RFQQ 2025 0131_Questions & Answers.docx
DOCX document 47 KB Posted
- Attached to
- Medical Invoicing Review Services
- Solicitation number
- RFQQ 2025 0131
- Issued by
- Adams County, Asotin County, Benton County, Chelan County, Clallam County, Clark County, Columbia County, Cowlitz County, Douglas County, Ferry County, Franklin County, Garfield County, Grant County, Grays Harbor County, Island County, Jefferson County, King County, Kitsap County, Kittitas County, Klickitat County, Lewis County, Lincoln County, Mason County, Okanogan County, Pacific County, Pend Oreille County, Pierce County, San Juan County, Skagit County, Skamania County, Snohomish County, Spokane County, Stevens County, Thurston County, Wahkiakum County, Walla Walla County, Whatcom County, Whitman County, Yakima County, Asotin City, Clarkston City, Clarkston Heights-Vineland CDP, West Clarkston-Highland CDP, Benton City, Chelan City, Chelan Falls CDP, Clallam Bay CDP, Lewisville CDP, Rock Island City, Pacific Beach CDP, Whidbey Island Station CDP, Mercer Island City, Pacific City, Bainbridge Island City, Kingston CDP, Kitsap Lake CDP, Kittitas City, Klickitat CDP, Okanogan City, Anderson Island CDP, Fort Lewis CDP, Fox Island CDP, Herron Island CDP, Ketron Island CDP, North Fort Lewis CDP, Raft Island CDP, Stevenson City, Hat Island CDP, Lake Stevens City, Snohomish City, Spokane City, Spokane Valley City, Puget Island CDP, Garfield Town, Yakima City, Washington
About this file
This is a Questions and Answers document for RFQQ 2025-0131 Medical Invoicing Review Services issued by the Washington State Department of Transportation (WSDOT) for medical invoice review services related to Washington State Ferries Jones Act claims. Based on the questions and responses, the anticipated contract award date is April 14, 2025. The scope includes reviewing medical invoices, with the current volume averaging 147 billings per month or approximately 1,696 bills annually. The contractor will access documents through WSDOT's SFTP DMZ Gateway system and may be required to provide legal testimony, though this has not been needed historically.
The current vendor is PMSI, LLC (d.b.a. Optum Managed Care Services). The annual billing volume in 2024 was $1,179,217, with an average annual billing of $1,167,961 since January 2020. The program has achieved an average savings rate of 40.6% in 2024 and 40.8% since January 2020. The majority of invoices (273) fall within the $2,000-$9,999 range, with only one invoice exceeding $200,000 since January 2020. WSDOT typically uploads batches of 30-50 bills approximately every two weeks rather than following a set schedule.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit G_Data Sharing Agreement.docx | DOCX document | |
| Exhibit A-3_Client Reference.docx | DOCX document | |
| Exhibit D-1_Contract Issues List.docx | DOCX document | |
| Exhibit F_Scope of Work.docx | DOCX document | |
| Exhibit A-1_Bidders Certification.docx | DOCX document | |
| Exhibit A-2_Bidders Profile.docx | DOCX document | |
| Exhibit D_Contract.docx | DOCX document | |
| RFQQ 2025 0131_Medical Invoicing Review.pdf | ||
| Exhibit C_Bid Price.docx | DOCX document | |
| RFQQ 2025 0131 - Amendment1.docx | DOCX document | |
| S2501 Market Conduct Continuum Activities.pdf | ||
| Exhibit E_DiverseBusinessInclusionPlanSubs.docx | DOCX document | |
| Exhibit H_Business Associate Agreement.docx | DOCX document | |
| Exhibit B_Performance Requirements.docx | DOCX document |
Show all 14
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Text version
Question & Answer # 01
MEDICAL INVOICING REVIEW SERVICES – RFQQ 2025-0131
This document is posted to capture the questions received during the question & answer period for RFQQ 2025-0131 Medical Invoicing Review Services. This document is the official response to the questions received.
Any additional questions regarding this solicitation must be directed to the Procurement Coordinator listed below.
Chase Johnson 360-705-7741 chase.johnson@wsdot.wa.gov
| Question # |
| Question |
| Response |
| Did this change the solicitation? |
| 1. |
| What is the current average monthly volume of medical invoices to be reviewed, and what percentage are considered complex cases requiring additional review time? |
| We averaged 147 billings per month in 2024.We do not keep data regarding complex cases requiring additional review time. However, since 1/1/2020 we have had the following number of billed invoices per price range: |
· $200,000 and above: 1
· $100,000 - $199,999: 6
· $50,000 - $99,999: 9
· $10,000 - $49,999: 44
· $2,000 - $9,999: 273 No
| 2. |
| Regarding the FTP site mentioned in Exhibit F, what are the specific security requirements and technical specifications that our system needs to be compatible with? |
| The vendor will have a unique user id and password to log into the public facing WSDOT SFTP DMZ Gateway. The vendor will choose a dedicated SFTP client (such as FileZilla, CuteFTP, WinSCP) compatible with their Operating System. The vendor must review and comply with all data security requirements set forth in the available exhibits and agreement. |
| No |
| 3. |
| Can you provide more detail about the expected frequency and nature of legal testimony mentioned in the Scope of Work, including typical scenarios where this has been required? |
| To the best of our knowledge, this has not happened in the past |
| No |
| 4. |
| What specific performance metrics or KPIs will be used to determine satisfactory performance for the potential contract extensions mentioned in Section 2.3? |
| Fulfillment of the Scope of Work and no breach of agreement |
| No |
| 5. |
| What has been the historical average savings rate achieved through medical bill review and pre-negotiations over the past year? |
| In calendar year 2024, the average savings rate was 40.6%. Since 1/1/2020, the average savings rate has been 40.8% |
No
| 6. |
| If there is an incumbent provider, what is the expected timeline and process for transitioning the services to ensure continuity of operations? |
| The anticipated timeline to award a contract is 4/14/2025. This assumes a timely contract negotiation process and fulfillment of the protests process listed in Section 5. |
| No |
| 7. |
| What is the estimated annual medical bill count? |
| We have averaged 1696 bills per year since 1/1/2020. We had 1764 bills in 2024. |
No
| 8. |
| What is the estimated total annual medical billing invoiced? |
| We have averaged $1,167,961 since 1/1/2020. We were billed a total of $1,179,217 in 2024. |
| No |
| 9. |
| Who is the current vendor providing the Medical Invoicing Review Services? |
| The current vendor is PMSI, LLC, d.b.a., Optum Managed Care Services. |
| No |
| 10. |
| Does the WSDOT upload bills on a set schedule, like every Thursday of the week, or should we expect bills uploaded to the FTP site any/everyday? |
| We do not upload bills on a set schedule. We normally hold the billings until we have enough to send in a batch (30 to 50 bills usually). This is normally about every two weeks. We send an email to the vendor’s contact when billings are uploaded so they’re aware |
| No |
(Rev5/8/2023)
(Rev5/8/2023) image1.png
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