J-07_Basis of Estimate.xlsx

XLSX spreadsheet 43 KB Posted Feb 11, 2011

Attached to: Solicitation RRB11R001 - RRB Specialty MAC
Solicitation number: RRB11R001
Issued by: Railroad Retirement Board

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Solicitation RRB11R001 Attachment J07 Basis of Estimate

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File	Type	Posted
J-15 CLIN 0006 Cost Proposal Template - Opt Year_4_RRB_SMAC_Rev_A5.xlsx	XLSX spreadsheet	Mar 18, 2011
J-11 CLIN 0002 Cost Proposal Template - Base Year_RRB_SMAC_Rev_A5.xlsx	XLSX spreadsheet	Mar 18, 2011
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J-13 CLIN 0004 Cost Proposal Template - Opt Year_2_RRB_SMAC_Rev_A5.xlsx	XLSX spreadsheet	Mar 18, 2011
A5 RRB SMAC SF-30 pages 1 thru 4.pdf	PDF	Mar 18, 2011
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J-10A Cost Template Summary Sheet_RRB_SMAC.xlsx	XLSX spreadsheet	Feb 11, 2011
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Instructions

RRBSMAC Business Proposal

Basis of Estimate - Template Instructions

To provide RRB and CMS with an understanding of the Offeror's basis of estimate, the Offeror shall complete this template for the Base Year and Option Year One as part of its Volume II submission. RRB is providing instructions to the Offeror for populating this template below. In addition, RRB has provided a sample calculation for the Offeror under the Base Year Tab.

	Column A,
Cost Estimating Factor	The first column of the spreadsheet has the workload categories identified in RFP section L. Note: In instances where Section L describes "provider counts" (i.e., Provider Customer Service), the Offeror shall provide the workload assumptions used in its Proposal based on the number of providers identified in the RFP. The Offeror shall insert a separate row for each workload category under the high-level workload category (shaded in grey) provided in the template.The Offeror shall copy and paste the FTE calculation formula in Column G for each inserted row. Also, the Offeror shall insert its proposed workload (by category) identified in its Medical Review Strategy (Tab F, Volume I) for Automated Reviews under the Medical Review heading. At a minimum, the Offeror shall include the categories identified in this Attachment. However, the Offeror is instructed to insert additional rows for Automated Reviews as necessary based on the categories proposed in its Medical Review Strategy. The Offeror shall copy and paste any formulas in the worksheet for each inserted row.
	Column B,
Annual Workload	The Offeror shall identify the RFP workloads for each cost estimating factor subheading in either light blue or grey (see the example provided in Red under the Base Year Tab). The Offeror shall also provide the annual workload for each workload category using Column B. The annual workload represents the portion of the total functional workload that is projected to be impacted by the specific labor category in Column B (Position / Labor Category). For example, if Claims Analyst I performs some function in handling all paper claims, the workload touched by this position would equate to the total paper claims volume. However, if Claims Analyst I only handles 75% of paper claims, with 25% handled by a Claims Analyst II, this would be reflected in a workload number 75% of that quoted in the RFP Section L. Any workloads listed must tie back to those identified in Section L of the RFP. NOTE: A formula is provided in the template to calculate the workload for each labor category following each sub-heading shaded light blue or grey. However, the Offeror shall ensure that the formula is updated to reflect any new/inserted rows.

	Column C,
% Workload Processed with Direct Labor	For each workload category identified in Column A, the Offeror shall identify in Column C the percentage of the annual workload (Column B) that will be processed using direct labor.
	Column D,
Position/Labor Category	For each workload category identified in Column A, the Offeror shall identify in Column D all positions/labor catagories required to meet the functional requirements of the statement of work. Each position/labor category shall be displayed using a separate row. Note: This may require the Offeror to insert additional rows. The Offeror shall copy and paste all formulas in the worksheet for each inserted row. For manager and supervisor positions/labor categories, the Offeror is instructed to adjust formulas as needed and insert the FTEs based its own proposal assumptions.
	Column E,
Annual Productive Hours	The Offeror shall provide the annual productive hours for each position/labor category (identified in Column D) using Column E.
	Column F,
Daily Production per FTE	The Offeror shall provide the workload that can be accomplished by one (1) FTE in one (1) business day using Column E. For this template, one (1) business day is defined as eight (8) hours. For example, if Claims Analyst I requires an average of 24 minutes to complete the position-specific tasks for a single paper claim, the Daily Production per FTE for this position would be 20 paper claims (2.5 claims per hour x 8 hours in a day).
	Column G,
Total FTEs	Column G contains a formula (in unshaded rows only) to automatically calculated total FTEs for each position/labor category provided by the Offeror. This should reflect the CLIN templates submitted with the Offeror's Business Proposal. Note: For all high-level workload headings (dark blue shading) and sub-headings (light blue or grey), the offeror shall provide a sum of the total FTEs (see example provided under the Base Year tab).
	Column H,
% Workload Processed by Indirect Cost Center	Where applicable, for each workload category identified in Column A, the Offeror shall identify in Column H the percentage of the annual workload (Column B) that will be processed by an Indirect Cost Center.
	Column I,
CLIN Template Crosswalk	The Offeror shall provide a crosswalk to the CLIN templates for the FTEs identified for each workload category using Column I.
	Column J,
Basis of Estimate	The Offeror shall specify whether the proposed productivity for each labor category is based on its history, or if it is based on a new innovation and/or process improvement proposed for this contract. The Offeror shall also crosswalk any referenced new innovation and/or process improvement in this column to the page, tab, and Volume of its Proposal that contains the narrative describing this innovation/process improvement (e.g., Volume I, Tab G, page 26). In addition, if the basis of the Offeror's proposed productivity is its history, which includes an implemented innovation and/or process improvement referenced in another section of its Proposal, the Offeror shall also crosswalk this to the page, tab, and Volume of its Proposal that contains the applicable narrative to support this implemented innovation and/or process improvement. Note: For the Bills/Claims workload, the Offeror shall notate the Suspence rates used in development of their Bills/Claims productivity estimates for both EMC and Paper claims using the light blue sub-headings (see example provided under the Base Year tab). Offerors shall propose their suspense rate based upon their history and their technical innovations which shall be fully explained in their innovations section.
	NOTE: The Offeror shall only provide Attachment J-07 via CD-ROM. The Offeror shall not submit hard copies of this document.

RFP- RRB11R001

Part B Specialty Medicare Administrative Contractor

Attachment J-07 Basis of Estimate Source Selection Information - See FAR 2.101 and 3.104 &P

Base Year

	RRB SMAC Volume II			RRB SMAC Volume II				RRB SMAC Volume II
	Basis of Estimate - Base Year			Basis of Estimate - Base Year				Basis of Estimate - Base Year
	Example (Only)
	Cost Estimating Factor	Annual
Workload1	% Workload Processed with Direct Labor	Position/Labor Category	Annual Productive
Hours2	Daily Production per FTE2	Total FTEs	% Workload Processed with Indirect Cost Center	CLIN Template Crosswalk	Basis of Estimate
	Bills/Claims Part B						176.24
	Bills Claims - EMC	6,600,000					0.01		History - EMC suspense rate of 16% based on implemented edits in 2008 (see page 15, Tab E, Volume I)
	Bills/Claims - EMC	10,560	0.16%	Claims Analyst I	1,864.00	3,200.00	0.01	All CLIN 0002, SLINAA, SOW D.1.2	History - EMC suspense rate of 16% based on implemented edits in 2008 (see page 15, Tab E, Volume I)
	Bills Claims - Paper	900,000					176.23		New - Paper suspense rate of 9% on new OCR technology (see page 20, Tab E, Volume I)
	Bills/Claims - Paper	315,000	35.00%	Claims Analyst I	1,864.00	20.00	50.70	All CLIN 0002, SLINAA, SOW D.1.2	History - Based on new OCR technology implemented in 2007 (see page 17, Tab E, Volume I)
	Bills/Claims - Paper	585,000	65.00%	Claims Analyst II	1,864.00	15.00	125.54	All CLIN 0002, SLINAA, SOW D.1.2	History - Based on automated process flow implemented in 2006 (see page 17, Tab E, Volume I)
	Appeals Part B						ERROR:#DIV/0!
	Written Redeterminations						ERROR:#DIV/0!
	Redeterminations	0					ERROR:#DIV/0!
	QIC Requests Supported						ERROR:#DIV/0!
	QIC Requests Supported	0					ERROR:#DIV/0!
	Clerical Error Reopenings						ERROR:#DIV/0!
	Clerical Error Reopenings	0					ERROR:#DIV/0!
	Non-Clerical Error Reopenings						ERROR:#DIV/0!
	Non-Clerical Error Reopenings	0					ERROR:#DIV/0!
	Effectuations						ERROR:#DIV/0!
	Effectuations	0					ERROR:#DIV/0!
	PM Beneficiary Inquiries Part B						ERROR:#DIV/0!
	Complex Beneficiary Inquiry Responses						ERROR:#DIV/0!
	Complex Beneficiary Inquiry Responses	0					ERROR:#DIV/0!
	Complex 2nd Level Screenings						ERROR:#DIV/0!
	Complex 2nd Level Screenings	0					ERROR:#DIV/0!
	Participating Physicians Part B						ERROR:#DIV/0!
	Enrollment Packages Mailed to Providers						ERROR:#DIV/0!
	Enrollment Packages Mailed to Providers	0					ERROR:#DIV/0!
	Enrollments and Withdrawals Processed						ERROR:#DIV/0!
	Enrollments and Withdrawals Processed	0					ERROR:#DIV/0!
	Limiting Charge Reports, Violations, and Complaints Processed						ERROR:#DIV/0!
	Limiting Charge Reports, Violations, and Complaints Processed	0					ERROR:#DIV/0!
	Provider Enrollment Part B						ERROR:#DIV/0!
	Initial Applications & CHOWS						ERROR:#DIV/0!
	Initial Applications & CHOWS	0					ERROR:#DIV/0!
	Change of Information						ERROR:#DIV/0!
	Change of Information	0					ERROR:#DIV/0!
	Benefit Request Reassignments						ERROR:#DIV/0!
	Benefit Request Reassignments	0					ERROR:#DIV/0!
	PM Provider Customer Service Part B						ERROR:#DIV/0!
	Provider Outreach and Education Activities						ERROR:#DIV/0!
		0					ERROR:#DIV/0!
	Provider Inquiries Part B						ERROR:#DIV/0!
	Telephone Inquiries						ERROR:#DIV/0!
	Telephone Inquiries	0					ERROR:#DIV/0!
	Written Inquiries						ERROR:#DIV/0!
	Written Inquiries	0					ERROR:#DIV/0!
	PM Change Management						ERROR:#DIV/0!
	Draft Change Requests						ERROR:#DIV/0!
	Draft Change Requests	0					ERROR:#DIV/0!
	Finalized and Issued Change Requests - Shared System Changes						ERROR:#DIV/0!
	Finalized and Issued Change Requests - Shared System Changes	0					ERROR:#DIV/0!
	Finalized and Issued Change Requests - No Shared System Changes						ERROR:#DIV/0!
	Finalized and Issued Change Requests - No Shared System Changes	0					ERROR:#DIV/0!
	MIP Medical Review (MR) Part B						ERROR:#DIV/0!
	Routine Manual Medical Reviews						ERROR:#DIV/0!
	Routine Manual Medical Reviews	0					ERROR:#DIV/0!
	Existing LCDs Revised						ERROR:#DIV/0!
	Existing LCDs Revised	0					ERROR:#DIV/0!
	New LCDs Developed						ERROR:#DIV/0!
	New LCDs Developed	0					ERROR:#DIV/0!
	Complex Probe Reviews						ERROR:#DIV/0!
	Complex Probe Reviews	0					ERROR:#DIV/0!
	Prepay Complex Reviews						ERROR:#DIV/0!
	Prepay Complex Reviews	0					ERROR:#DIV/0!
	Postpay Complex Reviews						ERROR:#DIV/0!
	Postpay Complex Reviews	0					ERROR:#DIV/0!
	Medical Review Reopenings						ERROR:#DIV/0!
	Medical Review Reopenings	0					ERROR:#DIV/0!
	MIP Provider Reimbursement and Audit						ERROR:#DIV/0!
	Cost Report Acceptances						ERROR:#DIV/0!
	Cost Report Acceptances	0					ERROR:#DIV/0!
	Tentative Settlements						ERROR:#DIV/0!
	Tentative Settlements	0					ERROR:#DIV/0!
	Desk Reviews						ERROR:#DIV/0!
	Desk Reviews	0					ERROR:#DIV/0!
	Audits						ERROR:#DIV/0!
	Audits	0					ERROR:#DIV/0!
	Reopenings						ERROR:#DIV/0!
	Reopenings	0					ERROR:#DIV/0!
	Interim Rate Reviews						ERROR:#DIV/0!
	Interim Rate Reviews	0					ERROR:#DIV/0!
	Cost Report Settlements						ERROR:#DIV/0!
	Cost Report Settlements	0					ERROR:#DIV/0!
	Cost Report Appeals						ERROR:#DIV/0!
	Cost Report Appeals	0					ERROR:#DIV/0!
	MIP MSP Prepay Part B						ERROR:#DIV/0!
	Claims Edits Resolved / "I" Records Resolved						ERROR:#DIV/0!
	Claims Edits Resolved / "I" Records Resolved	0					ERROR:#DIV/0!
	MIP Benefit Integrity Part B Workload						ERROR:#DIV/0!
	PSC Support Requests-Non Law Enforcement						ERROR:#DIV/0!
	PSC Support Requests-Non Law Enforcement	0					ERROR:#DIV/0!
	PSC Support Requests- Law Enforcement						ERROR:#DIV/0!
	PSC Support Requests- Law Enforcement	0					ERROR:#DIV/0!
	# of PSC Support Services Provided						ERROR:#DIV/0!
	# of PSC Support Services Provided	0					ERROR:#DIV/0!
	MIP Provider Customer Service						ERROR:#DIV/0!
	Provider Outreach and Education Activities						ERROR:#DIV/0!
		0					ERROR:#DIV/0!
	MIP Provider Customer Service HHA						ERROR:#DIV/0!
	Provider Outreach and Education Activities						ERROR:#DIV/0!
		0					ERROR:#DIV/0!
	MIP Provider Customer Service Part B						ERROR:#DIV/0!
	Provider Outreach and Education Activities						ERROR:#DIV/0!
		0					ERROR:#DIV/0!
	MIP MSP Postpay Part B						ERROR:#DIV/0!
	Provider/Supplier Duplicate Primary Payments						ERROR:#DIV/0!
	Provider/Supplier Duplicate Primary Payments	0					ERROR:#DIV/0!
	General MSP Inquiries Resolved						ERROR:#DIV/0!
	General MSP Inquiries Resolved	0					ERROR:#DIV/0!
	Debt Collection and Referrals						ERROR:#DIV/0!
	Debt Collection and Referrals	0					ERROR:#DIV/0!

RFP- RRB11R001

Part B SPECIALTY MEDICARE ADMINISTRATIVE CONTRACTOR (RRB SMAC)

Source Selection Information - See FAR 2.101 and 3.104 &P

Option Year One

RRB SMAC Volume II	RRB SMAC Volume II	RRB SMAC Volume II
Basis of Estimate - Option Year One	Basis of Estimate - Option Year One	Basis of Estimate - Option Year One

	Cost Estimating Factor	Annual
Workload1	% Workload Processed with Direct Labor	Position/Labor Category	Annual Productive
Hours2	Daily Production per FTE2	Total FTEs	% Workload Processed with Indirect Cost Center	CLIN Template Crosswalk	Basis of Estimate
	Bills/Claims Part B					ERROR:#DIV/0!
	Bills Claims - EMC					ERROR:#DIV/0!
	Bills/Claims - EMC	0				ERROR:#DIV/0!
	Bills Claims - Paper					ERROR:#DIV/0!
	Bills/Claims - Paper	0				ERROR:#DIV/0!
	Appeals Part B					ERROR:#DIV/0!
	Written Redeterminations					ERROR:#DIV/0!
	Redeterminations	0				ERROR:#DIV/0!
	QIC Requests Supported					ERROR:#DIV/0!
	QIC Requests Supported	0				ERROR:#DIV/0!
	Clerical Error Reopenings					ERROR:#DIV/0!
	Clerical Error Reopenings	0				ERROR:#DIV/0!
	Non-Clerical Error Reopenings					ERROR:#DIV/0!
	Non-Clerical Error Reopenings	0				ERROR:#DIV/0!
	Effectuations					ERROR:#DIV/0!
	Effectuations	0				ERROR:#DIV/0!
	PM Beneficiary Inquiries Part B					ERROR:#DIV/0!
	Complex Beneficiary Inquiry Responses					ERROR:#DIV/0!
	Complex Beneficiary Inquiry Responses	0				ERROR:#DIV/0!
	Complex 2nd Level Screenings					ERROR:#DIV/0!
	Complex 2nd Level Screenings	0				ERROR:#DIV/0!
	Provider Enrollment Part B					ERROR:#DIV/0!
	Initial Applications & CHOWS					ERROR:#DIV/0!
	Initial Applications & CHOWS	0				ERROR:#DIV/0!
	Change of Information					ERROR:#DIV/0!
	Change of Information	0				ERROR:#DIV/0!
	Benefit Request Reassignments					ERROR:#DIV/0!
	Benefit Request Reassignments	0				ERROR:#DIV/0!
	PM Provider Customer Service Part B					ERROR:#DIV/0!
	Provider Outreach and Education Activities					ERROR:#DIV/0!
		0				ERROR:#DIV/0!
	Provider Inquiries Part B					ERROR:#DIV/0!
	Telephone Inquiries					ERROR:#DIV/0!
	Telephone Inquiries	0				ERROR:#DIV/0!
	Written Inquiries					ERROR:#DIV/0!
	Written Inquiries	0				ERROR:#DIV/0!
	Participating Physicians Part B					ERROR:#DIV/0!
	Enrollment Packages Mailed to Providers					ERROR:#DIV/0!
	Enrollment Packages Mailed to Providers	0				ERROR:#DIV/0!
	Enrollments and Withdrawals Processed					ERROR:#DIV/0!
	Enrollments and Withdrawals Processed	0				ERROR:#DIV/0!
	Limiting Charge Reports, Violations, and Complaints Processed					ERROR:#DIV/0!
	Limiting Charge Reports, Violations, and Complaints Processed	0				ERROR:#DIV/0!
	PM Change Management					ERROR:#DIV/0!
	Draft Change Requests					ERROR:#DIV/0!
	Draft Change Requests	0				ERROR:#DIV/0!
	Finalized and Issued Change Requests - Shared System Changes					ERROR:#DIV/0!
	Finalized and Issued Change Requests - Shared System Changes	0				ERROR:#DIV/0!
	Finalized and Issued Change Requests - No Shared System Changes					ERROR:#DIV/0!
	Finalized and Issued Change Requests - No Shared System Changes	0				ERROR:#DIV/0!
	MIP Medical Review (MR) Part B					ERROR:#DIV/0!
	Routine Manual Medical Reviews					ERROR:#DIV/0!
	Routine Manual Medical Reviews	0				ERROR:#DIV/0!
	Existing LCDs Revised					ERROR:#DIV/0!
	Existing LCDs Revised	0				ERROR:#DIV/0!
	New LCDs Developed					ERROR:#DIV/0!
	New LCDs Developed	0				ERROR:#DIV/0!
	Complex Probe Reviews					ERROR:#DIV/0!
	Complex Probe Reviews	0				ERROR:#DIV/0!
	Prepay Complex Reviews					ERROR:#DIV/0!
	Prepay Complex Reviews	0				ERROR:#DIV/0!
	Postpay Complex Reviews					ERROR:#DIV/0!
	Postpay Complex Reviews	0				ERROR:#DIV/0!
	Medical Review Reopenings					ERROR:#DIV/0!
	Medical Review Reopenings	0				ERROR:#DIV/0!
	MIP Provider Reimbursement and Audit					ERROR:#DIV/0!
	Cost Report Acceptances					ERROR:#DIV/0!
	Cost Report Acceptances	0				ERROR:#DIV/0!
	Tentative Settlements					ERROR:#DIV/0!
	Tentative Settlements	0				ERROR:#DIV/0!
	Desk Reviews					ERROR:#DIV/0!
	Desk Reviews	0				ERROR:#DIV/0!
	Audits					ERROR:#DIV/0!
	Audits	0				ERROR:#DIV/0!
	Reopenings					ERROR:#DIV/0!
	Reopenings	0				ERROR:#DIV/0!
	Interim Rate Reviews					ERROR:#DIV/0!
	Interim Rate Reviews	0				ERROR:#DIV/0!
	Cost Report Settlements					ERROR:#DIV/0!
	Cost Report Settlements	0				ERROR:#DIV/0!
	Cost Report Appeals					ERROR:#DIV/0!
	Cost Report Appeals	0				ERROR:#DIV/0!
	MIP MSP Prepay Part B					ERROR:#DIV/0!
	Claims Edits Resolved / "I" Records Resolved					ERROR:#DIV/0!
	Claims Edits Resolved / "I" Records Resolved	0				ERROR:#DIV/0!
	MIP Benefit Integrity Part B Workload					ERROR:#DIV/0!
	PSC Support Requests-Non Law Enforcement					ERROR:#DIV/0!
	PSC Support Requests-Non Law Enforcement	0				ERROR:#DIV/0!
	PSC Support Requests- Law Enforcement					ERROR:#DIV/0!
	PSC Support Requests- Law Enforcement	0				ERROR:#DIV/0!
	# of PSC Support Services Provided					ERROR:#DIV/0!
	# of PSC Support Services Provided	0				ERROR:#DIV/0!
	MIP Provider Customer Service Part B					ERROR:#DIV/0!
	Provider Outreach and Education Activities					ERROR:#DIV/0!
		0				ERROR:#DIV/0!
	MIP MSP Postpay Part B					ERROR:#DIV/0!
	Provider/Supplier Duplicate Primary Payments					ERROR:#DIV/0!
	Provider/Supplier Duplicate Primary Payments	0				ERROR:#DIV/0!
	General MSP Inquiries Resolved					ERROR:#DIV/0!
	General MSP Inquiries Resolved	0				ERROR:#DIV/0!
	Debt Collection and Referrals					ERROR:#DIV/0!
	Debt Collection and Referrals	0				ERROR:#DIV/0!

RFP- RRB11R001

PART B SPECIALTY MEDICARE ADMINISTRATIVE CONTRACTOR (RRB SMAC)

Source Selection Information - See FAR 2.101 and 3.104 &P

File details come from the government source that posted it. Updated Nov 14, 2017.