RFP-11-18 - Questions and Answers 2.pdf

QUESTIONS & ANSWERS ON RFP-11-18

1. What are the productivity and accuracy/quality requirements for Items #1,2,3,4,5,6,7, and 8?

Answer: Please see Statement of Work, Section C-15 – Performance-Based Service Delivery Summary

2. Will there be multiple awards made?

Answer: No.

3. If so, is vendor required to provide a proposal for all services (items) requested in the solicitation or are we able to bid only on select services?

Answer: There is only one award for this solicitation therefore a proposal will be made for all items.

4. What is the rate of on-site vs. remote services for all items?

Answer: This can be done on-site or remotely.

5. Can you please provide us with most updated copy of the IHS Internal Control Policy?

Answer: There is no updated copy at this time; it is being revised and once completed a copy will be provided.

6. As VPN access will be provided, can we assume that we are able to provide a remote solution for providing services?

Answer: We can only utilize IHS software.

7. Must we make a quarterly on-site visit per line item? Or will one visit per quarter suffice?

Answer: The site visit would cover all areas of the task order.

8. Would you want a coding person at each site?

Answer: If the Service Unit requests someone to be on-site; depends on the Service Unit.

9. What is the total number of sites?

Answer: There are 15 sites.

10. Are all facilities work be accessible using the RPMS system? Is there any other software packages used besides the gooey add-ons to RPMS?

Answer: RPMS

11. Will all records be accessible electronically via a VPN connection? Do all facilities have EHR?

Answer: No, there are still paper documents and not all are EHR; each site uses EHR but not for all clinics or Emergency Room.

12. The price schedule identifies number 7 as printing mailing and submission of claims. Will the

Aberdeen Area or each facility the RFP covers be remitting their own claims?

Answer: The IHS facilities will export for Medicare and Medicaid. Private Insurance can be decided on whether the vendor or the facility will print the claims and mail to the insurer. The agency would like to know the price it will cost in the event the contractor provides this service.

13. What reporting requirements are being included in this RFP? i.e. monthly A/R, collections, denials, coding or claim status?

Answer: This will be decided between the vendor and the Service Units.

14. Please identify the number of facilities this RFP includes?

Answer: It could include all 15 sites.

15. Will there be separate reporting requirements to Aberdeen Area and to each facility? If so, please identify what reporting requirements you have?

Answer: The reporting requirements may be different for each site.

16. When we take on a new client and project, we like to visit each facility in which we are working with, therefore I anticipate some travel requirements. Please identify your requirements for travel for each facility?

Answer: It is in the contract that the vendor will do an initial site visit to discuss the work needed.

17. The quantities identified on the Price Schedule are estimates of quantities. If the actual needs of this

RFP exceed the estimated quantity, will the contract for that specific line item be compensated as bid? Will an addendum to the agreement be required to exceed any one estimate of quantity?

Answer: This is a firm fixed price requirements type contract so therefore the quantities are just estimates only; the quantities will vary but will be compensated according to the task order issued.

18. There is not a line item for denied insurance claims. Does this agreement anticipate that there will, not be any denied claims to work? If there are denials, which there will be, is it rolled into the A/R under category #4?

Answer: Denials are a part of the A/R function.

19. Will Aberdeen Area consider the A/R portion on a contingency based fee which would be all inclusive of standard aged accounts as well as denied insurance claims?

Answer: A/R is on an hourly fee.

20. Coding is a large part of the RFP. Starting Oct 1, 2013 the number of ICD codes will increase significantly roughly 8 times. 17000-141000 Does this RFP consider the significant changes that will affect each facility with coding requirements?

Answer: Yes.

21. Does every facility considered in this RFP provide super bills?

Answer: Yes.

22. If super bills are provided, does each super bill have a preprinted code for services?

Answer: Yes.

23. If each super bill has preprinted codes, does this RFP include the Aberdeen Area updating the new

ICD10 codes when available?

Answer: Yes.

24. If each facility uses the RPMS software, will all patches and updates be maintained for each facility?

Answer: Yes.

25. Will each facility have the same version of the RPMS software?

Answer: Yes.

26. Will the various data entry, coding and billing include pharmacy?

Answer: At times, Yes.

27. Will the various data entry, coding and billing include optometry?

Answer: Where they have optometry, Yes.

28. We believe that there are two groups of issues that should be identified and perhaps included in this process. It includes the denials portion of current claims that have been denied?

Answer: Denials are a part of A/R.

29. Is there a separate/unique Part 2?

Answer: Due to uploading errors of attachments and vendor confusion of the attachments on

Original Advertisement on January 14, 2011 and Amendment #1 and on attachment labeled amendment #2 on January 21, 2011; all the attachments on both of these advertisements dates are deleted in their entirety with the exception of the Wage Determinations Attachment.

30. Why are only 1.5 business days being allotted for Offerors to prepare and submit RFP questions?

Can you extend the deadline for questions submittal by five (5) business days to enable ALL interested Offerors to perform the optimum due diligence in researching and submitting RFP questions?

Answer: Five (5) calendar days was allotted for submission of questions.

31. Why are only 9 business days being allotted for Offerors to prepare and submit optimal response proposals? Can you extend the deadline for proposal submittal by 30 days to enable ALL interested Offerors to perform the optimum due diligence in preparing the very best solution and proposal in meeting the Aberdeen Area Offices needs?

Answer: Consistent with the commercial requirements of this solicitation the Contracting Officer determined that less than 30 days for receipt of offerors for commercial products is acceptable.

32. The RFP provision above as currently written appears to provide the incumbent an unfair competitive advantage and is therefore unduly restrictive of competition. Specifically, in that the solicitation stipulates in part “The offeror's technical capabilities shall be assessed based on a demonstrated understanding of the PWS requirements…for the Aberdeen Area”.

If the “demonstrated understanding” is unique to the Aberdeen Area operations, processes and needs rather than the general technical process as a whole, then this provision provides substantial limitation for any vendor other than the current vendor and/or provides an unfair bias and/or advantage favoring the current vendor.

We request that the agency revise the solicitation to reflect the agency’s minimum needs in a manner that enhances competition.

Answer: Only “for the Aberdeen Area” is hereby deleted from the sentence.

Therefore, the sentence shall now read

: The offeror's technical capabilities shall be assessed based on a demonstrated understanding of the PWS requirements. The Contractor shall define a technical approach that integrates contract management and contract performance activities, using a multifunctional team, to meet cost and performance objectives in the provision of medical record coding, data entry, third party billing, accounts receivables services.

33. The RFP provision above as currently written appears to provide the incumbent an unfair competitive advantage and is therefore unduly restrictive of competition. Specifically, in that the solicitation stipulates in part “The offeror shall specifically outline knowledge and experience as it relates…Aberdeen Area Chargemaster”. If the “knowledge and experience” is unique to the Aberdeen Area operations, processes and needs rather than the general technical process as a whole, then this provision provides substantial limitation for any vendor other than the current vendor and/or provides an unfair bias and/or advantage favoring the current vendor.

Answer: Only “Aberdeen Area” is hereby deleted from the sentence.

Therefore, the sentence shall read: The offeror shall document that they have the necessary technical skills to complete contract requirements in a timely, comprehensive, and successful manner. The offeror shall specifically outline knowledge and experience as it relates to: IHS Internal Control Policy, IHS 3 party billing according to Internal Control Policy (ICP), IHS accounts receivable process according to the ICP, Resource Patient Management System (RPMS); Chargemaster; IHS Inpatient and medical record coding, surgical services coding and data entry issues; IHS third party billing issues; Privacy Act; and HIPAA. The above cited documents can be found on the IHS Website at www.ihs.gov or can be made available upon request.

34. The RFP provision above as currently written appears to provide the incumbent an unfair competitive advantage and is therefore unduly restrictive of competition. Specifically, in that the solicitation stipulates “The Contractor shall outline the common areas of difficulty in performing medical records coding, data entry, third party billing, accounts receivables and coding queue services for Aberdeen Area Indian Health Service facilities and provide in writing what those areas are.”

In that the solicitation seeks Aberdeen Area specific “common areas of difficulty” that are unique to the Aberdeen Area, then this provision provides substantial limitation for any vendor other than the current vendor and/or provides an unfair bias and/or advantage favoring the current vendor.

Additionally, A recent report by Sen. Byron Dorgan, chairman of the Senate Committee on Indian Affairs indentified many performance related issues and critical deficiencies and called for urgent and immediate corrective action; would it not be prudent for proposals to be evaluated on known difficulties as well as the contractor’s proven ability to remedy such issues?

We request that the agency revise the solicitation to reflect the agency’s minimum needs in a manner that enhances competition. In view of this information will you revise the requirements?

Answer: The following sentence hereby replaces what was originally contained in the solicitation.

The Contractor shall outline the common areas of difficulty in performing medical record coding, data entry, third party billing, accounts receivables and coding queue services that could affect the Aberdeen Area Indian Health Service facilities and provide in writing what those areas are. The contractor shall propose a strategic process that delivers measurable results, significant cost savings, http://www.ihs.gov/� streamlined operations, increased operational efficiency, flexibility to meet operational environment demands, and access to technology innovations without major investment.

The statement regarding the report from the Senate Committee on Indian Affairs will not constitute a revision to this solicitation.

35. Does AAO contact CMS for vendor compliance? Does AAO solicit comments from the relevant service unit officials on past performance? Is data or reporting available on error rates, timeliness and other contract performance criteria under current contracts documented in Aberdeen Area Office vendor files? Is data or reporting available on error rates, timeliness and other contract performance criteria under past/prior contracts documented in Aberdeen Area Office vendor files? In evaluating past performance, will the Aberdeen Area Office consider both all Offeror-submitted past performance information from non Aberdeen Area contracts in addition to its own past performance fact finding? If the answer to the above question is “no”; why not? If the answer to the above question is “yes” how will Offeror-submitted past performance information be weighted?

Answer: The Contracting Officer has read the above questions and has determined that the questions are not relevant at the point of the solicitation phase. The following question has been determined to be relevant and is therefore addressed below:

“How will offeror-submitted past performance information be weighted”. See Statement of Work, Section I-3.

36. How can an objective scoring of proposals be conducted without the assignment of weighted scoring components? Can Aberdeen Area office provide an objective scoring scheme providing relative/weighted scoring to key/critical performance criteria such as has been done in other similar IHS areas wide solicitations?

Answer: All factors are clearly stated in the solicitation. See Section I-3.

37. Please clarify what the phrase “begin performance” means. We understand that the current vendor is the only vendor with current RPMS connectivity to most Aberdeen Area sites. As a result and given that there is an incumbent who can perform during any transition or turnover period, the RFP as currently written appears to provide the incumbent an unfair competitive advantage and is therefore unduly restrictive of competition. We request that the agency revise the solicitation to reflect the agency’s minimum needs in a manner that enhances competition.

Answer: “Begin performance” means that the successful contractor will begin within 24 hours from the date of award to engage with the facilities in all aspects of performance of this solicitation. This includes but is not limited to:

• Facility contact

• Connection to RPMS

• Receipt of task orders and performance of task orders received.

38. In Section C-6 a. is this an initial on-site AND video conference? Or is this an initial on-site OR video conference?

Answer: an initial on-site OR video conference.

39. The training requirement is referenced in multiple sections of the RFP. Is two days of onsite training and technical support specified here the same two days indicated elsewhere, such as in Section C-10

p. “Contractor shall provide on-site training and consultation at least two days quarterly for each service unit that is contracted”; or is it cumulative? Is the requirement of two days of onsite training and technical support for each unique service unit (two days PER service unit) or is the two days to be provided/made available to ALL service units at centralized Area facility/location, conference center, training facility, etc.?

Answer: Two(2) days per quarter per service unit.

40. In Section C-6 c. How many days or hours of training is needed each quarter under this requirement?

As written this is ambiguous; please quantify. What is expected in terms of “resources”? As written this is ambiguous; please clarify including if “resources” includes the on-site conferencing facility, the conferencing equipment, a training environment, individual desktops and/or/laptops, etc.

Answer: The length of the training will be decided by each facility on an as needed basis.

41. C-7. j. as written is ambiguous in terms of frequency, total hours, response time, expressed limitations, conditions, etc. Is the “on-site support as needed and requested by Service Unit representative” provided by Contractor as billable services as part of “Revenue Generation Cycle Hour Consultative Services” hours/pricing? If answer to above question is “no”; then: What is the expected frequency? Minimum? Maximum? What are the expected total hours? Minimum?

Maximum? What is the expected response time to arrive on site? Minimum? Maximum? Are there any limitations to the total number of requests or hours expended by contractor in fulfillment of this requirement? Minimum? Maximum? Are there any limitations to who is authorized to initiate requests for such on-site services?

Answer: The task orders will identify the quantities ordered. There is no minimum or maximum as this is a requirements type solicitation.

42. In Section C-7, Is this claim data only to be reported for EHR visit encounters? Yes. Is the hardcopy health record claim data not included in this data request? Yes. Is there a specific time frame as to how far back the “past electronic health record data” to be provided should go? From the point of award forward.

43. In Section C-7 v, Does “The contractor shall provide personnel as to perform billing duties at each service location as required.” indicate (through the provision “at each service location”) that these services are to be performed “on-site” at each service location?

Answer: If requested by the Service Unit.

44. In Section C-9 a, o, & p, If on the job training and technical advisor services are called for in this scope of work why are these services also called for in C-8.? Also; Patient Accounts Receivable under paragraph “l.”; and in C-10. Coding, Data Entry, Compliance Auditing and Reporting, letter “o.” & “p.” This is asking for these services to be provided under three different line item pricing structures. As such: Which line item does paragraph “l.” fall under? Which line item does paragraph “o.” fall under? Which line item does paragraph “p.” fall under?

Answer: These services can be provided in any area of the Statement of Work. Paragraph “o” & “p” fall under Revenue Generation Cycle Consultative Services.

45. In Section C-10 d, Is the service to be provided under pricing structure #8 - “Auditing & Coding

Queue Review” expected to be priced on a hourly basis or per unit? See Section B, Price Schedule.

If during an Audit & Coding Queue Review a visit is determined to need addition, revision or deletion of codes— is this action reported under the PCC/EHR unit price (Item #1, #2 or #3)? No, this is included under item #8, Auditing & Coding Queue Review price of the original task order issued.

46. In Subpart 13.5-Test Program for Certain Commercial Items the thresholds are $5.5 million (11 million under certain circumstances) including option this effectively puts a cap of $2.2 million per year on the bids. To the extent that the government estimate or information that is available to the government indicates that the actual proposed amounts will exceed these thresholds, the RFP will be contrary to the FAR. Has the agency obtained a FAR deviation or waiver? Is there some other legal basis for conducting the procurement on this basis?

Answer: See revised FEDBIZOPPS advertisement; this has been deleted as it is not applicable.

47. The report issued by the Senate Indian Affairs Committee on AAO on 12/30/210 was extremely critical and highlighted several areas of mismanagement of Third Party Billing. Is the successful bidder expected bring the backlogs into compliance with Internal Control Standards within a specific time frame?

Answer: Yes, if the facility has a backlog.

48. A number of the requirements of this contract are the same as the current contract, which was extended but now coming to an end. Does the RFP allow for changes in the "Pricing Per Unit of Issue” beyond what is submitted as the base and option year prices? " (For example if hourly were changed to per unit or per unit changed to hourly.)What are the criteria for changing "Pricing Per Unit of Issue" after the award of a contract and is the current practice consistent with the administration of the prior contract.

Answer: The price schedule contained in this solicitation will remain until the contract expires.

ICD-10 codes will come out in 2013. The solicitation does not address the change and it is unclear as to whether work on the new codes will be covered on the contract. The vague RFP references the ICD-9 code set only and accordingly exposes the government to great risk of subsequent claims and additional cost during contract performance. The RFP should be amended and clarified to include this so that all offerors are competing to the same standard and limit the government’s future risk. We request the agency amend the solicitation to clarify this point and provide specific guidance on how to address the code change both in terms of technical and price.

Answer: In the event, ICD-10 codes are in fact released in 2013 the Government will address ICD- 10 codes at that point in time either through discussions with the successful contractor or via a formal written modification to the contract.

Can the responses be submitted by fax, email or paper copy? Also, please specify how many copies are needed. The RFP does not have the a standard form attached to complete. Please confirm the agency has authority not to use the standard form and this is how you want us to respond.

Answer: The announcement is clearly stated that receipt of proposals will be accepted by US mail or electronically through email. The agency needs an original plus three (3) copies of your proposal.

AAO in the past has awarded the contract to two vendors. Given the status of the backlogs, as documented in the Dorgan report, and other revenue generation issues, does it makes sense to make this a multi-vendor award so that revenues are maximized thereby providing better services to those who the AAO is entrusted to serve.

Answer: The Government anticipates a single award.

The pricing schedules for outpatient coding combines PCC's and EHR under one price. Does AAO have a breakdown of PCC's vs EHR on coding for the length of the last area wide contract issued for these services?

Answer: No.

In evaluating the financial proposals, are the quantities on the pricing schedules the quantities that will be used to determine pricing by line item in the analysis of the total cost of the bids?

Answer: See Section I-3.

Consultative Services are more than 5 times higher under this contract than estimated under the prior contract. Is there an opportunity for the successful bidder to provide consultative services for medical record coding, data entry, 3rd party billing, accounts receivables & coding que which would be outside the parameters of the contract? So that we can bid appropriately, is this consistent with the administration of the prior area wide contract?

Answer: See Section B, Price Schedule and Section C-9, Consultant Service/Auditing for Revenue Generation Cycle Functions and Processes – Scope of Work.