Clearing house to support health care electronicdata interchange

1. Title: Clearing House to Support Health Care Electronic Data Interchange2. Solicitation Reference Number: VA-101-08-RP-0260 Amendment 01

3. Description: Request for Quote (RFQ) #: VA-101-08-RP-0260 is hereby amended to respond to vendor submitted questions and provide a revised price schedule included as an attachment to this amendment. The due date for responses to this RFP, both technical and price quotes is hereby extended to 5:00 PM EST October 20, 2008. The questions and answers are included as an attachment to this document.

The Department of Veterans Affairs Center for Acquisition Innovation (CAI) on behalf of the Veterans Health Administration (VHA) Chief Business Office (CBO) intends to issue anunrestricted solicitation to the Federal Business Opportunities website. The applicable NAICS code is 518210 with a small business size standard of $23.0M. Preference will be given to SDVOSB and VOSB concerns. The solicitation will result in the award of a Firm Fixed Price Indefinite Delivery Indefinite Quantity (IDIQ) contract. The period of performance shall consist of a base year and four option years.



The successful Contractor must be a fully "Accredited Healthcare Network" by the Electronic Healthcare Network Accreditation Commission (EHNAC) at the time of proposal submission and maintain accreditation for the duration of the contract. Additionally, the successful Contractor must be certified by the Council for Affordable and Quality Healthcare (CAQH), as a CORE Phase I Certified Clearinghouse for both batch and real-time eligibility benefits (HIPAA 270/271) at the time of award and maintain certification for the duration of the contract. The HCCH must also work towards future CORE Phase II and any other future phase certifications within a mutually specified timeframe. Under this requirement, the contractor shall provide the following services:



Provider Services:



The HCCH shall transmit HIPAA compliant X12 and NCPDP transactions via batch and real-time transfer and translate proprietary formats to and from HIPAA compliant transactions on behalf of VHA. Connectivity shall be provided to health care payers or their authorized agent/clearinghouse, VHA payment entities, health care providers associated with the VA Medical Center Network (VA billing entities) and private health care providers not associated with the VA Medical Center network.



The HCCH shall support VHA current electronic healthcare transactions and volumes by providing access to payers with whom it currently conducts e-business. In addition, the HCCH shall expand access to additional payers.



The HCCH shall assist VHA in its effort to submit electronic secondary claims via the provider to payer to provider model of coordination of benefits (COB) to payers.



The HCCH shall provide services to print and mail compliant UB04, HCFA 1500s and Pharmacy Claims as well as a paper representation of the Medicare-equivalent Remittance Advice when applicable.



The HCCH shall assist VHA in transitioning to future HIPAA regulations including migration to transaction version 5010 and NCPDP version D.0.



The HCCH shall assist VHA in identifying and implementing additional transactions and process improvements.



Payer Services:



The HCCH shall provide connectivity to and receive both batch and real-time transactions to and from a comprehensive HCCH network, other industry providers and clearinghouses. Final destination for the transactions include: other health care clearinghouses, health care providers, providers associated with the VA Medical Center Network (CITI), private health care providers not associated with the VA Medical Center network and state Medicaid's.



The HCCH shall assist VHA to continue with its strategy to increase its electronic claims receipt from other industry provider (VHA and non-VHA) entities and transition from receipt of paper claims to industry standard HIPAA electronic claims (837).



The HCCH shall receive from VHA (835) Health Care Payment/Advice transactions for routing to providers or their representatives.



The HCCH shall also enable provider 835 Health Care Payment/Advice enrollment and routing of the 835 Health Care Payment /Advice for medical and dental claims submitted to VHA.



The HCCH shall provide a real-time transaction solution to VHA and shall provide for real-time transaction provider enrollment and real-time receipt and response to HIPAA transactions including eligibility (270/271), claim status (276/277) and the health care services review (278) for provider enrollment.



The HCCH shall provide a comprehensive Medicare Crossover solution for VHA connectivity to, eligibility routing and reporting and electronic claims receipt from the Center for Medicare and Medicaid Services Coordination of Benefits Contractor (COBC) for the CHAMPVA program.



The HCCH shall provide the capability to receive scanned medical and dental paper claim images and convert them into HIPAA 837 standard transactions.



The HCCH shall assist VHA in transitioning to future HIPAA regulations including migration to version 5010, NCPDP version D.0, implementation of ICD-10 code sets and any other new HIPAA transactions.



The HCCH shall assist VHA in identifying and implementing additional transactions and process improvements.



All prospective offerors must have a Commercial and Government Entity (CAGE) code, be registered with the Central Contractor Registration (CCR) at http://www.ccr.gov, and VETS 100 at http://vets.dol.gov/vets100/. This will be an electronic solicitation release. A written Request for Proposals (RFP) will be posted on or about September 12, 2008 for download on the FedBizOpps website under solicitation title: Clearing House to Support Health Care Electronic Data Interchange. No offers are being requested at this time. No paper copies of the solicitation will be issued. All amendments to the solicitation will be posted to this FedBizOpps website. Contractors are cautioned to check this website for amendments. No solicitation mailing list will be complied. The contractor is responsible for all costs for producing and submitting its proposal. The Point of Contact is Shaundra J. Duggans, Contract Specialist, Shaundra.Duggans@va.gov, Dept. of Veterans Affairs, Office of Acquisition & Logistics, Center for Acquisition Innovation, 810 Vermont Ave., NW, Room 765Q, Washington DC 20420. No requests for information, requests for clarification or questions concerning this notice will be provided in response to telephone calls. Formal communications such as requests for clarification and/or information or questions concerning this notice should be submitted via email.