QA-Sol 75H70726Q00046 remote medical coders.pdf

Amend 0001- to provide an update and extend the due date to April 02, 2026 at 03:00 PM.

Solicitation Page #

Section # Section Title Question Answer

N/A N/A General Can you please tell me the incumbent, value, and contract number?

There is no incumbent. This is a new requirement with no prior contract, contract number, or historical value.

N/A N/A General

Question 1 — Definition of "Completed Action" When a Provider Query Is Pending

The solicitation defines a completed action as an encounter that has been "fully coded, validated, and moved to completed status in the RPMS/EHR coding queue." Please clarify: when a coder identifies a documentation deficiency and submits a provider query, at what point is the encounter considered a completed action for billing purposes — upon query submission, or only after the provider responds and final code assignment is made?

Billable only when fully coded, completed in RPMS/EHR, and accepted. Queries alone are not billable.

Question 2 — Four-Calendar-Day Turnaround: Start Point and System Outage Exceptions

The Statement of Work requires all coding actions to be completed within four (4) calendar days of the visit date, with an exception for provider documentation deficiencies. Please confirm: (a) Does the four-day clock begin from the date of patient visit or the date the encounter is released into the RPMS/EHR coding queue? (b) Are there documented exceptions for system outages or IHS network access interruptions beyond the contractor's control?

Measured from visit date. Provider delays are excluded. Documented Government system issues will be considered if reported.

Question 3 — Prior Contract Performance Issues

The solicitation indicates this is a re-procurement. Without disclosing proprietary or source-selection-sensitive information, can the Government provide a general summary of the performance issues that led to the predecessor contract's non-performance? This information would allow offerors to specifically address those risk areas in their technical approach and demonstrate how they would mitigate similar concerns.

Not applicable. This is a new requirement.

NA NA General Is the current incumbent Badger Health & Associates LLC with award #75H70726P00001?

There is no incumbent; this is a new requirement with no prior contract, contract number, or historical value.

NA NA General How is the work under this Solicitation_75H70726Q00046 different than 75H70726P00001?

The requirement has been modified. For example, the new requirement is for base plus two option periods.

NA NA General

Can the Government provide historical performance metrics (e.g., productivity rates, accuracy levels, backlog trends) from prior contract performance?

No information to report.

3 B.3 Period of

Performance

Will economic price adjustments or labor rate adjustments be permitted in option periods?

FAR 52.216-4, if applicable. Price all periods as requested.

4 B Pricing Summary Of the estimated annual volume, what portion represents backlog versus ongoing steady-state workload?

The quantities provided are estimates for pricing purposes only.

4 B Pricing Summary What is the expected volume by month accounting for the backlog and steady-state workload?

Not provided.

4 B Pricing Summary

While quantities are stated as estimates, is there an expected minimum level of utilization or baseline workload that contractors should plan for?

80-120 a day.

4 B Pricing Summary

Can the Government confirm whether multiple coding activities associated with a single patient encounter (e.g., multiple specialties or add-on procedures) will be counted as one completed action or multiple actions?

If primary care visit has lab & pharmacy, these two can be merge to 1 visit, but if a pt. has a primary care visit and a podiatry visit it will count as two separate visits.

4 B.4 Pricing Summary Is the maximum estimated quantity (124,800) fully funded, or subject to availability of funds?

Subject to availability of funds.

5 B Work Schedule What is the current number of coding backlogs?

Over 50,000 as of 03/20/2026.

5 5.a Statement of Work (SOW)

Can contractors propose a flexible staffing model that scales above or below the estimated 1–4 coders based on workload fluctuations?

The Government anticipates workload may fluctuate based on operational need, including backlog reduction, leave coverage, and unanticipated surges.

5 5.b Statement of Work (SOW)

Given the PRN nature of the contract, how does the Government anticipate workload distribution across the contract period (steady vs intermittent)?

The Government anticipates workload may fluctuate based on operational need, including backlog reduction, leave coverage, and unanticipated surges. No specific distribution is guaranteed.

6 D.1 Productivity and

Performance Requirements

Does the DVX report generate from RPMS/EHR system?

Yes.

6 D.1 Statement of Work (SOW)

Will productivity expectations (80–120 completed actions per day) be adjusted based on visit complexity and specialty type?

Yes. The solicitation stated 80-120 completed actions per 8-hour day, depending on visit complexity.

Quoters should account for complexity in their technical approach and pricing.

6 D.2 Statement of

Work

How will rework be classified and attributed between contractor error and provider documentation deficiencies?

Contractor error not billable.

Other issues handled via Program Office/COR oversight.

7 5.e Reporting

Requirements

Will delays caused by provider documentation deficiencies or system access issues be excluded from the 4-day turnaround requirement?

Provider delays excluded.

Documented Government issues considered if reported.

7 5.g Quality

Assurance Summary

What is the required coding accuracy threshold (e.g., ≥95%), and how will it be measured (audit frequency, sample size, methodology)?

Evaluated through Government QA processes. Quoters shall describe approach.

9 9.b Orientation and

Training:

Will the Government provide training or sandbox environment for coders prior to production access?

Orientation provided. No sandbox specified.

10 9.c Remote Network

Access:

How will system downtime, VPN access delays, or RPMS/EHR performance issues be accounted for in productivity expectations?

Considered if documented and reported.

22 F.3 Price Quote Assessment

Will the Government perform a price realism analysis to ensure proposed pricing reflects the level of effort required for compliant and accurate coding?

Evaluated for reasonableness, completeness, and balance per solicitation.

22 F.4 Price Quote Assessment

Can the Government clarify how tradeoffs between technical qualifications and price will be evaluated when proposals are technically comparable?

Price becomes more important as quotes become more equal.

22 F

EVALUATION

FACTORS FOR

AWARD.

How will the Government assess unbalanced pricing given variability in workload, specialty mix, and productivity expectations?

Evaluted for material and imbalance and realism.

N/A N/A General

1. Can the Government provide insight into the distribution of encounter types and specialties (e.g., primary care, behavioral health, dental)?

Primary care, urgent care, ER, observations, PT/OT, Podiatry, Dental, Optometry, Women’s health, Ressay/colpo, paps.

N/A N/A General

1. Is there an expected distribution of chart complexity (low, moderate, high), or should a blended complexity be assumed?

All types- mixed.

N/A N/A General

1. Beyond the ≥95% accuracy requirement, are there any additional QA audit thresholds or penalties applied?

No additional thresholds stated.

1. Are there any Zuni-specific or facility-level coding guidelines beyond standard IHS and CMS requirements?

Addressed during onboarding.

1. Are there priority categories of encounters that require expedited turnaround within the 4-day window?

Priority on billables.

**For purposes of pricing and invoicing under this contract, a complete action is defined as:

Question 1

• One (1) distinct patient encounter/visit record that has been fully coded, validated, and moved to completed status in the RPMS/EHR coding queue, and is reflected as completed on the applicable facility coding productivity report (DXV or successor report).

How will the vendor reflect real work associated with the medical coding processes? Example Encounter is reviewed but incomplete in RPMS due to lack of documentation from the provider and/or clinical team.

Not billable until completed and reviewed.

Billing and Counting Rules The following conditions apply:

Question 2

• Corrections to previously coded visits shall not be counted as new completed actions.

How will this process be managed both by the site and the vendor? What happens if a correction is unrelated to the coder. Example a billing edit is returned.

Not billable as new actions.

Question 3 Are billing edits available to the coder at the time of coding

• Excluded visit Types identified in the SOW (e.g. chart reviews, telephone calls, pharmacy refills, radiology-only visits, lab pre-visits) shall not be counted as completed actions

• Only completed actions verified and accepted by the COR or designated representative are billable

• Pricing shall be quoted as a firm-fixed price per completed actions.

• The Government shall pay only for actual quantities performed

No.

and accepted, not to exceed the stated maximum (ceiling) quantities.

• Quantities listed are estimates only and do not guarantee a minimum volume.

Question 4 Is there a backlog? If so, please provide the total backlog and oldest encounter to be coded.

a. Scope of Work The Contractor shall provide remote medical coding services to the Zuni Comprehensive Community Health Center (ZCCHC). The estimated number of Contract coders for this requirement is one (1) to four (4), based on the projected workload.

Over 50,000.

N/A N/A Scope Of Work

Question 5 Per above and if there is a backlog, we would request to load more coders, then adjust accordingly back to the requested 1 to 4 coders. Can vendor staff higher than the requested per RFQ to address coding backlogs

No-max is 4 coders.

5 5a Statement of

Work – Scope of work

Can the Government provide the approximate breakdown of encounter types expected to be coded under this contract (e.g., primary care, specialty care, dental, behavioral health, emergency , inpatient, outpatient visits)?

Primary care, urgent care, ER, observations, PT/OT, Podiatry, Dental, Optometry, Women’s health, Ressay/colpo, paps.

5 4 Pricing Summary

Can the Government provide historical encounter volumes for the past 12–24 months to help vendors better estimate staffing levels and pricing assumptions?

Max= 4 coders.

6 5(d)(3) Coding

Responsibilities

Can the Government provide historical data on the percentage of encounters that typically require provider queries or documentation clarification prior to coding completion?

Max= 4 coders.

7 5.e Reporting

Requirements

Are there formal reporting deliverables required (e.g., monthly productivity reports or QA reports), or will reporting requirements be limited to weekly coordination with the HIM Supervisor?

The contract requires weekly coordination with the HIM Supervisor and such reporting as necessary to support productivity status, workload issues, deficiencies, documentation gaps, and compliance concerns.

Additional contract administration reporting may be required by the COR/CO consistent with the contract.

10 9.c Remote Network

Access

The solicitation references the requirement for an Interconnect Security Agreement (ISA). Will the Government provide the ISA template and technical requirements for vendors to complete prior to performance?

The Government will provide applicable onboarding instructions and security access requirements to the successful quoter.

6 5(f) Contractor

Qualification Requirements

The SOW references experience with Current Dental Terminology (ADA).

Approximately what percentage of total encounters are expected to require dental coding services?

Currently, we have not dentist. If we get dentist onboard, it could be 5%.

15 12 Key Personnel

Does the Government intend to designate specific key personnel positions under HHSAR 352.237-5, or will proposed coders be considered interchangeable personnel under the contract?

Yes, only the selectees who submitted resumes.