Questions and Answers1.docx
DOCX document 17 KB Posted
- Attached to
- Medical and Dental Coding, Auditing, and Data Entry Services, Area-wide Phoenix Area IHS Federal contract opportunity
- Solicitation number
- RFQ-26-PHX-021
About this file
This is a Questions and Answers document for RFQ-26-PHX-021, addressing clarifications regarding medical and dental coding, auditing, and data entry services for the Phoenix Area Indian Health Service.
The Q&A clarifies key operational parameters for the anticipated Blanket Purchase Agreement (BPA). Regarding inpatient coding services (estimated 600 encounters), the Government will not provide detailed metrics on average length of stay, as this varies by facility and service type. Inpatient cases may be assigned to coding at varying documentation completion stages, and provider response times to queries vary by facility and workload. For outpatient coding services (estimated 165,000 encounters), service types vary across multiple Service Units and include hospital-based Emergency Departments, observation, same-day surgery, and specialty services. Audit scope for both inpatient auditing (estimated 80 cases) and outpatient auditing (estimated 4,520 cases) will be defined at individual BPA call levels and may include clinical documentation review, regulatory compliance issues, and third-party denials as requested. Audits may encompass both Government and contractor coding activities. The Government does not provide encoder software; contractors must supply their own tools. Contractors may be required to identify documentation deficiencies and initiate or track queries according to Service Unit procedures, which vary by location and workload. The document emphasizes that no minimum volume is guaranteed, quantities are estimates only, and specific volumes, priorities, and requirements will be determined at the BPA call level. The Government manages third-party billing and accounts receivable separately from coding services.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| RFQ-26-PHX-021 Medical Coding.pdf | ||
| Att 1 - PWS Medical Coding.pdf | ||
| Att 3 - Business Associate Agreement.pdf | ||
| Att 2 - Pricing Schedule.docx | DOCX document | |
| Att 2.1 - Pricing Schedule.xlsx | XLSX spreadsheet | |
| IEE Representation Form.pdf |
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Text version
RFQ-26-PHX-021
Q&A
| Per Review, Inpatient coding 600, please provide the average length of stay for your organization. |
| Average length of stay varies by facility and service type; detailed metrics will not be provided. |
| Are inpatient presented to coding prior to chart completion? |
| Encounters may be assigned at varying stages of documentation completion. |
| Do your providers respond to queries promptly? |
| Response times may vary by facility and workload. |
Per review Outpatient coding 165,000, Please provide the service type. I.e. Emergency Department, Observation, Same Day Surgery, Endo??
Service types vary by Service Unit. Several facilities include hospital-based services with Emergency Departments, as well as outpatient and specialty services.
Per review Inpatient auditing 80, Should the audit include Clinical Documentation for providers, regulatory compliance issues for accrediting agency, third party denials
When requested, coding quality audits will be specified in the BPA call. Additional scope will be defined at the BPA Call level.
Per review Outpatient auditing 4520, Should the audit include Clinical Documentation for providers regulatory compliance issues for accrediting agency, third party denials.
Audit scope and methodology will be defined at the BPA call level.
Are the audits for the site or just limited to the vendors coders?
Audits may include both Government and contractor coding activities, as specified in the BPA call.
What encoder software will the vendor have access to?
The Government does not currently provide encoder software. Contractors shall provide their own tools as necessary
Are there any unique coding policies and procedure per site?
Yes
What is the internal process for handling queries, documentation missing, etc?
The Government utilizes established clinical documentation query processes consistent with standard coding and compliance practices. When documentation is incomplete or clarification is required, queries are routed to the appropriate provider or clinical staff for response.
The Contractor may be required to identify documentation deficiencies and initiate or track queries in accordance with Service Unit procedures.
Response timelines and processes may vary by Service Unit and workload conditions. Specific processes will be defined at the BPA call level
| Based upon the volumes mentioned, it is correct to assume this will be a minimum volume expectation? If so, we could project staffing. |
| No minimum quantity is guaranteed. Quantities are estimates only. |
Please describe process for handling payor edits and denials?
Third-party billing and accounts receivable functions are managed separately
Is there a backlog currently? If so, what are the backlog numbers.
Backlog conditions may exist and may be addressed through BPA calls. Specific volumes will be defined at the call level.
| Of the sites mentioned, please provide which sites will need help immediately? |
| Priorities will be determined at the BPA call level based. |
Workload distribution, complexity, and prioritization may vary by Service Unit and over time. Specific requirements will be defined at the BPA call level.
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