TDP-7 1 on 1s RFI Response Matrix.xlsx
XLSX spreadsheet 14 KB Posted
- Attached to
- TRICARE DENTAL PROGRAM 7 INDUSTRY 1:1s
- Solicitation number
- Not on record
- Issued by
-
Defense Health Agency
About this file
This file is a Request for Information (RFI) Response Matrix designed to gather industry input from dental insurance carriers regarding the Seventh Generation TRICARE Dental Program (TDP-7). The Defense Health Agency (DHA) structured the RFI around twelve topic areas to identify commercial best practices and industry standards that should be incorporated into the TDP-7 acquisition strategy. The RFI questions cover service standards and innovation (including emerging technologies like teledentistry), provider management and quality assurance, provider incentives and performance metrics, OCONUS (overseas) benefit delivery, and contract and proposal process considerations.
The matrix specifically addresses operational requirements such as customer service standards, benefit and claims processing procedures, provider network management, beneficiary and provider education practices, and quality enforcement mechanisms for clinical outcomes. For OCONUS populations, the RFI seeks information on international provider credentialing, network expansion timelines, claims adjudication procedures, language barrier protocols, and translation turnaround times. The contract and proposal section requests vendor perspectives on administrative barriers to competition, proposal evaluation factors, reasonable preparation timelines, pricing forecasting methodologies, contract repricing mechanisms, Third Party Administrator (TPA) experience, and how commercial contracts handle dynamic policy updates and regulatory changes. This RFI matrix was used during virtual one-on-one industry sessions held August 18-20, 2026, where the DHA intended to contract with two to four dental insurance carriers to deliver worldwide dental coverage to TRICARE-eligible family members.
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Other files
| File | Type | Posted |
|---|---|---|
| TRICARE DENTAL PLAN (TDP-7) HIGH LEVEL OBJECTIVES.pdf | ||
| TDP6 Program Operations.pdf |
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Sheet1
| Organization Name | |||
| Question # | Request for Information Question | Industry Response | Supporting Information |
| Service Standards and Innovation | |||
| 1 | Are there new/emerging dental care standards, requirements, technologies (e.g., teledentistry), innovations, or beneficiary support services that the Government should consider incorporating into its requirement? If so, please describe them. | ||
| 2 | Are there industry standards for customer service? What are your standard commercial practices for customer service? | ||
| 3 | Are there industry standards for benefit management? What are your standard commercial practices for benefit management? | ||
| 4 | Are there industry standards for provider network management? What are your standard commercial practices for provider network management? | ||
| 5 | Are there industry standards for claims processing? What are your standard commercial practices for claims processing? | ||
| 6 | Are there industry standards for beneficiary and provider education? What are your standard commercial practices for beneficiary and provider education? | ||
| Provider Management and Quality | |||
| 1 | Providers may not be timely in notifying the contractor they are no longer in network. This can impact accuracy of the Provider Directory. What methods do you use to motivate providers to notify you immediately when they are no longer in network? | ||
| 2 | What measures do you use, or would you suggest, to ensure clinical/restorative quality standards are being enforced to the standard of care required by Regional/State board requirements? | ||
| 3 | What is your organization’s methodology for identifying and managing providers who deliver substandard care? Please include your protocols for addressing high grievance volumes, substantiated complaints, poor clinical outcomes, and technical failures, such as restoration longevity (e.g., crowns lasting fewer than five years). | ||
| Provider Incentives and Performance | |||
| 1 | Does your organization provide designations for providers online (i.e. in the provider search tool) such as 'high performing' or 'better value' based on patient satisfaction scores and clinical outcome metrics? If so, have such designations proven effective? Have they impacted beneficiary behavior? | ||
| 2 | What provider incentives do you use in your other product lines (Government and commercial contracts)? How effective are they? | ||
| OCONUS Benefit: If you currently provide benefits to an OCONUS population: | |||
| 1 | Identify the specific OCONUS regions or countries your organization currently serves or has served. | ||
| 2 | Describe the methodology you use to ensure proper credentialing for international providers. | ||
| 3 | How do you go about finding providers in a new area overseas (if we have to extend coverage to an area we don’t have families in now). How quickly can you stand up new agreements with providers in an "under-served," or "non-served" location overseas? | ||
| 4 | What is the standard timeframe applied for the adjudication and payment of OCONUS claims? | ||
| 5 | Detail the protocols and tools you use to facilitate communication when language barriers exist. | ||
| 6 | Specify the turnaround time you apply for the translation of claims or associated correspondence. Is there a commercial standard in this area? | ||
| Contract and Proposal Process | |||
| 1 | What administrative barriers, real or perceived, could hinder competition or prevent dental carriers from submitting proposals for this requirement? | ||
| 2 | What solicitation factors (e.g., proposal evaluation approach, pricing structure, etc.) would encourage your company to bid? | ||
| 3 | What amount of time is reasonable to prepare proposals? | ||
| 4 | What are the pros/cons of having six, seven, or eight option years versus five option years? | ||
| 5 | What factors do you use to forecast future dental care costs (in general), and what can the Government do (or not do) to ensure you are able to accurately forecast dental care costs under TDP-7? | ||
| 6 | Should the Government offer the ability to reprice the high option each year? Or can pricing be done up front for the life of the contract? | ||
| 7 | What experience does your company have working with a Third Party Administrator (TPA)? | ||
| 8 | How can the Government structure the Request for Proposal (RFP) to encourage your organization to submit a bid proposal? | ||
| 9 | How are the types of services the government anticipates including in its TPD7 requirement priced in the commercial marketplace? | ||
| 10 | Given the applicability of the TRICARE manuals, DHA will require agility to update requirements. How do your commercial contracts typically handle dynamic updates or unilateral-type changes? How does this impact the pricing structure of the contract, if at all? | ||
| 11 | In terms of any changes related to government policy, law, or regulation, how are such contract changes executed in a commercial environment? | ||
| 12 | How are contract changes priced and negotiated in a commercial environment? What type of pricing information, if any, is typically exchanged? |
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