DA10--BIC Medicare Pricer contract (VA-22-00006938) (VA-22-00038201)

The Department of Veterans Affairs Office of Community Care requires resources to price up to 20,000 healthcare claims annually using Medicare payment methodologies to validate payments made to outside providers through VA's Community Care program. Claims requiring Medicare pricing are identified by VA for internal audits. Offerors must demonstrate experience with Medicare pricing methodologies and the ability to process large volumes of medical claims through a web-based portal or bulk uploads. Proposals will be evaluated on technical approach, past performance, and pricing accuracy based on sample claims provided. Proposals are due by March 16, 2022.

There is no set-aside designation for this requirements contract. The base period of performance is April 6, 2022 through April 5, 2023 with a total evaluated price of $35 million including four one-year options. The contractor must price up to 20,000 claims annually, with 2,000-5,000 claims entered manually through a web portal and an optional 15,000 claims via bulk uploads. Pricing services will take place at the contractor's location to support internal audits conducted by VA auditors on identified medical claims paid through the VA's Community Care program.