RFQ S1567_FINAL#2-Addendum#1.pdf

SUNY Upstate Medical University

Insurance Revenue Collection Services for Low-Balance Accounts (Under $500)

RFQ S-1567

ADDENDUM #1

Please Note: Revisions in the RFQ document are noted in red font and/or strikethroughs.

REVISON(S):

1) Cost Worksheet, which is located on Page 3, has been updated with revisions in red.

Please sign here to acknowledge receipt of this revision addendum:

Signature:

Company name:

Print name:

BIDDER MUST SUBMIT THIS SIGNED PAGE WITH BIDDER’S PROPOSAL TO CONFIRM RECEIPT OF

THIS REVISION.

State University of New York Upstate Medical University

Date: 07/06/2026

Description: Insurance Revenue Collection Services for Low-

Balance Accounts (Under $500)

Response due by: 2:00 PM Wednesday, July 29, 2026

This Request for Quotation (RFQ) is a fill-able document using Microsoft Word. Please e-mail the completed document to BrownEmi@upstate.edu

ADDRESS RESPONSE OR INQUIRIES TO: Please provide the following:

Attn: Emily Brown Company Name:

Contracts & Campus Purchasing Address:

SUNY Upstate Medical University 750 East Adams Street

Syracuse, NY 13210 Contact Name:

Telephone No. (315) 464-8922 Phone No.

E-mail: BrownEmi@upstate.edu Fax No.

Federal ID No.

This Is Not an Order

R E Q U E S T F O R Q U O T A T I O N

RFQ Scope:

This Request for Quotation (RFQ) is for Insurance Revenue Collection Services for Low-Balance Accounts (Under $500). The Contractor shall perform comprehensive follow-up activities necessary to pursue reimbursement from commercial insurance carriers on referred low-balance claims. Services shall be performed in a timely, accurate, compliant, and professional manner and may include, but are not limited to: verification and follow-up as needed, coordination with Upstate, account resolution activities, payment processing and commission eligibility, and nationwide geographic coverage.

List of Items:

The information below is the list of services Upstate is looking to contract for, for a five (5) year term. Please confirm your company is able to meet and comply with each Requirement listed below on the line to the left of each item.

Service Insurance Revenue Collection Services for Low-Balance Accounts (Under $500)

Requirements:

Bidder must be a New York State Certified Minority or Woman-Owned Business Enterprise.

Bidder must have a minimum of five (5) years of experience providing insurance follow-up, revenue recovery, or similar services for healthcare providers, health systems, or hospitals.

Bidder must have demonstrable experience working with a range of commercial insurance plans and conducting follow-up activities on low-balance accounts.

Bidder must be fully compliant with HIPAA privacy and security regulations. Bidder must maintain policies and procedures to ensure the confidentiality of protected health information.

Bidder must possess the system capabilities required to accept and return electronic placement files, generate required mailto:BrownEmi@upstate.edu

END OF SECTION – Please Continue reports, maintain secure data environments, and comply with Upstate’s technical specifications.

Bidder must demonstrate sufficient financial resources and stability to perform the services for the full contract term.

Upstate reserves the right to request financial documentation as needed.

All services under the resulting contract must be performed within the United States of America. No offshore work is permitted.

Bidder must accept and return electronic account files using Upstate’s secure file layout and transmission protocol.

All data exchanges must occur through approved secure methods, including VPN, secure FTP, or other encrypted transmission.

Bidder must load all data into its secure system and update information promptly upon notification of changes.

When insurance contact information is incomplete or outdated, bidder must perform reasonable skip-tracing procedures to identify correct payor contact pathways.

Bidder must submit for approval any form letters, templates, or communication tools that involve contact with payors. Only approved forms may be used.

Bidder must provide weekly remittance reports of payments expected or resulting from its efforts. Insurance payments must be made directly to Upstate.

Bidder must submit monthly invoices for earned commissions along with detailed payment activity reports.

Bidder shall provide the following reports in Microsoft Excel Format: monthly inventory of all active accounts, monthly report of payments received, monthly list of returned accounts with work history, and additional reports as reasonably requested by Upstate.

Bidder must acknowledge receipt of accounts within two (2) business days.

Bidder must return accounts within one (1) year of placement regardless of activity or collection status.

Monthly reports must be delivered by the 10th day of the following month.

PRICING – COST WORKSHEET

PLEASE PROVIDE PRICING PERCENTAGE RATES FOR THE FOLLOWING INFORMATION: estimated $5,000,000.00 in referrals per year.

PLEASE PROVIDE PRICING RATES IN THE FORMAT BELOW. ANY PROPOSAL SUBMITTED WITH PRICING RATES IN A FORMAT OTHER THAN REQUESTED BELOW WILL BE REJECTED AND THE PROPOSAL WILL BE DEEMED NON-RESPONSIVE.

Account Balances Estimated Total Referral Collection % Commission % on Collections

Total (Referral Estimate x Collection % x Commission %)

Under $500.00 $5,000,000.00 (per year)

Estimated Total (4th Column) x5 (Years): $_____________________________

Please continue to next page.

General Information

1. All inquiries must be in writing and sent via e-mail to Emily Brown at BrownEmi@upstate.edu.

2. Participating vendors must return this entire RFQ package to: Emily Brown, SUNY Upstate Medical University, no later than 2:00 PM EST on Wednesday, July 29, 2026. The completed and signed RFQ package may be e-mailed. The e-mail address is BrownEmi@upstate.edu. If the RFQ package is not received by the date and time stated above, the package will not be accepted. It is the responsibility of the vendor submitting the RFQ response package to verify SUNY Upstate Medical University has received the package.

3. This RFQ package must be completed in its entirety or may be rejected.

4. All RFQ responses must include any deviations from or exceptions to the specifications.

5. The response to this RFQ must be fully and properly executed by an authorized person.

6. The vendor acknowledges that Upstate’s issuance of a Contract will be contingent upon Upstate’s determination that the vendor is responsible.

7. Each Contracting New York State Agency (e.g., SUNY Upstate Medical University, aka Upstate) conducts a review and evaluation of prospective contractors (vendors) to provide reasonable assurances that the vendor is responsible.

Also, each agency must comply with New York State Finance Law §139 and New York State’s Tax Law Section 5-a.

Upstate’s VENDOR QUESTIONNAIRE PACKET is designed to provide information to assess a vendor’s authorization to do business in New York State, its business integrity, financial and organizational capacity, performance history, compliance with State Finance Law 139, and whether or not a vendor is required to collect state sales and compensating use tax. The vendor must complete the forms contained within the VENDOR QUESTIONNAIRE PACKET and include the completed forms with its RFQ response. The VENDOR QUESTIONNAIRE PACKET contains instructions related to all sections of the PACKET. Do not hesitate to contact me should you have any questions regarding the PACKET.

Vendors not providing the documents, forms, certificates, etc., with their RFQ response may be disqualified.

8. The VENDOR QUESTIONNAIRE PACKET contains SUNY Exhibit A Standard Contract Clauses and SUNY Exhibit A-1 Affirmative Action Clauses, which are incorporated in each contract or Purchase Order issued by Upstate.

9. The VENDOR QUESTIONNAIRE PACKET contains directions and information related to the required insurance certificates. The vendor is required to submit valid and current NYS Workers’ Compensation and Disability insurance certificates with its response.

10. Payments will be processed upon receipt of a proper invoice, and the review and approval of received invoice by SUNY Upstate Medical University.

11. Timeliness of payment and any interest to be paid to Vendor for late payment shall be governed by Article 11-A of the New York State Finance Law to the extent required by law.

12. The vendor’s response to this Request For Quotation must include: a. The completed and signed Request For Quotation, including the attached and completed PRICING – COST WORKSHEET page, b. The completed, signed, and certified Vendor Responsibility Questionnaire, c. The completed and signed SFL139 form, d. The completed and signed ST-220-CA form, e. The required NYS Workers’ Compensation and Disability insurance certificates. Vendor responses not containing all of the above described forms, documents, and certificates may be disqualified.

Required Signature Page to Follow

By signing this Request for Quotation you indicate your express authority to sign on behalf of yourself, your company, or other entity, and where the provisions of SUNY Exhibits A and A-1 apply to this quotation, agree to the terms and conditions contained there-in, and the prices quoted are equal to or lower than those quoted to any other governmental agency or private institution.

Name Title Date Phone No.

Signature