RFP 27-03 QA Addendum 3 FINAL.docx

This ADDENDUM 3 (this “Addendum”), dated August 14, 2026, is being issued to Respondents of the referenced RFP 27-03 Revenue Integrity, Contract Performance & Patient Financial Platform (the “RFP”), and serves to modify or clarify, as applicable, the following information in the RFP.

Questions and Answers Question 1

Would Roswell Park consider responses by functional area?

Answer 1

Yes. Proposals addressing only a portion of the scope will be evaluated in accordance with the requirements and evaluation criteria set forth in the RFP. Roswell Park reserves the right to determine the most advantageous overall solution and may ultimately select a single integrated solution, multiple vendors, or another approach that best meets its needs. As such, acceptance of proposals for specific functional areas should not be interpreted as a commitment to award contracts for those individual areas.

Question 2

How heavily is Authorization Management weighted in the evaluation?

Answer 2

The authorization management functionality is equally weighted with the other functional areas and is a priority for our institute.

Question 3

Is a partner-supported best-of-breed approach something that your team would consider?

Answer 3

Yes.

Question 4

Can you please provide annual claim volume or annual encounter volume for the past 12 months?

Answer 4

The approximate volumes below reflect Roswell Park's most recent complete twelve (12) month period and are provided solely to support proposal sizing and pricing. These figures are estimates, are not warranted as exact, and do not constitute a commitment to any minimum or maximum volume.

1. Institutional / hospital (HB) claims: 5,636

1. Professional (PB) claims: 515,311

1. Total patient encounters (inpatient discharges, outpatient and infusion visits): 520,947 All volume data provided under this Addendum is consolidated in Answers 4, 13, and 23. Respondents should state clearly any pricing assumption that is dependent on volume and should identify the volume tier or band on which their pricing is based, consistent with Section 1.6.

Question 5

Does Roswell intend to have Contract Manager & Analysis in scope for both Hospital Billing (HB) & Professional Billing (PB)? If both, please answer Questions 6 and 7. If only PB, please answer Question 6 and skip Question 7. If only HB, please answer Question 7 and skip Question 6.

Answer 5

Consistent with Section 1.2, Roswell Park's preference is a solution that models payer contract terms and monitors contract performance across both hospital and professional billing within a single platform, under a single agreement and support model.

Respondents able to support only one of HB or PB should state this clearly, identify which is supported, and respond in accordance with Answer 1. See also Answers 11 and 28.

Question 6

Contract Manager for Medical Groups (PB):

1. What percentage of your EOBs/Remittances are electronic?

1. Does your clearinghouse convert the paper claims to 837p format for you? If yes, what percentage?

1. Are claims ever split for any reason? If yes, explain scenarios where this would occur and whether it's handled manually or automatically by system.

1. Are remits posted at the line-item level or claim level?

1. How many clinics are part of the organization?

1. How many TINs? For each TIN, please list the entity name, group type, address, TIN, if it is the same contract as other TINs, and if it is the same reimbursement structures as other TINs?

1. Does group bill for anesthesia?

1. Are there any fee schedules set up in your billing system that automatically populate the “Approved” or “Allowed” field?

1. Is it a mandatory requirement that Medical Group clients' PMS/HIS be able to create/export an extract file daily for utilization in CM. Are you able to do so or are you only able to output 835/837 integrations?

Answer 6

Responses are provided in the order the questions were submitted:

1. Percentage of EOBs/remittances received electronically (835): ~95%

1. Paper conversion: Roswell Park interprets this question as addressing both directions of paper conversion. (i) Paper claims converted to electronic 837p by the clearinghouse: clearing house for 837P, under 5%. (ii) Paper remittance advices converted to 835 by the clearinghouse or a lockbox/conversion vendor: Clearinghouse

1. Claim splitting: Yes on occasion, for IP stays to CMS that cross over Medicare’s fiscal year, IP stays for patients (being per diem, rather than DRG, this is required). This is manually split.

1. Remittance posting level: Remits are at the line. Payments are posted at the claim level.

1. Number of clinics: see Answer 9.

1. Number of TINs: 1 for Hospital and CPP. Entity-level detail — including legal entity name, group type, address, TIN, contract alignment, and reimbursement structure alignment — will be furnished to respondents on request following proposal submission, and in all cases to shortlisted respondents during the Phase II evaluation described in Section 1.8, subject to an executed confidentiality agreement. Roswell Park will not publish taxpayer identification numbers or entity address detail through this Addendum.

1. Anesthesia billing: Professional service bills anesthesia services and yes, we are reimbursed with base units on top of the time units.

1. Automated “Approved”/“Allowed” population: Yes, to varying degrees by service, not ideally integrate

1. Daily extract capability: Standard should be fine.

Respondents should state clearly whether a proprietary daily extract is a mandatory prerequisite for their contract management module, or whether standard 835/837 feeds are sufficient, and should describe any reduction in functionality if only 835/837 feeds are available. Data prerequisites are a required disclosure under Section 1.4.5(a) and will be considered in the evaluation of integration and technical fit.

Question 7

Contract Manager for Hospital/Facilities (HB):

1. Does your clearinghouse convert the paper claims to 837i format for you? If yes, what percentage?

1. Some services may be billed using the 1500 form or 837p format. Please identify any such scenarios and specify which are billed from the HIS (ex. vaccines).

1. Are claims ever split? If yes, explain scenarios where this would occur and whether it's handled manually or automatically by system.

1. Is an ambulatory surgical center (ASC) owned or billed for by the organization? How many?

1. How many facilities are part of the organization? For each facility, please list the facility name, facility type (Hosp, Rural, Critical Access, ASC, SNF, LTAC, etc.), facility address, facility TIN, if it is the same contract as other facilities, and if it is the same reimbursement structures as other facilities?

1. Are there hospital-based clinics within the organization that perform provider-based billing (on HCFA 1500s via 837p)?

Answer 7

Responses are provided in the order the questions were submitted:

1. Paper-to-837i conversion by clearinghouse: Yes, AthenaEDI. Less than 5%

1. Services billed on the CMS-1500 / 837p: All physician billing

1. Claim splitting: See Question 6

1. Ambulatory surgical center: N/A

1. Number of facilities: see Answer 9. Facility-level detail — including facility name, facility type, address, TIN, contract alignment, and reimbursement structure alignment — will be furnished as described in Answer 6. Roswell Park will not publish taxpayer identification numbers or facility address detail through this Addendum.

1. Provider-based billing: Yes, all physician billing Respondents should note that Roswell Park is a PPS-exempt cancer center. Respondents must confirm in their proposal that their contract modeling and expected-reimbursement engine supports PPS-exempt cancer hospital reimbursement methodologies, including Medicare reasonable cost-based payment, the applicable payment adjustment, and payer methodologies that reference or deviate from standard IPPS/OPPS logic. This capability is material to requirements U1, U2, and C1.

Question 8

The RFP specifies a 12-page limit for proposals, including responses to the questions in Sections 1.4, 1.6, 1.7, and 1.10.1. Given the number and depth of the questions contained within these sections, respondents would be limited to very brief responses that may not fully address the Authority's requirements. Would the Authority consider increasing the page limit to enable comprehensive yet concise responses to all requested information?

Answer 8

Yes. Section 1.10 of the RFP is modified as follows. The requested narrative response length is increased from eight to twelve (8–12) pages to a maximum of twenty (20) pages.

In addition, and for the avoidance of doubt, the following materials do not count toward the page limit:

1. The completed Requirements Checklist and the Required Evidence Pack (Section 1.3);

1. Pricing tables, pricing assumptions, and total cost of ownership submissions (Section 1.6);

1. Case examples and client references (Section 1.7);

1. Company background and required information (Section 1.10.1);

1. Required forms (Section IV);

1. Sample agreements, exceptions, and redlines (Sections 1.10.9 and V);

1. Any optional or adjacent capability appendix submitted in accordance with Answers 24 and 25.

Respondents are reminded that Section 1.4 requires responses that are concise, factual, and specific to the proposed solution, and that marketing language should be avoided. Length will not improve a score; specificity and evidence quality will.

Question 9

# of Facilities: How many hospitals are in scope? How many clinics are in scope?

Answer 9

1. Hospitals in scope: Roswell Park Cancer Institute Corporation d/b/a Roswell Park Comprehensive Cancer Center

1. Clinic / ambulatory locations in scope: Elm & Carlton Streets, 203 Park Club Lane, 199 Park Club Lane, 100 College Park Amherst Center, 6934 Williams Road Summit Park Respondents should assume that all Roswell Park locations at which billable services are rendered are within scope unless otherwise stated and should describe how their pricing model treats the addition of locations during the Term. See also Answers 5, 7, and 28.

Question 10

What EHR and patient accounting platforms are currently in use?

Answer 10

1. Electronic Health Record: Altera Sunrise

1. Patient accounting / billing system: Athena IDX

1. Clearinghouse: Athena IDX Respondents are directed to Section 1.4.5(e) and to Answer 18 regarding integration with a future successor EHR platform. Respondents should describe integration requirements at the transaction and interface level (e.g., HL7 v2, FHIR APIs, flat-file extract, 837/835 feeds, direct database access) so that integration scope can be evaluated independent of any specific platform.

Question 11

Does the scope include only institutional (hospital) claims, or are professional claims also in scope?

Answer 11

See Answers 5 and 28.

Respondents should clearly identify any functional, pricing, or integration differences between institutional and professional claim support, and should state whether any proposed module supports only one claim type.

Question 12

What is your payer mix? What, if any, payers are excluded?

Answer 12

No payer is excluded from scope. Roswell Park's payer landscape includes concentration among Western New York regional commercial and Medicare Advantage plans and New York State Medicaid and Medicaid managed care plans, together with out-of-area and national commercial plans reflecting Roswell Park's regional and national referral base. Respondents should describe how out-of-area and single-case-agreement arrangements are modeled and monitored. See also Answer 15.

Question 13

Please provide the following volumes:

1. # of estimates performed annually

1. # of eligibility checks performed annually

1. # of authorization checks performed annually

Answer 13

Approximate annual volumes, provided for sizing purposes only and subject to the qualifications set forth in Answer 4:

1. Patient estimates generated annually: Not currently being tracked with any regularity or consistency.

1. Eligibility verification transactions annually (real-time and batch combined; real-time / batch if available): Not currently being tracked with any regularity or consistency.

1. Authorization transactions annually (initial requests; excludes status inquiries and renewals unless noted): Not currently being tracked with any regularity or consistency.

Respondents whose pricing is transaction-based must state the unit of measure precisely, for example, whether an eligibility transaction is counted per inquiry, per response, per payer attempted, or per patient encounter, and whether authorization status inquiries, renewals, and retries are separately chargeable. Ambiguity in the unit of measure will be resolved against the respondent for purposes of price normalization under Section 1.6.

Question 14

What service lines are required for authorization checks?

Answer 14

Authorization support is expected across the full oncology continuum. Respondents should assume the following service categories are in scope and should identify any category their solution does not support:

1. Medical oncology and infusion services, including chemotherapy, immunotherapy, biologics, biosimilars, and supportive injectables

1. Radiation oncology, including IMRT, IGRT, SBRT/SRS, brachytherapy, and treatment planning

1. Surgical services, both inpatient and ambulatory

1. Advanced diagnostic imaging, including CT, MRI, PET/CT, and nuclear medicine

1. Interventional radiology and image-guided procedures

1. Cellular therapy and transplant, including autologous and allogeneic HSCT and CAR-T and other cell and gene therapies

1. Molecular diagnostics, comprehensive genomic profiling and next-generation sequencing panels, and hereditary genetic testing

1. Specialty pharmacy and oral oncolytics, including medical versus pharmacy benefit determination and site-of-care authorization

1. Inpatient admissions and observation, including concurrent review and continued stay authorization

1. Routine care services associated with clinical trial participation, where authorization is required

1. Supportive and ancillary services, including behavioral health, rehabilitation, home health, DME, and nutrition, as applicable Respondents should note that oncology authorization frequently involves multi-code, multi-cycle, and multi-modality requests spanning an extended treatment course. Consistent with Section 1.2.5 and requirement A4, respondents must describe support for regimen-level and course-level authorization, unit and cycle tracking, and renewal workflow, not solely single-service authorization.

Question 15

Who are your top payers for authorization checks?

Answer 15

Highmark, Univera, Independent Health, Aetna, United Roswell Park's authorization volume is concentrated among Western New York regional commercial and Medicare Advantage plans, New York State Medicaid and Medicaid managed care plans, and Medicare fee-for-service, with additional volume from national and out-of-area commercial plans.

Respondents should not scope payer connectivity to a fixed payer list. Consistent with requirement L2 and Question 1.4.2(c), respondents must describe overall payer connectivity breadth, the connection method available for each payer type (X12 278, payer portal automation, clearinghouse, or manual), and specifically identify payers or plan types for which only manual or portal-based workflow is available. Utilization management delegation to third-party benefit managers (for example, radiology, radiation oncology, genetic testing, and specialty drug benefit managers) is common in oncology; respondents must describe how delegated review entities are supported.

Question 16

Please define “recovery/appeal workflow support.” Are you seeking only technology with this functionality, or are you seeking outsourced personnel to perform the recovery/appeal workflow process?

Answer 16

For purposes of this RFP, “recovery/appeal workflow support” means technology-enabled workflow, including:

1. Automated identification and prioritization of underpaid, denied, and variance accounts based on modeled contract terms;

1. Assignment, work queue, status, and productivity management for Roswell Park staff;

1. Generation, templating, and tracking of appeal and reconsideration correspondence and supporting documentation;

1. Payer response, timely-filing, and appeal deadline tracking with escalation;

1. Outcomes reporting through resolution, including recovered dollars, resolution reason, and root-cause categorization.

Roswell Park's primary intent under this RFP is to acquire a software platform that enables Roswell Park staff to perform this work. Outsourced personnel are not the core scope of this solicitation.

Respondents that also offer outsourced or managed recovery and appeal services may propose them as a clearly identified, separately priced optional component in accordance with Section 1.6. Optional services will be evaluated separately and will not be accepted as a substitute for the underlying platform capability required by Section 1.2.1 and requirement U4. See also Answers 17 and 27.

Question 17

If Roswell Park is seeking outsourced support to perform recovery/appeals workflow, please address these additional questions:

1. What is the minimum/maximum account balance/underpayment variance to be referred?

1. When are accounts referred? Does your staff work on accounts before referral?

1. Are denials included in the underpayment classification?

1. Is there a backlog of accounts to be referred?

1. What is the percentage breakdown between inpatient and outpatient referrals? If PB accounts are in scope, what is the breakdown between inpatient, outpatient, and professional accounts?

1. Can Roswell Park share a detailed ATB file so that we can understand volumes, payer mix, and potential collectability?

1. In addition to the 835 and 837 feed as part of the referral file, can Roswell Park provide regular ATB, Transaction, and Notes files to support the project?

1. How are denials and underpayments identified, prioritized, and worked today, and what are the biggest gaps in the current process?

1. Approximately how many appeals are generated each month?

1. How are coding denials currently identified and routed back to coding teams?

1. Do you currently outsource any of your underpayment/denial recovery work?

Answer 17

See Answer 16. Because outsourced recovery and appeal services are optional rather than core scope, Roswell Park is not providing account-level or current-state operational detail at this stage.

Respondents proposing optional outsourced services should base their proposal on clearly stated assumptions, disclosed in accordance with Section 1.6, and should describe:

1. The referral criteria, balance thresholds, and account age they typically recommend, and the basis for those recommendations;

1. The data files required to operate the service (for example, 835, 837, aged trial balance, transaction, and notes files) and the minimum viable data set;

1. The division of labor between vendor personnel and client staff, including where accounts are worked and by whom;

1. Fee structure (contingency, fixed fee, hybrid), including whether contingency fees apply to accounts subsequently resolved by Roswell Park staff.

Detailed accounts receivable data, including aged trial balance files, referral volumes, backlog, inpatient/outpatient/professional mix, monthly appeal volumes, and current-state process detail, will be made available to shortlisted respondents during the Phase II evaluation described in Section 1.8, subject to an executed confidentiality agreement and, where applicable, a Business Associate Agreement. Roswell Park will not distribute patient-level or account-level data through this Addendum.

With respect to whether denials are included in the underpayment classification: for purposes of this RFP, Roswell Park considers contractual underpayment, zero-pay and partial-pay denials, and authorization-related denials to be related but distinct categories. Respondents must describe how their platform distinguishes among them, and how an account is prevented from being worked twice under two classifications. See also Answer 19.

Regarding current outsourcing arrangements, see Answers 21, 22, and 30.

Question 18

1.4.5 Integration, Data, Architecture & Security — Describe the solution's compatibility with current Electronic Health Record (EHR) systems and the expected approach to supporting integration with a future successor EHR platform: Please confirm current EHR or anticipated future EHR for integration.

Answer 18

Roswell Park's current EHR and patient accounting environment is identified in Answer 10.

Roswell Park has not identified a successor EHR platform for purposes of this RFP, and respondents should not assume any particular successor platform.

Consistent with Section 1.4.5(e), respondents must confirm the ability to integrate with a successor EHR environment within an anticipated three-and-a-half (3.5) to four (4) year timeframe, or clearly describe any dependencies, limitations, or transition requirements, and must identify any contractual, technical, or commercial considerations required to support transition to, or replacement by, a future EHR providing equivalent or overlapping functionality.

Respondents should specifically address: whether integration is achieved through standards-based interfaces that are portable across EHR platforms; whether re-implementation, re-interfacing, or contract restructuring would be required upon an EHR transition; the anticipated cost and effort of such work; and whether termination or reduction-in-scope rights are available if successor EHR functionality overlaps the proposed solution. Proposals that condition performance on a specific EHR platform, or that would require re-implementation at additional cost upon an EHR transition without disclosing that cost, will be evaluated accordingly under Sections 1.6 and 1.9.

Question 19

1.2.5 Authorization Management — Denial reason tracking and appeal workflow integration specific to authorization-related denials, with outcomes reporting: Please clarify what is being asked for with “appeal facilitation” support? For denials, are you referring to authorization requests that are initially denied, or are you referring to the claim denial?

Answer 19

Both are in scope, and Roswell Park expects the platform to connect them.

1. Authorization-level determinations. Adverse determinations, partial approvals, and reductions issued by the payer or its delegated review entity in response to an authorization request. Required support includes capture of the determination and denial reason, assembly of clinical and medical necessity documentation, generation of appeal or reconsideration correspondence, support for peer-to-peer review scheduling and outcome capture, and monitoring of payer-specific appeal and external review deadlines.

2. Claim denials with authorization-related root causes. Claim-level denials carrying authorization-related adjustment and remark codes — for example, no authorization on file, service not authorized, authorization does not match services rendered, or units, site of service, or date range exceeded. Required support includes categorization by authorization defect type, routing into the appeal workflow, linkage back to the originating authorization record, and root-cause reporting sufficient to prevent recurrence.

“Appeal facilitation” means platform-enabled workflow: identification, documentation assembly, correspondence generation and templating, deadline and status tracking, and outcomes capture. It does not, of itself, require outsourced personnel to draft or submit appeals. See Answer 16 regarding optional outsourced services.

Respondents should describe how the authorization record and the claim denial record are linked within the platform, since this linkage is the basis for requirement A5 (authorization-to-claim matching) and requirement A6 (denial tracking and outcomes reporting).

Question 20

E2 Patient Estimation — Automated estimate triggers and optional touchless automation: Please clarify what is being asked for with “optional touchless automation?” Where is workflow expected to be managed — in your EMR or in an outside UI?

Answer 20

“Optional touchless automation” means the ability to generate and deliver a patient estimate end-to-end without staff intervention when defined criteria are satisfied — for example, a scheduled service mapped to a defined procedure or charge set, active and verified eligibility, an available contract-modeled rate, and a configured confidence threshold — with rules-based exception routing to a work queue when any criterion is not met. “Optional” means Roswell Park requires the ability to enable, disable, and tune this automation by service line, payer, or estimate type; it is not a requirement that all estimates be produced touchless.

Respondents should describe the conditions under which touchless generation is supported, the configurability of those conditions, the proportion of estimates typically generated touchless at comparable clients, and how exceptions are surfaced and worked.

Regarding workflow location: Roswell Park's preference is that estimate creation be triggered by events in the EHR and patient accounting system (scheduling, registration, order entry), that the resulting estimate be written back to and viewable within the patient account or record, and that patient-facing delivery use Roswell Park's existing patient communication channels where feasible. Use of a vendor user interface for configuration, exception management, analytics, and audit is acceptable.

Respondents should describe both embedded and standalone models, the integration method required for each, and any functionality available only within the vendor user interface. Respondents should also address estimate generation for extended oncology treatment courses, where an accurate estimate depends on the full planned regimen rather than a single scheduled visit.

Question 21

Could you provide additional context on the organization's objectives for this RFP? Specifically, is this intended as a competitive evaluation that includes the incumbent partner(s), or is the organization pursuing a transition to a new solution/provider?

Answer 21

This is a competitive evaluation and is open to all qualified respondents, including any incumbent providers. Roswell Park has not made a determination to replace any existing solution or provider.

Roswell Park's objectives are as stated in Section 1.1: automated, auditable, and operationally usable workflows across the revenue integrity and patient financial functions described in Section 1.2; measurable financial impact with minimal reliance on manual processes; audit readiness; and a strong preference for consolidation under a single vendor, a single agreement, and a single implementation and support model. An additional objective is a solution that remains viable and portable through a potential future EHR transition, as described in Answer 18.

Award will be made in accordance with Sections 1.9 and 2.9. See also Answers 1, 3, 22, and 30.

Question 22

Could you please provide the current production environment for revenue cycle technologies (e.g., clearinghouse, eligibility verification, prior authorization, contract management, patient estimates, insurance discovery, and patient payment solutions)?

Answer 22

Roswell Park's EHR, patient accounting platform, and clearinghouse are identified in Answer 10, and respondents should use those for integration scoping.

To preserve a fair and competitive process, Roswell Park is not itemizing the incumbent point solutions currently in use for eligibility verification, prior authorization, contract management, patient estimates, coverage discovery, or patient payments. Respondents should not assume that any given function is or is not currently automated and should not scope their proposal around displacing or coexisting with a specific incumbent product.

Additional current-state detail will be shared with shortlisted respondents during the Phase II evaluation described in Section 1.8. See Answers 21 and 30.

Question 23

Volumes — (estimated monthly or annualized):

1. Eligibility transaction volume?

1. Total encounters volume (discharges + outpatient visits + ER visits)?

1. Self-pay volume?

1. Payer Mix % (Commercial, Medicare, Government non-Medicare, Other/self-pay)?

1. Charity screening volume?

Answer 23

Volume data is consolidated in Answers 4 and 13 and is subject to the qualifications set forth in Answer 4. Payer mix is provided in Answer 12. The following additional data is provided:

1. Self-pay volume (encounters with no active coverage identified at time of service, annualized): Less than 5% of volume is self-pay

1. Financial assistance / charity screening volume (annualized): Less than 5% of volume

1. Financial assistance applications processed (annualized): Less than 5% of volume Respondents should describe how coverage discovery volume is priced relative to eligibility verification volume, and whether unsuccessful discovery searches are chargeable.

Question 24

Should respondents propose their complete end-to-end integrated revenue cycle platform of solutions across all RCM solution areas — including Financial Clearance/Patient Access, Patient Financial Care/Patient Payments, Clinical Integrity & Revenue Capture, Claim & Payer Payment Management, Denial Prevention & Recovery, and Analytics & Reporting — or should proposals focus only on the specific capabilities Roswell Park intends to evaluate for replacement at this time?

Answer 24

Proposals should focus on the scope defined in Section 1.2 (Sections 1.2.1 through 1.2.5). Scoring under Section 1.9 will be based on that scope.

Respondents may identify adjacent or end-to-end capabilities in a clearly separated, separately priced optional appendix, which will not count toward the page limit (see Answer 8). Adjacent capabilities will not be scored as part of the core evaluation. However, because Roswell Park has stated a preference for consolidation (Section 1.1 and requirements P1 through P3), the availability of adjacent modules under the same agreement, implementation model, and support model may be considered as a qualitative factor.

Optional functionality must be identified separately and must not be bundled into base pricing, in accordance with Section 1.6.2. See also Answer 25.

Question 25

Digital Estimate Delivery is a feature of our patient payments & communication solution which is integrated with our Estimator tool. Given RPCI's stated goal of consolidating technology solutions as much as possible, would you be interested in us including this in our proposal response? If yes, we would need the following data pts: (1) avg monthly statement volume and (2) avg monthly patient collections in dollars (if possible, by credit card vs mailed check/cash).

Answer 25

Yes. Digital estimate delivery and the associated patient payment and communication functionality may be included as a clearly identified, separately priced optional component, consistent with Answer 24 and Section 1.6. Inclusion is optional and will not be scored within the core evaluation criteria; omission will not be penalized.

Requested data points:

1. Average monthly patient statement volume: Nominal

1. Average monthly patient collections: NA Roswell Park will provide patient collections data at an aggregate level only. A breakdown by payment channel will be made available to shortlisted respondents during Phase II. Respondents should clearly state any pricing assumption that depends on payment channel mix.

Respondents proposing patient payment functionality must address PCI DSS compliance and the security requirements of Appendix C, and must confirm that the optional component can be declined without affecting the pricing, functionality, or support of the core scope.

Question 26

Which Oracle Cerner EHR product are you currently using, and which Cerner instance or environment (e.g., Millennium, CommunityWorks, etc.) is in place?

Answer 26

See Answers 10 and 18. Roswell Park's current EHR product and instance or environment is: Roswell uses Sunrise Clinical Manager Version 22.1 PR38. We do not have a Cener product.

Respondents should not rely on assumptions regarding platform, version, or hosting model. Respondents should describe integration requirements at the transaction and interface level — for example, HL7 v2 message types, FHIR API use, flat-file extracts, 837 and 835 feeds, and any direct database access — so that integration scope, effort, and cost can be evaluated independent of a specific platform and remain assessable against a future successor EHR.

Question 27

Regarding the collections portion of the project, are you looking for a vendor to perform the collections and recovery services on your behalf, or are you seeking a workflow solution that enables your internal team to manage the collections process?

Answer 27

Roswell Park is primarily seeking a workflow solution that enables its internal teams to manage the process, with the automation, prioritization, audit trail, and outcomes reporting required by Section 1.2.1 and requirements U1 through U4. This applies both to payer underpayment and denial recovery and to patient balance resolution.

Respondents that also offer outsourced recovery, early-out, or collections services may propose them as a clearly identified, separately priced optional component. Roswell Park makes no commitment to purchase such services, and they will not be accepted as a substitute for the required platform functionality. See Answers 16 and 17.

Question 28

Will the requested services apply to both Roswell Park Cancer Center and the affiliated physician practices, or are they intended for the Cancer Center only?

Answer 28

[COMMITTEE TO CONFIRM: The requested services apply to both Roswell Park Comprehensive Cancer Center and its affiliated physician practice and professional billing operations. Confirm the specific legal entities to be named in the Resultant Agreement.] See Answers 5, 9, and 11. Respondents should identify any functionality, pricing, or integration differences between hospital/facility and professional/physician practice scope and should describe how their pricing model accommodates the addition of affiliated entities or locations during the Term.

Question 29

Does your organization have a current or future strategy for incorporating AI into revenue cycle workflows related to this initiative (e.g., collections, underpayment detection, contract management, denials, or other revenue integrity processes)? If so, are there any specific AI capabilities or use cases you would like vendors to address in their response?

Answer 29

Roswell Park is interested in the applied use of artificial intelligence and machine learning where it produces explainable, auditable, and measurably better outcomes than rules-based automation. Inclusion of AI functionality is not a requirement of this RFP, and AI capability will not be scored independently of the requirements set forth in Sections 1.2 and 1.3.

Respondents describing AI or machine learning capabilities should address the following:

1. Specific production use cases — for example, underpayment and variance detection, denial and authorization-requirement prediction, coverage discovery matching, remittance and correspondence extraction, propensity-to-pay segmentation, and documentation or appeal letter drafting — and whether each is generally available, in limited release, or on the roadmap;

1. Model governance, validation, and ongoing monitoring, including accuracy and false-positive performance and how that performance is reported to clients;

1. Human-in-the-loop controls, including the ability to review, override, or disable AI-driven determinations, and whether any AI output is applied to an account without human review;

1. Explainability and audit trail sufficient to support the audit readiness required by Sections 1.2 and 1.3, including requirements S1, E4, and A7 — specifically, whether the basis for an AI-generated determination is reconstructable at the account level;

1. Use of Roswell Park data. Respondents must state whether Roswell Park data, including protected health information or de-identified derivatives, would be used to train, fine-tune, or otherwise improve models, and whether any such use extends to models serving other clients. Roswell Park's expectation is that its data will not be used for model training or product improvement beyond Roswell Park's own instance absent express written consent, and that any such use will comply with Appendix C – Information & System Security Requirements and the Business Associate Agreement;

1. Use of subcontractors, sub-processors, or third-party model providers, and the geographic location of any processing, consistent with Question 1.4.9(c);

1. How AI functionality is licensed and priced — whether included in base pricing or offered as an optional or add-on component — consistent with Section 1.6.

Respondents should not treat AI capability as a substitute for the transparency and auditability required elsewhere in this RFP. Where a determination affects a patient financial obligation or a payer appeal, Roswell Park requires that the underlying logic be documentable.

Question 30

Are there any incumbent vendors currently providing any of the requested services, such as underpayment recovery, contract management, patient financial estimates, or other revenue cycle optimization solutions? If so, are you looking for vendors to replace, augment, or integrate with these existing solutions?

Answer 30

Roswell Park currently utilizes multiple solutions and vendors across the functional areas included in this RFP. There is no single incumbent platform providing the full scope of services. Respondents may propose solutions that replace, augment, or integrate with existing capabilities.

To preserve a fair and competitive process, Roswell Park is not identifying incumbent vendors or solutions at this stage. Roswell Park has not predetermined whether any resulting award will replace, augment, or integrate with existing solutions Respondents should propose the approach they believe delivers the best overall value against the criteria in Section 1.9 and should describe their ability to coexist with, or integrate alongside, third-party solutions where their proposal does not cover the full scope of Section 1.2.

Roswell Park reserves all rights set forth in Section 2.9, including the right to award to a single respondent, to multiple respondents, to award only a portion of the RFP, or to make no award.

Acknowledgment Except as expressly modified by this Addendum, all terms, conditions, requirements, dates, and milestones of the RFP remain unchanged and in full force and effect. Each Respondent must list this Addendum and acknowledge that it has been read and incorporated into its Proposal, in accordance with Section 1.10.1 of the RFP. In the event of a conflict between this Addendum and the RFP, this Addendum controls.

Questions regarding this Addendum must be directed to Jennifer M. Gaenzler at jennifer.gaenzler@roswellpark.org, in accordance with Sections 2.4, 2.7, and 2.8 of the RFP.

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