RFP_9100_JOG3030_ADD_1_v1.pdf

SOLICITATION ADDENDUM

AUSTIN FINANCIAL SERVICES – CENTRAL PROCUREMENT

Solicitation: RFP 9100 JOG3030 Addendum No: 1 Date: May 21, 2026

This addendum is to incorporate the following changes to the above referenced solicitation:

1.0 Extension: The solicitation due date is hereby extended until June 9, 2026, at 2:00 PM CST.

2.0 Net Collection Rate Proposal: The Net Collection Rate Proposal has been updated and replaced with Version 2 to add the missing zero in the Annual Net Collections Estimate ($2,000,000).

3.0 Questions:

Q1: How many locations does Austin Public Health (APH) have?

A1: APH has 4 clinic locations as well as mobile operations and public health nursing services that are provided in multiple settings.

Q2: What is the monthly claim volume and total collections for the past 12 months?

A2: Immunization Program billed 76 claims on monthly average and for the Refugee clinic 167 claims on monthly average. Collection was $49,293.65 for Refugee and $25,306.09 for Immunization in the past 12 months. Two claims for Medicare were billed and paid $ 241,41

Q3: What is the payer mix (%) across Medicaid, Medicare, commercial, and self-pay?

A3: For the Refugee clinic it was 58% Point of Comfort and 42% Medicaid. For the Immunization program it was 13.6 % Medicaid and 86.4 % self-pay. We do not bill commercial

Q4: What percentage of total encounters are billable versus non-billable (grant-funded)?

A4: For the Immunization Program 13.6 % was billable and the rest was charged to patients. For the Refugee Program 95% was billable and 5% was paid by the grant.

Q5: Are there plans to increase the proportion of billable services?

A5: Yes

Q6: What programs or service lines are expected to be added to the billing scope?

A6: Sexual Health Clinic, TB Clinic, Family Connects, Mother Infant Outreach Program, Public Health Nursing

Q7: What is the expected timeline for this expansion?

A7: 6-12 months

Q8: Which RCM functions will be fully outsourced versus retained by APH staff?

A8: APH is seeking 3rd party support for all aspects of RCM functions. However, fully outsourced functions will likely include verification, charge capture, medical coding, claims submission, payment posting, denial management, financial reporting, and compliance.

Q9: Is there any backlog of unbilled claims, denied claims, or A/R cleanup included in the scope?

A9: No, there is no backlog or unbilled claims

Q10: What is the current operating model (in-house or incumbent vendor), and what transition support is expected?

A10: We bill for vaccine administration for the Immunization and Refugee Programs in house using the eCW application and Cognizant (Trizetto) as the clearinghouse.

We use a phased implementation methodology including discovery, workflow validation, integration testing, payer enrollment review, user acceptance testing, training, and go-live stabilization support.

You should avoid hard staffing or SLA commitments that depend on these missing metrics unless your pricing model explicitly includes assumptions.

The proposed staffing model, implementation timeline, and operational assumptions are based on information currently available in the solicitation and addendum responses. Final operational scope, transaction volumes, interfaces, workflow ownership, and performance baselines will be validated during discovery and contract finalization.

Q11: What level of system access will be provided to the selected vendor?

A11: Vendor will have appropriate access to EMR for billing purposes.

Q12: Please provide a list of the EHR platform as well as the services provided.

A12: eCW is the medical records repository with billing features like claim creation, editing, error detection and fixing suggestions, automatic claim submission, ERA reports, automatic and manually posting for claims paid or denied, manage claim settings, resubmit claims, manage revenue information and reporting.

Q13: Please provide the exact scope of work for Contractor to be performed A13: The Scope of Work is available on Austin Finance Online.

Q14: Please provide Front, Middle, Back and overall Revenue Cycle dashboards that contain process/performance metrics by month for the past 12 months.

A14: eCW provides different reports with dashboards to monitor the process and performance. The Immunization program has 97 % average rate of reimbursement in past 12 months

Q15: Currently, what interfaces or automation tools does APH use (RPA, bots, AI tools) and for what functions in the revenue cycle?

A15: eCW has an interface with Cognizant (Trizetto) to bill claims to health insurances and verify eligibility with Medicaid. We do not use AI tools. Submitted this question to eCW Support for a response regarding eCW automation tools.

Q16: Are any interfaces or automation tools proprietary to the current vendor that will need to be de-installed?

A16: Cognizant (Trizetto) has an agreement with eCW.

Q17: Are there are any restrictions to do any of the work from outside the US?

A17: All services will be delivered using U.S.-based personnel.

Q18: Are there restrictions for federal payer claims requiring onshore work?

A18: All services will be delivered using U.S.-based personnel.

Q19: Please provide a breakdown of FTEs, onshore, offshore by Front, Middle and Back functions for each facility or consolidated in one location. Please delineate by staff, supervisor, manager and director if possible.

A19: Staff FTEs are all onshore.

Q20: Based on the Solicitation, only coding scope, we can assume is immunization and vaccination services, health screening, prevention and counselling services, please confirm if any other coding scope is involved.

A20: The codes for vaccination services are already in the EHR system and implemented.

Q21: If coding is involved, provide the average number of charts per month by chart type (IP, OP, Profee).

A21: This is TBD as medical billing is expanding.

Q22: If this is a multiple specialty practice, then please provide the volume for each Specialty: (Ortho, Cardio, etc.)

A22: Not Applicable

Q23: What are your current productivity standards by specialty type?

A23: This is not a specialty practice.

Q24: How is coding currently performed? Is it by providers or coders? How many providers or coders are performing Coding?

A24: Currently eCW is set to automatically drop the immunization administration and vaccines codes to bill. We do not have coders.

Q25: Please provide Charge master or procedure master.

A25: The current codes used are 90471, 90472, 90473, 90474, 96381,90480, G0008, 90656 and 90662.

Q26: Describe the process to manage backlog.

A26: Monitor, investigate, fix the problem and submit the claims

Q27: Do you currently have an Inpatient CDI program?

A27: Each program has their own CQI or quality control process to verify if clinical documentation is correct.

Q28: Do you currently have a Professional CDI program?

A28: No

Q29: How Payer enrollment is performed. Please provide the average monthly volumes.

A29: Currently we have a contract agreement with Medicare for roster biller, Medicaid for traditional, Texas health Steps and Local Health department plus Medicaid with Superior Health Plan. We have not pursue new enrollments.

Q30: How is recredentialing and Provider data management is maintained?

A30: It is maintained and managed by the Immunization billing team. We received email and mail notifications from TMHP or Medicaid when it is time for revalidation. Also the providers (we have two right now) reach out to the Immunization billing team when they received their notifications.

Q31: Please name the Platform used to manage Credentialing.

A31: PECOS and PEMS.

Q32: Average number of new provider enrolled per year.

A32: Not applicable.

Q33: Average number of new provider enrolled per month.

A33: Not applicable.

Q34: Does the Contractor need to do CAQH maintenance & provider onboarding?

A34: Yes on CAQH.

Q35: What percentage of charges are integrated and automatically flow into the billing system. What percentage require manual entry?

A35: 48% of our claim payments comes through ERA’s and 52% are entered manually into eCW.

Q36: Which clearinghouse(s) are used for hospital and physician revenue cycles. Are they real -time and batch enabled?

A36: We use Cognizant (Trizetto) they are real-time and batch enabled.

Q37: Please provide Charge Detail reports by month for the past 12 months.

A37:

Point Of Comfort Medicaid all plans Medicare Claims dates CHARGES CHARGES CHARGES

Jun-24 1212.75 925.48 Jul-24 1205.84 881.64

Aug-24 815.67 1569.24 Sep-24 2401.62 1992.14 Oct-24 2487.95 2313.68 Nov-24 1569.74 1901.01 Dec-24 3445.55 2064.53 Jan-25 5562.19 2573.89 Feb-25 4318.04 2577.18

Mar-25 3810.83 1691.21 Apr-25 2799.22 2412.35

May-25 1529.92 1944.67 Jun-25 4090.31 2168.64 Jul-25 4829.43 1362.01

Aug-25 4596.35 4041.08 Sep-25 6007.54 4200.44 Oct-25 3220.68 2364.11 243.87 Nov-25 2101.11 1179.8 Dec-25 949.79 1510.56 Jan-26 655.5 1291.31 Feb-26 745.83 1509.8 Mar-26 532.24 1035.01

58888.1 43509.78 243.87

Q38: What percentage of claims are submitted electronically and what percentage are paper submissions. Please provide by month for 12 months.

A38: 100% of Medicaid and Point of Comfort are submitted electronically. 50% of Medicare claims are submitted through Availity and 50% in paper.

Q39: Please provide rejections data/ report by month for the past 12 months. Please bifurcate that by Payer and Clearing house rejections A39:

Denials Payer Month # claims denied Medicaid BCBSTX Point of Comfort

May-25 6 3 3 Jun-25 14 11 3 Jul-25 10 4 6

Aug-25 10 5 1 4 Sep-25 14 13 1 Oct-25 8 7 1 Nov-25 7 6 1 Dec-25 3 1 2 Jan-26 3 3 Feb-26 11 5 6 Mar-26 3 2 1 Apr-26 0

Q40: If printed claims are the responsibility of the new vendor, do they need to be printed and sent to from APH or can they be sent from the vendor location?

A40: All claims should be submitted electronically.

Q41: Please provide the number of claims printed by payor by month for the past 12 months.

A41: For last 12 months we only printed one Medicare claim.

Q42: Please provide Aged Trial Balance for both hospital and physician revenue cycle with dollars and volumes broken out by major payor groupings. Please provide most recent 12 months.

A42: 0-30 days: 33 claims and 31-60 days: 3 claims. 61 days or more: none

Q43: Please provide report with charges, payments broken out by major payors by month for 24 months.

A43:

Point Of Comfort

Medicaid all plans Medicare

Claims dates CHARGES $ PMTS/ADJS $ CHARGES $ PMTS/ADJS $ CHARGES $ PMTS/ADJS $

Jun-24 1212.75 1212.75 925.48 925.48 Jul-24 1205.84 1205.84 881.64 881.64

Aug-24 815.67 815.67 1569.24 1569.24 Sep-24 2401.62 2401.62 1992.14 1992.14 Oct-24 2487.95 2487.95 2313.68 2313.68 Nov-24 1569.74 1569.74 1901.01 1901.01 Dec-24 3445.55 3445.55 2064.53 2064.53 Jan-25 5562.19 5526.1 2573.89 2244.83 Feb-25 4318.04 4318.04 2577.18 2577.18 Mar-25 3810.83 3833.82 1691.21 1691.21 Apr-25 2799.22 2799.22 2412.35 2412.35

May-25 1529.92 1529.92 1944.67 1944.67 Jun-25 4090.31 4090.31 2168.64 2168.64 Jul-25 4829.43 4829.43 1362.01 1362.01

Aug-25 4596.35 4596.35 4041.08 4041.08 Sep-25 6007.54 6007.54 4200.44 4200.44 Oct-25 3220.68 3220.68 2364.11 2364.11 243.87 243.87 Nov-25 2101.11 2101.11 1179.8 1179.8 Dec-25 949.79 949.79 1510.56 1510.56 Jan-26 655.5 655.5 1291.31 1291.31 Feb-26 745.83 745.83 1509.8 1509.8 Mar-26 532.24 532.24 1035.01 1035.01

Q44: Detail denials report with volumes and dollars by CARC and RARC codes by month for 12 months.

A44:

Denials Dollar amount Denial codes Month # claims denied $

May-25 6 190.2 P27, 01163, CO-197, N77 and CO16 Jun-25 14 296.31 P27, 01163, CO-197, N77 and CO16 Jul-25 10 187.13 P27, CO-197 and 01163

Aug-25 10 271.1 P27, CO-197 and 01163 Sep-25 14 377.37 P27, CO-197 and 01163 Oct-25 8 429.11 P27, CO-197 and 01163 Nov-25 7 212.68 P27, CO-197 and 01163 Dec-25 3 68.97 P26, P27 and 01163 Jan-26 3 101.27 P26, P27 and 01163 Feb-26 11 176.22 P26, P27 and 01163 Mar-26 3 59.73 P26, P27 and 01163 Apr-26 0 0

Q45: Would Credit balance & refund would be IN-Scope or will this be part of AR?

A45: Refunds to health insurances should be part of the scope

Q46: Please provide detailed denials appeals success report by CARC and RARC codes by payor by month for 12 months.

A46: For Point of Comfort: May, June, July, August, September, October, November, December 2025: P27.

February, March: P26 and P27. For Medicaid: May, June 2025: 01163, CO-197, N77, CO16. July, August, September, October and November: 01163 and CO-197. December 2025, January, February and March 2026: 01163

Q47: For paper or fax appeal submissions, does APH use a third‑party vendor?

A47: No third-party vendor. All appeals are managed by Immunization billing team.

Q48: Please provide the approximate number of providers included in scope for this engagement.

A48: 20

Q49: Please provide the number of Tax Identification Numbers (TINs) currently utilized for billing operations.

A49: One. It is 74-6000085

58888.1 58875 43509.78 43180.72 243.87 243.87

Q50: Please provide the provider license types/specialties included in scope (e.g., MD, DO, NP, PA, RN, etc.).

A50: MD, NP, RN, X-Ray tech the TC, Licensed Dietitian

Q51: Please provide the average claim value and/or average reimbursement per claim, if available.

A51: Not available.

Q52: The Net Collection Rate Proposal workbook pricing section references an “Annual Net Collections Estimate ($2,00,000).” Please confirm the intended annual net collections estimate amount to be used for proposal evaluation purposes.

A52: The Annual Net Collections Estimate ($2,000,000) has been corrected on Net Collections Rate Proposal, Version 2.

Q53: Beyond eClinicalWorks, does APH utilize or plan to implement additional systems that the selected vendor would need to interface with?

A53: Not at this time.

Q54: What is the estimated date for contract execution and the commencement of services?

A54: The estimated date for contract execution and commencement of services is late 2026.

We use a phased implementation methodology including discovery, workflow validation, integration testing, payer enrollment review, user acceptance testing, training, and go-live stabilization support.

You should avoid hard staffing or SLA commitments that depend on these missing metrics unless your pricing model explicitly includes assumptions.

The proposed staffing model, implementation timeline, and operational assumptions are based on information currently available in the solicitation and addendum responses. Final operational scope, transaction volumes, interfaces, workflow ownership, and performance baselines will be validated during discovery and contract finalization.

Q55: Can the services be provided offshore and/or domestic or combination of both?

A55: All services will be delivered using U.S.-based personnel.

Q56: Can you please provide a copy of the BAA document?

A56: The HIPAA Business Associate Certification document is located in the Offer and Certification packet located on Austin Finance Online.

Q57: How many Clinical staff do you have?

A57: TBD

Q58: How many users?

A58: TBD

Q59: How many billing providers?

A59: Currently two.

Q60: Are you willing to switch to another PM system?

A60: No.

Q61: What level of integration do you require with ECW?

A61: The level of integration with eCW is outlined in the SOW, Technology Integration, Section 4.4.

Our solution supports integration with eClinicalWorks (eCW) using standard healthcare interoperability methods including HL7, SFTP batch exchange, secure APIs, and clearinghouse integrations as applicable. We routinely support charge capture, claim submission, remittance posting, denial workflows, and reporting integrations with ambulatory/public health environments.

We will validate the final integration architecture during implementation and discovery in alignment with APH SOW Section 4.4 Technology Integration requirements.

Q62: Who takes care of your billing now?

A62: Our billing is managed in house by the Immunization Program staff ( equivalent of 1 FTE)

Q63: Why are you switching to another system?

A63: We are looking to expand medical billing which will require more resources than we have available in house.

Q64: Who will take care of the AR?

A64: Austin Public Health Accounting.

Q65: Do you require Benefit verification?

A65: It is possible that the new services we are planning to bill do.

Q66: Do you require prior authorizations?

A66: It is possible that the new services we are planning to bill do.

Q67: Do you require credentialing services?

A67: Yes.

Q68: What is your place of service code (POS Code)?

A68: Currently we use 11 for Medicaid and 60 for Medicare.

Q69: What services does APH offer?

A69: Per the SOW, Section 1 APH delivers a variety of community health programs, including immunizations, tuberculosis management, sexual health services, refugee health assessments, and chronic disease prevention initiatives.

Q69: What are the billing issues that you currently face?

A69: The current challenges are outlined in the SOW, Section 1.1.

4.0 ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME.

ACKNOWLEDGED BY:

Offeror Name Offeror Authorized Signature Date

RETURN ONE COPY OF THIS ADDENDUM WITH YOUR RESPONSE PRIOR TO THE SOLICITATION CLOSING

DATE. FAILURE TO DO SO MAY CONSTITUTE GROUNDS FOR REJECTION OF YOUR OFFER.

Solicitation: RFP 9100 JOG3030 Addendum No: 1 Date: May 21, 2026