RFP 2025-01 - Conversational Intelligence Tool - Final.pdf

RFP 2025-01 Conversational Intelligence Tool (Rev 2/2023)

REQUEST FOR PROPOSALS #2025-01

Conversational Intelligence Tool Publish Date: March 31, 2025

CareOregon, Inc. (“CareOregon”) is inviting submission of proposals for the Conversational Intelligence Tool project.

Closing Date/Time: April 28, 2025 - 2:00 PM, Pacific Time

Project Summary: CareOregon is seeking proposals from qualified vendors to provide a conversational intelligence tool for our contact center. The selected solution must be capable of evaluating and providing feedback on 100% of our calls to enhance performance, improve customer experience, and drive operational efficiency. The project is estimated to begin in July 2025 and run for two (2) years with the option for two (2) subsequent renewals at two (2) years each.

Contact Information: The sole point of contact for procurement process or technical questions is:

Ann Gregory, Procurement & Contract Analyst II gregorya@careoregon.org 503-416-1421

RFP Location: RFP Documents can be downloaded from OregonBuys at the following address:

https://oregonbuys.gov/bso/. Prospective Proposers will need to sign in to download the information and that information will be accumulated for a Plan Holder's List. Prospective Proposers are responsible for obtaining any Addenda or clarifying questions from OregonBuys.

Submission: All proposals must be emailed to vendorservices@careoregon.org. Do not attempt to submit proposals through or to the OregonBuys website. All proposals must be submitted to the email listed.

CareOregon encourages proposals from minority, women, service-disabled veteran, and emerging small businesses.

**NO PROPOSALS WILL BE RECEIVED OR CONSIDERED AFTER THE ABOVE

RFP CLOSING DATE/TIME**

SCHEDULE

Request for Proposals Issued…….................................................. March 31, 2025

Deadline to Submit Clarifying Questions....................................... April 18, 2025, 5:00 PM, Pacific Time

Request for Proposals Closing Date and Time (“Closing”)........... April 28, 2025, 2:00 PM, Pacific Time

Interviews/Demonstrations………………………………………. May 5-16, 2025, TBD

Anticipated Contract Start Date……..............................................July 1, 2025 mailto:gregorya@careoregon.org https://oregonbuys.gov/bso/ mailto:vendorservices@careoregon.org

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SECTION 2

INSTRUCTIONS TO PROPOSERS

2.1 Modification or Withdrawal of Proposal: Any Proposal may be modified or withdrawn at any time prior to the Closing deadline, provided that a written request is received by Procurement, prior to the Closing. The withdrawal of a Proposal will not prejudice the right of a Proposer to submit a new Proposal.

2.2 Requests for Clarification and Requests for Change: Proposers may submit questions regarding the specifications of the RFP until the deadline in the Schedule. Requests for changes must include the reason for the change and any proposed changes to the requirements. The purpose of this requirement is to permit CareOregon to correct, prior to the opening of Proposals, RFP terms or technical requirements that may be unlawful, improvident or which unjustifiably restrict competition. CareOregon will consider all requested changes and, if appropriate, amend the RFP. No oral or written instructions or information concerning this RFP from CareOregon employees or agents to prospective Proposers shall bind CareOregon unless included in an Addendum to the RFP.

2.3 Addenda: If any part of this RFP is changed, an addendum will be published on OregonBuys. It shall be Proposers responsibility to regularly check OregonBuys for any notices, published addenda, or response to clarifying questions.

2.4 Submission of Proposals: Proposals must be submitted in accordance with Section 5. All Proposals must include a signature that affirms the Proposer’s intent to be bound by the Proposal (this may be on cover letter, or on the Proposal). The Certification page must be signed as well. If a Proposal is submitted by a firm or partnership, the name and address of the firm or partnership shall be shown, together with the names and addresses of the members.

If the Proposal is submitted by a corporation, it shall be signed in the name of such corporation by an official who is authorized to bind the contractor. No late Proposals will be accepted.

2.5 Acceptance of Contractual Requirements: Failure of the selected Proposer to execute a contract and deliver required insurance certificates within ten (10) calendar days after notification of an award may result in cancellation of the award. This time period may be extended at the option of CareOregon.

2.6 Investigation of References: CareOregon reserves the right to investigate all references in addition to those supplied references and investigate past performance of any Proposer with respect to its successful performance of similar services, its compliance with specifications and contractual obligations, its completion or delivery of a project on schedule, its lawful payment of subcontractors and workers, and any other factor relevant to this RFP. CareOregon may postpone the award or the execution of the contract after the announcement of the apparent successful Proposer in order to complete its investigation.

2.7 RFP Proposal Preparation Costs and Other Costs: Proposer costs of developing the Proposal, cost of attendance at an interview (if requested by CareOregon), or any other costs are entirely the responsibility of the Proposer, and will not be reimbursed in any manner by CareOregon.

2.8 Clarification and Clarity: CareOregon reserves the right to seek clarification of each Proposal, or to make an award without further discussion of Proposals received. Therefore, it is important that each Proposal be submitted initially in the most complete, clear, and favorable manner possible.

2.9 Right to Reject Proposals: CareOregon reserves the right to reject any or all Proposals or to withdraw any item from the award, if such rejection or withdrawal would be in CareOregon’s interest, as determined by CareOregon.

Proposals may be rejected in whole or in part if they attempt to limit or modify any of the terms, conditions, or specifications of the RFP or the Sample Contract.

2.10 Proposal Terms: All Proposals, including any price quotations, will be valid and firm through a period of one hundred and eighty (180) calendar days following the Closing date. CareOregon may require an extension of this firm offer period. Proposers will be required to agree to the longer time frame in order to be further considered in the procurement process.

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2.11 Oral Presentations: At CareOregon’s sole option, Proposers may be required to give an oral presentation of their Proposals to CareOregon, a process which would provide an opportunity for the Proposer to clarify or elaborate on the Proposal but will in no material way change Proposer’s original Proposal. Any costs of participating in such presentations will be borne solely by Proposer and will not be reimbursed by CareOregon. Note: Oral presentations are at the discretion of the evaluating committee and may not be conducted; therefore, written Proposals should be complete.

2.12 Review for Responsiveness: Upon receipt of all Proposals, the Procurement Department will determine the responsiveness of all Proposals before submitting them to the evaluation committee. If a Proposal is incomplete or non-responsive in significant part or in whole, it will be rejected and will not be submitted to the evaluation committee.

CareOregon reserves the right to determine if an inadvertent error is solely clerical or is a minor informality which may be waived, and then to determine if an error is grounds for disqualifying a Proposal. The Proposer’s contact person identified on the Proposal will be notified, identifying the reason(s) the Proposal is non-responsive.

2.13 Communication Blackout Period: Except as called for in this RFP, Proposers may not communicate with members of the Evaluation Committee or other CareOregon employees or representatives about the RFP during the procurement process until the apparent successful Proposer is selected. Communication in violation of this restriction may result in rejection of a Proposer.

2.14 Prohibition on Commissions and Subcontractors: CareOregon will contract directly with persons/entities capable of performing the requirements of this RFP. Contractors must be represented directly. Participation by brokers or commissioned agents will not be allowed during the Proposal process. Contractor shall not use subcontractors to perform the Work unless specifically proposed or authorized to do so by CareOregon. Contractor represents that any employees assigned to perform the Work, and any authorized subcontractors performing the Work, are fully qualified to perform the tasks assigned to them, and shall perform the Work in a competent and professional manner. Contractor shall not be permitted to add on any fee or charge for subcontractor Work. Contractor shall provide, if requested, any documents relating to subcontractor’s qualifications to perform required Work.

2.15 Collusion: By responding, the Proposer states that the Proposal is not made in connection with any competing Proposer submitting a separate response to the RFP, and is in all aspects fair and without collusion or fraud. Proposer also certifies that no officer, agent, or employee of CareOregon has a pecuniary interest in this Proposal.

2.16 Evaluation Committee: Proposals will be evaluated by a committee consisting of representatives from CareOregon and potentially external representatives. CareOregon reserves the right to modify the make-up in its sole discretion.

2.17 Nondiscrimination: The successful Proposer agrees that, in performing the Work called for by this RFP and in securing and supplying materials, contractor will not discriminate against or treat differently, any person on the basis of race, color, religious creed, political ideas, sex, age, marital status, sexual orientation, gender identity, veteran status, physical or mental disability, national origin or ancestry, or any other class protected by applicable law.

2.18 Best and Final Offer: CareOregon may request best and final offers from those Proposers determined by CareOregon to be reasonably viable for contract award. However, CareOregon reserves the right to award a contract on the basis of initial Proposal received. Therefore, each Proposal should contain the Proposer’s best terms from a price and technical standpoint. Following evaluation of the best and final offers, CareOregon may select for final contract negotiations/execution the offers that are most advantageous to CareOregon, considering cost and the evaluation criteria in this RFP.

2.19 PROPOSAL CONFIDENTIALITY: Submitted proposals will be treated as confidential and will only be shared internally with applicable staff for this project. Proposers that responded to the RFP will be notified of the award at the completion of the process. Proposer scores and evaluation notes shall remain private and confidential information for CareOregon purposes only.

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SECTION 3

SCOPE OF WORK

3.1 BACKGROUND

Founded in 1993, CareOregon is a 501(c)(3) public benefit nonprofit company that draws nearly all its revenue from public programs such as Medicaid (the Oregon Health Plan – “OHP”), Medicare and the State Children’s Health Insurance Program (“SCHIP”). Coordinated care organizations (“CCOs”) are an Oregon innovation that integrates physical, behavioral and oral health care, and treats the whole person.

Through partnerships with our CCOs, we provide integrated managed care services. We partner with Health Share of Oregon to serve the tri-county Portland metro area. We own Jackson Care Connect and Columbia Pacific CCO. In addition to Medicare plans and CareOregon Dental lines of business, Housecall Providers delivers primary, palliative and hospice care to home-bound patients.

Our mission is to inspire and partner to create quality and equity in individual and community health.

Our vision is healthy communities for all individuals, regardless of income or social circumstances.

We focus on the total health of our members, not just traditional health care. In teaming up with members, their families and their communities, we help Oregonians live better lives, prevent illness and respond effectively to health issues.

We care about people We serve Oregonians eligible for the OHP and Medicare Advantage members who have us as their health care option. But that’s not all. We are a managed health care company with an overarching goal: to make world-class, high-quality health care available to all Oregon residents, regardless of income.

We support our neighbors We know that some Oregonians are in need but don’t qualify for OHP benefits. We work to strengthen the health care safety net that these Oregonians rely upon, from local health departments and community clinics to rural and migrant health centers. We partner with policy makers and legislators to improve services and provide access to quality care throughout the state, from urban centers to rural neighborhoods.

We work with first-class providers CareOregon has built a health care delivery system that assures access to physicians and health care professionals who understand special needs and provide quality care regardless of a patient’s financial resources.

We work with policy makers to ensure access We provide OHP enrollees access to health care services in exchange for a per member, per month capitation rate. The Oregon Legislature sets this payment rate. The payments are subject to available state funding. CareOregon takes full financial risk for the health care services our members use. CareOregon, formed by safety net health care providers in the state, is a Safety Net Health Plan. Safety Net Health Plans are nonprofits that derive their revenue from public programs.

To put it simply, CareOregon ensures that members have timely access to high quality health care from a broad network of providers, and CareOregon works hard every day to keep people healthy and active in their homes and communities.

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Equity, Diversity, and Inclusion:

CareOregon recognizes that to achieve the vision of “Healthy communities for all individuals, regardless of income or social circumstances,” it must intentionally cultivate authentic member engagement, community partnerships, and recruit, retain and develop a staff as diverse as the communities it serves.

CareOregon has embarked on a continuous effort to understand the effects of historical, institutional and structural oppression on the various communities represented within its membership and personnel.

CareOregon strives to internally, and in partnership with other like-minded organizations across sectors, to redress policies, systems and health related environmental issues that affect health care disparities and inequities.

Equity, diversity, and inclusion is a cornerstone of CareOregon’s mission, vision and strategic objectives.

CareOregon’s priority is strengthening our communities by making health care work for everyone by ensuring access to a broader and more diverse network of physical, behavioral, and oral health services that address the individual needs and cultural values of our members and reduces barriers to getting needed care.

It is the intent of CareOregon, through issuance of this RFP, to collaborate with like-minded firms that share the same values and that will take actual steps to embody those values in the services provided to CareOregon and its providers, members and clients.

Project Background:

CareOregon is seeking proposals from qualified vendors to provide a conversational intelligence tool for our contact center. The selected solution must be capable of evaluating and providing feedback to enhance performance, improve customer experience, and drive operational efficiency. The purpose of this RFP is to solicit competitive proposals that align with our business objectives, as outlined below.

Objectives:

• Effectively manage, budget and control costs while consistently meeting performance metrics:

o Reduction in overall staffing needs due to decreases in average handle time, repeat calls, new hire ramp time, and cost per call

• Meet regulatory compliance measures and expectations:

o 100% QA using conversational intelligence, real time customer issues and trends analysis, escalation of red flag calls for compliance review o Risk reduction with comprehensive visibility to effectively monitor compliance requirements with the potential to save the company and CSRs fines and criminal penalties

• Meet Member/Provider service expectations:

o Improved metrics for Provider and Member Satisfaction due to identification of areas of friction and administrative waste

• Improve Customer Service Employee Engagement:

o Increase in Employee Engagement and retention due to more targeted training and coaching, reduced administrative burden on leaders, and elimination of bias in quality scoring

3.2 SCOPE OF WORK

3.2.1 Scope: The selected vendor will provide conversational intelligence services to CareOregon. The solution selected shall provide the following Core Services with the Optional Services listed being desired but not required.

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Core Services – The required Core Services include but are not limited to:

1. Solution Design:

• Call transcription and analysis to identify trends and insights - The system will automatically transcribe calls, allowing for a comprehensive review of interactions.

• The solution design should deal with all the technical components necessary for deployment, including Natural Language Processing (NLP) and Natural Language Understanding (NLU), Sentiment Analysis, Automated Call Summarization, Agent Assist & Scripting, and Real-time Coaching & QA

• The ideal solution will include all necessary customizations needed to meet CareOregon’s needs and integrate with CareOregon’s systems.

2. AI Functionality:

• Sentiment analysis to assess caller experience and agent engagement - By evaluating tone, word choice, and speech patterns, the system can determine caller sentiment (positive, neutral, or negative) and assess agent engagement levels.

• Automated quality monitoring to support compliance and service improvements - The platform will automate call scoring based on predefined quality assurance criteria, ensuring consistent evaluation of agent performance. This reduces manual auditing efforts while identifying compliance risks, adherence to scripts, and best practices in real time.

• Speech and keyword recognition to track specific topics or concerns - Using advanced speech analytics, the system can detect keywords and phrases related to common customer concerns, compliance issues, or service trends.

• Ability to monitor quality in multiple languages to ensure consistency across diverse interactions

- With multilingual support, the system ensures accurate call monitoring and evaluation across all supported languages, maintaining quality and compliance standards regardless of the caller’s language. The 6 most common languages (besides English) we use at CareOregon, include:

Spanish, Vietnamese, Russian, Arabic, Somali, and Simplified Chinese/Traditional Chinese.

• Intelligent call rerouting based on caller intent and modality preferences - The system will analyze caller intent in real time and automatically reroute calls to the appropriate department or service channel. If a self-service option is available, the system can offer alternative solutions, such as sending a text message with a self-service portal link, reducing hold times and improving efficiency.

3. Training & Coaching:

• Real-time coaching and training simulations to enhance agent development and responsiveness.

• The system should provide instant feedback, helping agents adjust their approach in real time.

Additionally, interactive training simulations will allow agents to practice handling complex scenarios, improving their problem-solving skills and customer engagement techniques.

4. Reporting and Automation:

• Performance insights and coaching recommendations based on interaction data – the solution should detect and report on key metrics such as patient satisfaction, agent performance, compliance with healthcare regulations (e.g., HIPAA), identifying at-risk patients, and trends in patient behavior.

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• The platform should generate individualized performance reports, highlighting strengths and opportunities for improvement.

• Based on these insights, agents will receive personalized coaching recommendations to enhance service quality, accuracy, and efficiency.

• Solution should have the capability to exchange survey data, responses, and findings in machine readable format with CareOregon.

5. Security and Operations:

• Ensure robust data security measures and full compliance with CareOregon’s data security policies - View CareOregon’s data security policies at this link: https://careoregon.org/about-us/vendor-resources.

• Data Security considerations include secure data transferring, handling of Protected Health Information (“PHI”), and collaboration with CareOregon’s information systems teams to efficiently transfer member data via secure protocols. In addition, because of potential access to PHI during a phone call, all software, backup and processing must remain within the United States.

6. Project Approach:

• The selected solution must integrate with CareOregon’s existing NICE cxOne platform.

• The solution should come with a project management approach that will ensure a positive onboarding experience include deployment services and technology configurations.

Optional Services - The selected vendor should provide solution recommendations and options, including implementation approaches and cost estimates, for the following optional services:

• Integration of call transcription with QNXT or CIM for auto-notation of calls This feature would allow automatic documentation of call interactions within QNXT or CIM, reducing manual data entry and ensuring accurate, real-time call records.

• Real-time agent-assisted coaching The system would provide live coaching and guidance during calls, offering real-time prompts, recommendations, and corrective feedback to agents.

Work Schedule:

The table outlines target timelines for this project. It is important for Proposers to highlight their ability to meet these timelines or to propose alternatives based on their recommendations.

Date Description July 2025 Implementation Start Goal January 2026 System Go-Live (full operational use)

3.2.2 Term of Contract: The term of the contract shall for two (2) years from the effective date with the option for two (2) additional two (2) year renewals thereafter subject to the mutual agreement of the parties.

3.2.3 Sample Contract: Submission of a Proposal in response to this RFP indicates Proposer’s willingness to enter into a contract containing substantially the same terms (including insurance requirements) of the sample contract identified below. No action or response to the sample contract is required under this RFP. Any objections to the sample contract terms should be raised in accordance with Paragraphs 2.2 of this RFP pertaining to requests for clarification of the https://careoregon.org/about-us/vendor-resources https://careoregon.org/about-us/vendor-resources

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RFP/specifications. This RFP and all supplemental information in response to this RFP will be a binding part of the final contract.

The applicable Sample Professional Services Contract for this RFP can be found at https://careoregon.org/contact-us/vendor-resources.

Professional Services Contract (unless checked, item does not apply) The following paragraphs of the Professional Services Contract will be applicable:

Travel and Other Expense is Authorized Protection of Patient Privacy and Security (PHI) Criminal Background Check Requirements Key Persons On-Call Contract Basis CareOregon Data Security Requirements Hosted Software

The following insurance requirements will be applicable:

Commercial General Liability: combined single limit, or the equivalent, of not less than $1,000,000 per occurrence, with an annual aggregate limit of $2,000,000 for Bodily Injury and Property Damage.

Professional Liability: combined single limit, or the equivalent, of not less than $1,000,000 per occurrence, with an annual aggregate limit of $2,000,000 for damages caused by error, omission, or negligent acts.

Automobile Liability: combined single limit, or the equivalent, of not less than $1,000,000 per occurrence for Bodily Injury and Property Damage.

Cyber Liability: combined single limit, or the equivalent, of not less than $2,000,000 per occurrence for network security (including data breach), privacy, interruption of business, media liability, and errors and omissions.

For Software Purchases: For this project, CareOregon is open to using the selected Proposer’s contract template, however, the final contract should include provisions substantially equivalent to the CareOregon terms for the checked provisions above. In addition, the attached Contract Addendum (attached as Exhibit A) shall be required to be executed and will specifically supersede several typical clauses contained in the Proposer’s software agreements. Most of the clauses are required and will not be negotiated so it is important for interested Proposers to carefully read the Contract Addendum and understand that it will be executed along with the resulting Proposer contract.

https://careoregon.org/contact-us/vendor-resources

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SECTION 4

EVALUATION PROCEDURE

4.1 An evaluation committee will review all Proposals that are initially deemed responsive and they shall rank the Proposals in accordance with the below criteria. The evaluation committee may recommend an award based solely on the written responses or may request Proposal demonstrations/presentations.

Demonstrations/presentations, if deemed beneficial by the evaluation committee, will consist of the highest scoring Proposers. The invited Proposers will be notified of the time, place, and format of the demonstration/presentation. Based on the demonstrations/presentations, the evaluation committee may revise their scoring.

Written Proposals must be complete and no additions, deletions, or substitutions will be permitted during the interview/demonstration (if any). The evaluation committee will recommend award of a contract to the final CareOregon decision maker based on the highest scoring Proposal. The CareOregon decision maker reserves the right to accept the recommendation, award to a different Proposer, or reject all Proposals and cancel the RFP.

Proposers are not permitted to directly communicate with any member of the evaluation committee during the evaluation process. All communication must be facilitated through the assigned Procurement Analyst.

4.2 Evaluation Criteria

Category Points available:

Proposer’s General Background and Qualifications 25 Scope of Work 30 Equity, Diversity, and Inclusion Efforts 10 Demonstrations/Interviews 15 Fees 20

Available points 100

4.3 Once a selection has been made, CareOregon will enter into contract negotiations. During negotiation, CareOregon may require any additional information it deems necessary to clarify the approach and understanding of the requested services. Any changes agreed upon during contract negotiations will become part of the final contract. The negotiations will identify a level of Work and associated fee that best represents the efforts required. If CareOregon is unable to come to terms with the highest scoring Proposer, discussions shall be terminated and negotiations will begin with the next highest scoring Proposer. If the resulting contract contemplates multiple phases and CareOregon deems it is in its interest to not authorize any particular phase, it reserves the right to return to this solicitation and commence negotiations with the next highest ranked Proposer to complete the remaining phases.

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SECTION 5

PROPOSAL CONTENTS

5.1 Vendors must adhere to submission instructions and be advised as follows:

1. Complete Proposals must be emailed to vendorservices@careoregon.org. The subject line of the email must identify the RFP title. Proposers are encouraged to contact Procurement to confirm receipt of the Proposal.

2. CareOregon reserves the right to solicit additional information or Proposal clarification from the vendors, or any one vendor, should CareOregon deem such information necessary.

3. Proposal may not exceed a total of 25 pages (single-sided), inclusive of any exhibits, attachments or other information.

4. Proposers are required to structure Proposals following the below question outline. It is important for answers to be clear and concise.

5.2 Proposer’s General Background and Qualifications (25 Max points):

1. Description of the firm.

2. Credentials/experience of key individuals that would be assigned to this project.

3. Description of providing similar services to non-profit entities of similar size within the past five (5) years.

4. Describe your typical customer profile, such as size and service provided. What are your customer retention rates?

5. Description of the firm’s ability to meet the requirements in Section 3.

6. Description of what distinguishes the firm from other firms performing a similar service.

7. Describe if any of the proposed services will be performed by offshore (not US state or US territory) employees or subcontractors?

8. CareOregon requires that data must be stored within the continental United States. Please confirm that all applications and data base servers are located in the continental United States.

9. Describe if your firm is currently or potentially engaged in litigation.

10. Provide information demonstrating that your firm is financially stable.

11. Identify any issues or concerns in social media about your firm?

5.3 Scope of Work (30 Max points total):

Solution Design (5 Points Max)

1. Describe how your solution models/supports all the functions listed in the section 3 and a-e. Describe the technical components necessary for deployment of the solution.

a. Natural Language Processing (NLP) and Natural Language Understanding (NLU)

b. Sentiment Analysis

c. Automated Call Summarization

d. Agent Assist & Scripting

e. Real-time Coaching & QA

2. Does your solution have a test environment that will be used for development and testing before being migrated to production?

3. Is the AI solution built, owned, and managed by the original software vendor? Describe the role any third-party technologies or services play in the proposed solution. Are there additional third-party products/services that CareOregon will need to license/procure separately from this solution?

4. What customizations of your AI solution are needed to meet CareOregon’s needs?

5. What are the roles and responsibilities for CareOregon staff to operate and manage the solution

(hardware, software, connectivity)?

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6. Provide solution diagram on how your product will integrate with CareOregon’s systems, including the NICE cxOne platform. Please include high level data or process diagrams for a typical integration to meet the solution requirements. Are these built-in or custom integrations?

7. Describe your integration options with other systems such as:

a. Tools commonly used in healthcare environments, such as telemedicine platforms, electronic medical records systems (e.g. Epic), patient portals, and scheduling systems.

b. Data warehouse or other reporting systems (e.g., Snowflake).

c. Generic or specialized API (e.g., FHIR or REST) for custom integrations into other systems.

d. Bulk download of data.

8. How does your solution ensure a seamless experience for both customers and agents when switching between different communication channels?

AI Functionality (5 Points Max)

1. How does your AI solution leverage Natural Language Processing (NLP) and Natural Language

Understanding (NLU) to analyze customer interactions?

2. How does your AI solution monitor, identify, evaluate, and intervene to correct bias when found? Will it adjust for cultural considerations and avoid bias?

3. What is the core AI engine used for this tool?

4. Is this tool capable of monitoring other AI interactions, like ChatGPT?

5. How does your AI solution handle medical terminology, jargon, acronyms, and complex healthcare-related language in customer interactions? Does your solution support domain-specific language models, and can it be customized for specific healthcare needs (e.g., oncology, mental health, pediatrics)?

6. Does your AI solution learn and adapt over time from user interactions to improve accuracy and handle new medical terms and evolving language? How do you ensure that your AI solution is continuously trained with healthcare-specific data to improve performance over time?

7. How does your AI solution handle ambiguous, incomplete, or complex patient inputs (e.g., multiple symptoms, vague descriptions)?

8. Does your AI solution support multilingual capabilities and varied accents? Which languages and dialects does it support for healthcare-specific needs?

9. Describe how your sentiment analysis works. Is there a feedback mechanism for this?

10. Does your AI solution provide real time transcription or delayed time transcription?

11. Can users interact in various modes, such as voice, chat, and/or SMS?

12. Is there a user feedback feature for events such as if a user thinks there is an error? Is PII/PHI anonymized or redacted in this feature?

13. Can the AI solution identify critical areas requiring immediate attention (e.g., potential HIPAA violations, escalated customer issues)?

Training and Coaching (5 Points Max)

1. Is there a training environment where healthcare customer service agents can practice real-life scenarios? How customizable are the training simulations in terms of healthcare scenarios (e.g., billing inquiries, insurance questions, medical advice, appointment scheduling)?

2. How do you measure the effectiveness of training? Does the system report on agent progress over time?

Reporting and Automation (5 Points Max)

1. Does your AI solution detect and report on key metrics such as patient satisfaction, agent performance, compliance with healthcare regulations (e.g., HIPAA), identifying at-risk patients, and trends in patient behavior?

2. Describe the solution’s out of the box reporting capabilities.

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Security and Operations (5 Points Max)

1. How do you ensure that patient data is protected and HIPAA compliant according to healthcare industry standards?

2. How does the system handle sensitive topics like mental health, substance abuse, and sexual health in a manner that maintains confidentiality?

3. Describe your Information Security program, including organizational structure, leadership, and framework.

4. What encryption methods and algorithms do you use for data at rest and in transit?

5. How do you manage data access controls and audit trails, especially for sensitive healthcare data?

Provide a copy of your most recent data security audit.

6. Are your system security measures validated regularly by a third party? Please provide any certifications or 3rd party attestations to demonstrate, such as HITRUST CSF or ISO 27001.

7. Describe all places where CareOregon data may be stored by your staff, such as on workstations or paper, and physical locations such as in offices and/or data centers.

a. Describe your physical security model.

b. Is the data stored in this solution accessible by the service provider’s support staff? Please describe.

c. Do you allow customer data to be downloaded or moved outside of your applications and data centers? Please describe.

8. Describe your standard update/patch frequency, version upgrades, and the process to notify customers of upcoming new releases.

9. How will you ensure that CareOregon data is not stored or processed outside of the United States?

10. Describe how you keep CareOregon data separate from other customer data. How long will CareOregon data be stored? Will CareOregon data persist in your environment beyond contract termination?

11. Discuss how you train your AI model.

a. Will CareOregon data be used to train the AI model?

b. Will this training be applied to other customers?

c. Will other users have access to CareOregon data through the model?

12. How does your product provide high availability and resiliency to address service outages, compromises, data corruption, or other impairments? What does monitoring and reporting look like for breach events?

13. What systems (backups, redundancies, etc.) are in place to ensure continued availability of the tool in the event of a disruptive incident? Describe disaster recovery and business continuity plans, specifically addressing the most recent date and the number of times the vendor has practiced and tested its procedures in the past 5 years, and the results of those exercises.

14. How does the system handle spikes in demand (e.g., during healthcare crises, open enrollment periods)?

15. How does your AI solution ensure accuracy and reliability as it scales, especially in high-volume environments?

16. Do you offer 24/7 customer support, and what is your average response time for urgent issues? Confirm that customer support will be available minimally M-F, 8:00 am-5:00 pm, Pacific Time.

17. Where does data processing take place, locally or online?

18. What call and chat volumes can the system handle?

19. What kind of ongoing training and support do you offer for healthcare customer service teams after implementation?

20. How do you screen your employees and contractors to ensure the safety of customer data?

21. How does the proposed solution implement single sign-on with third-party identity systems, such as

Active Directory, Azure Active Directory, and/or other OAuth identity services?

22. Describe how the system records and reports on user access and activity. Do you periodically review your own staff access logs?

RFP 2025-01 – Conversational Intelligence Tool Page 12

23. What provisions do you have to allow us to retrieve data if/when our agreement ends? How do you ensure data is destroyed and/or permanently removed from your systems?

Project Approach (5 Points Max)

1. Describe your Project Management methodologies and approach for an implementation like this. How do you ensure a positive onboarding experience including deployment services and technology configuration?

2. The final solution may be composed of multiple integrated modules, features, and services. Describe the order in which you recommend implementing these modules and why. Describe any required prerequisites for these modules.

3. Describe solution implementation resources that would be provided as part of the project.

4. What skills and resources will CareOregon need to provide as part of the project implementation? What is your estimate for the time commitment of CareOregon staff during implementation?

5. Provide a sample project plan.

6. Provide your standard Service Level Agreement if you desire to use your standard contract template rather than CareOregon’s Professional Services Agreement template.

7. Describe/provide your operational and service level agreements and any other documents modifying your terms of service.

5.4 Equity, Diversity and Inclusion Efforts (10 Max points):

1. Describe your firm’s equity, diversity and inclusion values, policies, efforts, and successes. Include specific details of efforts and how they have shaped the composition and spirit of your firm.

2. Supplier diversity is the intentional inclusion of historically underutilized businesses in a firm’s supply base to achieve innovation, cost reduction, and building economic growth in our communities. If you plan to use subcontractors or other third-party services for the services proposed to CareOregon, describe your supplier diversity program.

3. Outline the specific elements of your proposed services that will support and advance CareOregon’s equity, diversity, and inclusion mission.

5.5 Fees (20 Max points):

Fees should be on a fixed fee basis. Alternative fee bases may be considered as needed depending on the bid.

Fees should be sufficiently descriptive to facilitate acceptance of a Proposal. List the not-to-exceed amount you propose for the service. If services are extended past the initial contract term, provide a maximum escalator to the fee for additional terms.

5.6 Demonstration: (15 Points Max)

After an initial review of the submissions received, it is anticipated that the top 2-3 vendors will be asked to provide a demonstration of their product for review by the full Evaluation Committee. More information will be provided to the qualifying vendors when asked for this demonstration.

5.6 References (No points awarded).

Provide at least three (3) references from clients your firm has served similar to CareOregon in the past three (3) years, including one client that has newly engaged the firm in the past thirty-six (36) months and one (1) long-term client. Provide the name, address, email, and phone number of the references. Please note the required three references may not be from CareOregon staff, but additional references may be supplied. Points awarded for this criteria are based on both the providing of references as well as information gleaned from the provided contacts. Evaluation Committee members may contact references at their sole discretion.

5.7 Completed Proposal Certification (see the below form)

RFP 2025-01 – Conversational Intelligence Tool Page 13

PROPOSAL CERTIFICATION

RFP #2025-01 – Conversational Intelligence Tool

Submitted by:

(Must be entity’s full legal name, and State of Formation)

Each Proposer must read, complete and submit a copy of this Proposal Certification with their Proposal. Failure to do so may result in rejection of the Proposal. By signature on this Proposal Certification, the undersigned certifies that they are authorized to act on behalf of the Proposer and that under penalty of perjury, the undersigned will comply with the following:

SECTION I. NONDISCRIMINATION: That the Proposer has not and will not discriminate in its employment practices with regard to race, color, creed, age, religious affiliation, sex, marital status, disability, sexual orientation, gender identity, national origin, veteran status, or any other protected class. Nor has Proposer or will Proposer discriminate against a subcontractor in the awarding of a subcontract because the subcontractor is a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a business that a service-disabled veteran owns or an emerging small business that is certified under ORS 200.055.

SECTION II. CONFLICT OF INTEREST: The undersigned hereby certifies that no officer, agent or employee of CareOregon is personally interested, directly or indirectly, in any resulting contract from this RFP, or the compensation to be paid under such contract, and that no representation, statements (oral or in writing), of the CareOregon, its officers, agents, or employees had induced Proposer to submit this Proposal. In addition, the undersigned hereby certifies that this proposal is made without connection with any person, firm, or corporation submitting a proposal for the same material, and is in all respects fair and without collusion or fraud.

SECTION III. COMPLIANCE WITH SOLICITATION: The undersigned further agrees and certifies that they:

1. Have read, understand and agree to be bound by and comply with all requirements, instructions, specifications, terms and conditions of the RFP (including any attachments);

2. Are an authorized representative of the Proposer, that the information provided is true and accurate, and that providing incorrect or incomplete information may be cause for rejection of the Proposal or contract termination; and

3. Will furnish the designated item(s) and/or service(s) in accordance with the RFP and Proposal.

Name:_______________________________________ Date:______________________________________

Signature:____________________________________ Title:______________________________________

Email:_______________________________________ Phone:_____________________________________

Oregon Business Registry Number:________________ OR CCB # (if applicable):________________________

Proposer Primary Point of Contact (Coordination during process and for award information):

Name:_______________________________________

Email:_______________________________________ Phone:_____________________________________

Business Designation (check one):

Corporation Partnership Sole Proprietorship Non-Profit Limited Liability Company

Minority (MBE), Women (WBE), Service-Disabled Veteran (SDV), and Emerging Small Business (ESB):

Certified by the State of Oregon (provide certification number as applicable):

MBE WBE SDV ESB

Self-identified (check as applicable):

MBE WBE SDV ESB

RFP 2025-01 – Conversational Intelligence Tool Page 14

Exhibit A – Sample Contract Addendum

CAREOREGON, INC.

CONTRACT ADDENDUM

Contract #

This Contract Addendum (“Addendum”) is entered into by CareOregon, Inc. (“CareOregon”) and (“Contractor”).

This Addendum shall be attached to, and incorporated into, the [Description of contract being attached] (“Vendor Agreement”). As used below, "Contract" means this Addendum and the Vendor Agreement and “Services” refers to the goods and/or services described in the Vendor Agreement. To the extent there is any conflict between the Addendum and the Vendor Agreement, the terms of this Addendum shall control.

1. Term. The Contract shall become effective upon signature of both parties. Unless earlier terminated or extended, this Contract shall expire on . This Contract or any Order Form may be extended only if ninety (90) days prior to the then expiration date, the Contractor provides a written quote to CareOregon for a one-year (unless the parties negotiate otherwise) renewal term, and CareOregon accepts a renewal term by the issuance of a CareOregon purchase order or agrees to a new Order Form. Except for the renewal term and associated fee, no other terms and conditions of the original Contract may be changed through this process.

2. Contractor and CareOregon Contract Administrators.

Contractor Administrator:

Phone:

Email:

Address

CareOregon Administrator:

Phone:

Email:

Address:

3. Invoices and Payments. Invoices shall be submitted to: covendorinvoices@careoregon.org.

Payment for completion of CareOregon contracts are made within 30 days following the date the entire order is delivered or the date the accurate invoice is received whichever is later. Contractor may not assess an overdue account charge in excess of eight percent (8%) per annum on outstanding balances. If Contractor fails to present invoices in proper form within sixty (60) calendar days after the end of the month in which the Services were performed, Contractor waives any rights to present such invoice thereafter and to receive payment therefor.

4. Fee Escalation Cap. In the event any Order Form, Statement of Work, or any other contract authorizing Services is entered into between the parties, any applicable fee shall not increase by more than three percent (3%) over the prior year fees.

5. Travel and Other Expense. If travel expense reimbursement is authorized in this Contract, such expense shall only be reimbursed at the rates in the CareOregon Contractor Travel Reimbursement Allowance, hereby incorporated by reference and found at: https://www.careoregon.org/about-us/vendor-resources.

Travel expense reimbursement is not in excess of the not to exceed compensation amount.

6. Insurance. Contractor shall secure at its own expense and keep in effect during the term of the performance under this Contract the insurance required and minimum coverage indicated below. A checked box indicates the coverage is required. If the box is not checked, it is not required. The insurance requirements outlined below do not in any way limit the amount of scope of liability of Contractor under this Contract. Contractor mailto:covendorinvoices@careoregon.org https://www.careoregon.org/about-us/vendor-resources

RFP 2025-01 – Conversational Intelligence Tool Page 15 shall provide proof of said insurance and name CareOregon as an additional insured on commercial general liability and business automobile liability policies. Contractor shall provide proof of insurance and shall provide CareOregon at least 30 days prior notice of any policy material change, lapse, or termination. Proof of insurance and any notification shall be emailed to: CareOregon Procurement Department at vendorservices@careoregon.org. Required insurance:

• Workers’ Compensation: Contractor shall comply with the statutory workers’ compensation requirements in ORS 656.017, unless exempt under ORS 656.027 or 656.126.

• Commercial General Liability: combined single limit, or the equivalent, of not less than $1,000,000 per occurrence, with an annual aggregate limit of not less than $2,000,000 for bodily injury and property damage.

• Cyber Liability: combined single limit, or the equivalent, of not less than $1,000,000 per occurrence for network security (including data breach), privacy, interruption of business, media liability, and errors and omissions.

• Umbrella coverage in the sum of $2,000,000 and will apply over all required liability policies, without exception.

The policy(s) stated herein shall provide primary and non-contributory insurance for all claims made pursuant to performance of this Contract.