RFQ-10-20-009-MH.Electronic Clearinghouse.docx

PART I – CLEARINGHOUSE CLAIMS SERVICES AT WIND RIVER SERVICE UNIT

The Wind River Service Unit (WRSU) is requesting quotes in accordance with the Request for Quotation (RFQ)-10-20-009-MH. This procurement is conducted pursuant to the authority of Federal Acquisition Regulation (FAR) Part 13, Simplified Acquisition Procedures and FAR 37.101, Non-Personal Service Contracts. The Government shall issue a firm-fixed-price purchase order to the responsible offeror whose quote, conforming to the RFQ, and represents the Best Value offer. This requirement is set-aside 100% for Small Business concerns.

A. PRICE SCHEDULE

BASE YEAR

OPTION YEAR ONE

OPTION YEAR TWO

OPTION YEAR THREE

OPTION YEAR FOUR

B. STATEMENT OF WORK

1. SCOPE OF WORK:

Contractor shall furnish Electronic Clearinghouse services for the Business Office Department, Health Information Management Department (HIM) and PRC Department at the Wind River Service Unit in Fort Washakie, WY. Contract performance shall be according to the requirements contained in this statement of work.

2. PERIOD OF PERFORMANCE:

January 1, 2020 – December 31, 2020 with 4 option years.

3. OBJECTIVES:

The contract resulting from this solicitation shall:

· Allow the government to evaluate the quality of professional and administrative services provided.

· Provide revenue cycle management for the validation and routing of electronic health care Medicare transaction claims submission between the Wind River Service Unit and Novitas Solutions, ensuring that established hospital policy guidelines are adhered to, while keeping abreast of current changes in government regulations, collection laws, FTC ruling,third party payer procedures and internal procedures that affect the Medicare claims transmission.

· Knowledge of ICD-10-CM and CPT/HCPCS coding terms in order to interpret and resolve problems based in information derived from system monitoring reports and the UB 92 and HCFA 1500 billing forms submitted to Novitas Solutions.

· Providing scalability for unlimited users and Medicare Contractor connections for the growing demand of Medicare transactions.

· Ensure that Contractor network and infrastructure complies with 1Pv6 Internet protocol version and new CMS security requirements for FIPS compliance. As of September 2013, SSL protocol for TN3270 access to Medicare Direct Data Entry is no longer sufficient.

· Login once with a single user ID and password and gain access to services via the internet without being prompted to log-in again.

· Ensure that our claims transmission are able to connect directly to the Medicare Common Working File (CWF) and Medicare Administrative Contractors (MACs) file transfer services, for claims submission and remit retrieval.

· Ensure that the Administrator is able to have the ability to add and configure new users, add and update MAC connections, add EDC connections for CWF, CSI and PPTN access and FedEx like tracking for claims/remits status.

· Contractor ensures that telephone Support Technicians, online training, as well as convenient self-paced CBT's (Computer Based Training) modules and job aids are available to the Business Office staff.

· Unlimited insurance eligibility verifications by all users.

4. REPORTING REQUIREMENTS:

Project Officer/Business Office manager, HIM Manager, PRC Manager or designated representative shall monitor the Contractor's service and promptly inform the Contracting Officer of any problems or potential problems they encounter. The government reserves the right to accept or reject services if the level of work is unsatisfactory.

5. MANAGEMENT:

The Contractor shall manage the total work effort associated with the Clearinghouse Services required herein to ensure fully adequate performance and support. Such management includes, but is not limited to, planning, scheduling, warranty enforcement, and quality control. The Contractor shall provide an adequate staff or personnel with the necessary management expertise to assure performance of the required work.

6. GENERAL REQUIREMENTS

1. Standards: All work shall meet the standards specified herein and shall be accomplished in conformance with approved and accepted standards of the industry; all applicable activity, local, state, and federal standards.

2. Completed Calls: With the invoice the Contractor shall add the following information to the written or electronic reports of all processed claims, insurance verifications, usage reports and deliver one completed copy to the Contracting Officer Representative:

· Number of verified insurance claims

· Number of patient verifications

· Name of items

· Usage reports

3. Permits: The Contractor shall, without additional expense to the Government, obtain all appointments, licenses, and permits required for the prosecution of the work. The Contactor shall comply with all applicable federal, state, local laws. Evidence of such permits and licenses shall be provided to the Contracting Officer or the COR before work commences.

7. INVOICES & PAYMENTS

The Supplier shall submit its invoice to:

Deborah Aragon P.O. Box 128 29 Blackcoal Drive Fort Washakie, WY 82514

With a courtesy copy to the Billings Area Financial Management Office: P.O. Box 36600, Billings, Montana 59107. The Supplier agrees to include the following information on each invoice: (1) Contractor's name and address; (2) Contact name, title, and telephone number; (3) Purchase Order Number; (4) Invoice number and date; (5) Remit to Address; (6) Taxpayer Identification Number (Employer Identification Number or Social Security Number); and (7) Data Universal Numbering System (DUNS) number (to ensure payment is made to the correct bank account) and vendor mailing address, as provided in the System for Award Management (SAM), formerly known as the Central Contractor Registration (CCR) database.

Payment shall be made after receipt of a correct invoice and confirmation that the supply/service was inspected and accepted. Failure to include all required information will result in delay of payment. Payments will be made by the Billings Area Financial Management Branch, in arrears.

CONTRACTING OFFICER AUTHORITY:

Authority to negotiate changes in the terms, conditions or amounts cited in this contract is reserved for the Contracting Officer.

PART II – CONTRACT CLAUSES & PROVISIONS

52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address:

https://www.acquisition.gov/

Certifications

(Other than Commercial Items)

Government (Fixed-Price)(Short Form)

DEPARTMENT OF HEALTH & HUMAN SERVICES ACQUISTION REGULATION

(HHSAR) CLAUSES

Opportunity Investigations

Accessibility Notice 352.239-74 Electronic and Information Technology Dec 18, 2015 Accessibility

52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)

Federal Law

PART III – INSTRUCTIONS TO THE OFFEROR

QUOTE SUBMISSION INSTRUCTIONS:

Quotes will only be accepted via email at Mitzi.Horn@ihs.gov in response to this RFQ. No other method of submission is acceptable. The offeror shall submit a quote that contains a technical description of the items being offered in sufficient detail to evaluate compliance with the requirements in this RFQ.

Quotes are due no later than 5:00 pm on December 23, 2019.

1. ACCEPTANCE PERIOD

Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm for a period of at least 90 days from the date of receipt by the Government.

2. EVALUATIONS

Quotations will be evaluated on Best Value Trade-Offs. When determining best value, the evaluation team may consider, among other factors, the following:

· Technical Proposal: Not to exceed 5 pages, that addresses the Objectives and Requirements of the RFQ. Other factors may include, but not limited to:

· Special Features for effective program performance

· Maintenance considerations

· Technical Support

· Procedures for Processing Claims

· Past Performance: Offerors must demonstrate their record of successful performance in past contracts and/or jobs. The Government is seeking to determine where the Offeror has the experience that will enhance its technical capability to provide the service described in the RFQ. Each offeror will be evaluated on Relevancy and Quality. Provide up to 3 examples.

EVALUATION APPROACH: The content of the written quotations, as well as information derived from discussions/negotiations, if discussions are held, will be evaluated to determine the degree and extent to which the requirements and objectives set forth in the solicitation are satisfied. No assumption will be made by Government evaluators regarding areas not defined in the offeror's written material/information provided to the Government for evaluation.

Technical and past performance, when combined, are considered approximately equal to cost or price. A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

BASIS FOR AWARD: Selection of the successful offeror will be made to the offeror whose proposal provides the combination of features that offers the best overall value to the Government. The quotations will be evaluated and a contract awarded under the Best Value Continuum approach to permit tradeoffs among cost or price and non-cost factors. This will allow the Government to consider award to other than the lowest priced offeror or other than the highest technically rated offeror. The Government is more concerned with obtaining performance capability rather than lowest overall cost. However, the Government will not make an award at a significantly higher overall cost to the Government to achieve only slightly superior performance. Overall cost to the Government may become the ultimate factor for award of a contract as proposals are considered more equal through evaluation.

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