirements.

• End User Training: The Vendor is responsible for the comprehensive training of all relevant county staff on the operation and functionality of the systems or solutions provided. This includes, but is not limited to, initial onboarding, ongoing updates, and any supplemental training required as the system evolves.

The Vendor must ensure that all training materials, guides, and instructional resources are up-to-date and accessible to staff. Furthermore, the Vendor is expected to tailor the training to accommodate various levels of technical proficiency among county employees, ensuring that all end users can effectively utilize the system to meet county objectives.

1.4. In-Scope Activities

• Research and Evaluate Full-Cycle Revenue Billing Systems: The vendor will research and propose solutions that meet the County’s needs for laboratory billing, addressing all technical, regulatory, and operational requirements.

• System Functionality Assessment: The selected solution must demonstrate compliance with government regulations such as HIPAA and CLIA and include necessary features for integration with the Orchard Harvest LIMS.

• Procure and Implement SaaS-Based Lab Billing Solution: The County will procure a SaaS-based billing system that fulfills all requirements, ensuring smooth transition and minimizing disruption to lab operations.

1.5. Regulatory and Mandated Requirements

• CLIA Compliance: The system must meet all requirements under the Clinical Laboratory Improvement

Amendments (CLIA), ensuring that the lab can continue to operate with certification.

• HIPAA Compliance: The solution must ensure compliance with the Health Insurance Portability and

Accountability Act (HIPAA), protecting patient privacy and securing all medical and billing information.

1.6. Out-of Scope Activities

• Non-Public Health Lab or Orchard LIMS Training: Any training related to systems or processes outside of the Public Health Lab or Orchard LIMS is out of scope.

• Integration with External Systems: Integration with non-Orchard LIMS external healthcare or government systems will not be part of this project.

• Sample Collection and Tracking: Logistics related to sample collection, tracking, or maintaining chain of custody are out of scope.

The selected vendor will be responsible for delivering a solution that meets all in-scope requirements and complies with all relevant regulatory mandates.

1.7. Public Health Lab Billing As-Is Workflow

• Refer to Attachment A. – As -Is Data flow

• Refer to Attachment B. - As -Is Business flow

2. Background

The Public Health Laboratory has been relying on an aging, on-premises billing software system to process and manage billing operations. While the system has served its purpose over the years, it is now antiquated and no longer meets the evolving needs of the laboratory's operations, or the modern standards required for scalability, security, and resiliency.

The primary goal of this RFI is to explore solutions for replacing the legacy billing system with a modern, fully hosted, and supported platform. A key priority is ensuring the new system enhances operational resiliency and disaster recovery (DR) capabilities, allowing the laboratory to maintain uninterrupted service even in the event of unforeseen disruptions.

Furthermore, the new billing solution must adhere to today’s stringent security and compliance requirements.

This includes supporting standard security protocols, such as Single Sign-On (SSO) and secure API integrations, to ensure seamless interoperability with other systems while safeguarding sensitive data.

Key objectives for the replacement system include:

• Resiliency and Disaster Recovery: The system must offer robust failover mechanisms, cloud-based redundancy, and disaster recovery solutions that minimize downtime and ensure continuity of operations.

• Modern, Fully Hosted Platform: The solution must be fully cloud-hosted and managed, reducing the need for on-premises infrastructure and providing consistent support and updates.

• Security and Compliance: Adherence to industry-standard security measures is essential. This includes features such as Single Sign-On (SSO), secure API integrations, data encryption, and audit trails to ensure compliance with relevant regulations.

• Scalability and Integration: The new system should have the ability to scale with the laboratory's needs, supporting future growth and enhancements, while easily integrating with existing laboratory information systems (LIS) and other critical tools.

This RFI seeks detailed information from vendors on how their solutions can address these requirements and support the Public Health Laboratory in modernizing its billing system to meet current and future operational demands.

3. Statement of Objective

Responding to this RFI, will not give any advantage to any organization or individual in any subsequent competition. Responses may be used by the County without restriction or limitation, therefore proprietary information should not be sent.

Responses should not exceed ten (10) pages and should focus on addressing the objectives and illustrative results requested in the Scope of Work section. Additional information limited to the offeror’s corporate and organizational capability statement to carry out their approach and case studies supporting the strategies in the approach may be included as an annex.

Please do not submit applications, resumes and promotional material as they will be discarded.

4. General Respondent Requirements

This section outlines the functional and non-functional requirements that the proposed system must fulfill. Any items not mentioned here are assumed to be outside the mandatory scope of the project and may be considered potential future enhancements, included as optional features within the standard technology stack.

The Vendor is required to submit a checklist indicating whether each of the listed requirements is met by the system.

4.1. Functional Requirements

ID Requirement Description Requested By Priority

4.1.1 The system must be compatible and integrated with

the Orchard Harvest Lab Information Management

System (LIMS)

PHL Mandatory

4.1.2 The system must support integration with and utilize

standard Current Procedural Terminology (CPT) coding

PHL Mandatory

4.1.3 The System must be capable of sending ANSI X12

837 Professional or Institutional file format (5010 version) electronic claim files to the insurance carrier

Partnership Healthplan (PHP)

PHL Mandatory

4.1.4 The System must be capable of utilizing one of

Partnership Healthplan’s qualified clearinghouses for electronic claims submissions

PHL Mandatory

4.1.5 The system must be capable of sending and

receiving HL7 (Health Level Seven) formatted billing containing data such as patient demographics, insurance details, billing codes, and claim information

PHL Mandatory

4.1.6 The system must be capable of generating customer

billing statements electronically, allowing lab staff to easily print in either Word or PDF format.

PHL Mandatory

4.1.7 The system must be capable of receiving and

processing electronic remittance files from the PHP insurance carrier

PHL Mandatory

4.1.8 The system must support multiple pricing models, including standard charges, negotiated rates and insurance-specific rates

PHL Mandatory

4.1.9 The system must provide functionality for authorized

users to update the fee schedule for procedure codes and adjust costs as needed.

PHL Mandatory

4.1.10 The system must be capable of integrating with the

County’s standard JP Morgan payment processing vendor for processing credit cards

Compliance Mandatory

4.1.11 The system should allow for generating EFT

payment reports for credit card transactions.

Compliance Mandatory

4.1.12 The solution must be able to produce a readable

electronic report for tracking and processing claim denials

PHL Mandatory

4.1.13 The system should allow for generating EFT

payment reports for credit card transactions.

Compliance Mandatory

4.1.14 The solution must be able to produce a readable

electronic report for tracking and processing claim denials

PHL Mandatory

4.2. Non-Functional Requirements

ID Requirement Description Requested By Priority

4.2.1 The solution must comply with the Health Insurance

Portability and Accountability (HIPAA) Act to ensure patient privacy and data security.

Compliance Mandatory

4.2.2 The solution must be in compliance with any Clinical

Laboratory Improvement Amendments (CLIA)

• Accurate Coding and Billing – ensure all tests are billed using correct Current Procedural Terminology (CPT) codes and

ICD-10 diagnosis codes.

PHL Mandatory

4.2.3 The solution must support integration with access

identity management solutions that comply with

Security Assertion Markup Language (SAML) 2.0 or

OpenID Connect (ODIC) standards.

IT Mandatory

4.2.4 The solution must be capable of multifactor

authentication (MFA)

IT Mandatory

4.2.5 The solution must have robust user access control

system with role-based access permissions (RBAC)

IT Mandatory

4.2.6 The solution must provide a seamless and efficient

integration with Power BI to enable real-time reporting and the dashboards.

PHL Mandatory

4.2.7 The solution must support an intuitive and user-

friendly interface to ensure ease of use with a minimal learning curve and training.

PHL Mandatory

4.2.8 The solution must support full cycle revenue billing for laboratory services ensuring efficient processing, tracking and reporting of financial transactions.

PHL Mandatory

5. Electronic Submittal

5.1. Respondent Agreement*

Respondent agrees:

Nothing in this document shall be construed as obligating the County to issue an RFI. No contract will be awarded based on this RFI, or to pay for any information voluntarily submitted as a result of this request.

Responding to this RFI, will not give any advantage to any organization or individual in any subsequent competition. Responses may be used by the County without restriction or limitation, therefore proprietary information should not be sent.

☐ Yes

☐ No

*Response required

5.2. Federal Tax ID Number*

Enter your Federal Tax ID Number

*Response required

5.3. Cover Letter*

The proposal must be submitted with a cover letter describing the proposer’s interest and commitment to the proposed project. The letter must state that the proposal is valid for a period of 120 days and include the name, title, address and telephone number of the individual to whom correspondence and other contacts should be directed during the selection process. The person authorized by the proposer to negotiate a contract with the

County must sign the cover letter.

Address the cover letter as follows:

Solano County General Services Department Purchasing Services 675 Texas Street Suite 2500 Fairfield, CA 94533 Attention: Karen Poole, RFI Coordinator

*Response required

5.4. Agency References*

Please refer to Attachments section to download, and complete the Agency Reference Form. Attachment C.

The Offeror shall provide the (3) references of government agencies and or firms for whom they have provided similar services during the last three (3) years. These references should be from different entities and not from

Solano County.

*Response required

5.5. Respondent Response to RFI

Respondent shall provide the following information as evidence the respondent’s experience in delivering services similar to those required by this RFI:

A. A brief, descriptive statement indicating the respondent’s credentials to deliver the services sought under this RFI.

B. A brief description of the respondent’s background and organizational history;

C. Years in business;

D. A brief statement of how long the respondent has been performing the services required by this RFI

E. Location of offices

F. A description of the respondent organization’s number of employees, longevity, client base

G. Whether there have been any mergers, acquisitions, or sales of the respondent company within the last ten years (if so, an explanation providing relevant details);

H. Form of business (i.e., individual, sole proprietor, corporation, non-profit corporation, partnership, joint venture, limited liability company, et cetera).

I. Statement of Work (e.g. scope, one-time (implementation) and ongoing cost, duration, dependencies, assumptions, responsibilities, prerequisites, milestones, resources, etc.)

J. Cost details and Payment pro

K. Master Services Agreement

L. SaaS Assessment packet

1. Complete Attachment D – SaaS Questionnaire

2. Provide Security Policies as follows:

1. Security Policy

2. Data Security Policy

3. Privacy Policy

4. HIPAA Security Policy (if relevant)

5. SOC2 Type2

6. Any System Certifications (e.g. HIPAA, Hitrust, PCI, Third party assessments etc.)

5.6. Debarment Certification*

By submitting a bid/offer/proposal/quote to the County of Solano, under penalty of perjury, I, the Proposer, hereby certify that the Prospective Contractor and/or its officers, directors, and employees:

A. Are not currently excluded, debarred, or otherwise ineligible to participate in a federally funded program

B. Have not been convicted of a criminal offense related to the provision of federally funded items or services nor has been previously excluded, debarred, or otherwise declared ineligible to participate in any federally funded programs, and

C. Are not, to the best of its knowledge, under investigation or otherwise aware of any circumstances which may result in contractor being excluded from participation in federally funded programs.

This representation shall be an ongoing representation during the term of any contract awarded to the

Prospective Contractor. If awarded a contract, Prospective Contractor hereby commits to immediately notify the County of any change in the status of the representations set forth in this Form.

Prospective Contractor authorizes the County to independently verify its suspension and debarment status.

Prospective Contractors are cautioned that making a false certification may subject the certifier to criminal prosecution or administrative sanctions.

I certify that I am authorized by the company named above to respond to this request.

☐Please confirm

*Response required

6. General Requirements and Information

6.1. Communications Regarding the RFI

Upon release of this RFI, all Respondents’ communications concerning this RFI must be directed to the RFI

Coordinator.

All communications shall be in writing to the RFI coordinator email at kdpoole@solanocounty.com. Any oral communications should be considered unofficial and nonbinding on the County. Written comments, including questions and requests for clarification, must cite the subject RFI number. The RFI coordinator must receive these written requests via this Procurement Portal (opengov.com) by the submission deadline specified in the

RFI. Questions/comments (for clarification purposes only) regarding this RFI may be communicated to the RFI coordinator by electronic means. However, respondent’s proposal to this RFI shall be communicated in written form.

The County shall respond in writing to written communications. Only written responses to written communications shall be considered official and binding upon the County. The County reserves the right, at its sole discretion, to determine appropriate and adequate responses to written comments, questions, and requests for clarification. The County shall post its responses to written comments, to all respondents expressing interest in this RFI.

Any data or factual information provided by the County shall be deemed for informational purposes only, and if a respondent relies on said factual information it should either:

A. independently verify the information; or

B. obtain the County’s written consent to rely thereon.

6.2. Response Preparation Costs

The County will not pay any costs associated with the preparation, submittal, or presentation of any response.

6.3. Disclosure of Response Contents

All responses and other materials submitted in response to this RFI information process become the property of the County of Solano. Selection or rejection of a response does not affect this right. The responses and associated materials shall be open for review by the public to the extent allowed by the California Public

Records Act, (Government Code Section 7920.000 et al. By submitting a response, the respondent acknowledges and accepts that the contents of the response and associated documents shall become open to public inspection.

6.4. Proprietary Information

The master copy of each response shall be retained for official files and will become public record, unless the response or specific parts of the response can be shown to be exempt by law (Government code

§6276). Each respondent may clearly label part of a response as "CONFIDENTIAL" if the respondent thereby agrees to indemnify and defend the County for honoring such a designation. The failure to so label any information that is released by the County shall constitute a complete waiver of all claims for damages caused by any release of the information. If a public records request for labeled information is received by the County, the County will notify the respondent of the request and delay access to the material until seven working days https://procurement.opengov.com/portal/solanocounty after notification to the respondent. Within that time delay, it will be the duty of the respondent to act in protection of its labeled information. Failure to so act should constitute a complete waiver.