FSC Healthcare Clearinghouse Services

1. The purpose of this Amendment A00003 is to provide questions and answers round 3



Number Solicitation Section Question Answer

1 NA Can you extend the due date for the proposals? No.

1. The purpose of this Amendment A00002 is to provide questions and answers round 2



Number Solicitation Section Question Answer

1 4.2.1 Can you confirm that the transactions in section 4.2.1 are based on 12 months? Yes, approximate transaction volumes are projected per 12 month period

2 Are we correct to assume that all HCFA and UB OCR claims are already scanned in and no mailroom processing will be needed? Yes.

3 What % of the HCFA and UB OCR claims are on the red line claim form vs. black line form? Approximately 95% red claim form and 5% black line form.

4 Will we have access to member file for data verification? The offeror shall submit the provider's EDI request for eligibility and our system will respond as eligible or not.

5 Can data verification/entry be done offshore or onshore? All work shall be performed in the U.S.

6 Is the 270/271 Transaction Real time or Batch? Vendor shall support both real time and batch.

7 Is the 276/277 Transaction Real time or Batch? Vendor shall support both real time and batch.

8 Can you break down the volumes for the following?

a. 270/271-

b. 276/277-

c. 278- No.

1. The purpose of this Amendment A00001 is to provide answers to questions received and to incorporate FAR clause 52.217-7 Option for increased quantity-separately priced line item into the solicitation.

2. All Technical and procedural questions shall be submitted in writing to the Contract Specialist at lauren.sankar@va.gov and the Contracting Officer at james.cozzolino@va.gov by 12 PM EST on 9/18/2014.





C.2 52.217-7 OPTION FOR INCREASED QUANTITY-SEPARATELY PRICED LINE ITEM (MAR 1989)



The Government may require the delivery of the numbered line item 3002AA-30002AF, identified in the Schedule as an optional task, in the quantity and at the price stated in the Schedule. The Contracting Officer may exercise anytime from time to time at the Government's discretion during the Base Period, Option Period 1 or Option Period 2 by written notice to the Contractor at any time during the period of performance. Delivery of added items shall continue at the same rate that like items are called for under the contract, unless the parties otherwise agree.



Questions for Clearinghouse Solicitation Number: VA118-14-R-0671

Number Solicitation Section Question Answer

1 P.14 What does/do the Optional Task 1 volumes represent? Please see FAR Clause 52.217-7, Option for increased quantity-separately priced line item and the Schedule of Deliverables.

2 P.17 what is the breakout of images (claims) coming directly from providers to the Contractor vs the volume from the FSC to the contractor ? Approximately 50% EDI and 50% paper claims.

3 What is the percentage breakout (by claim type) of handwritten vs machine printed claims that will be submitted for processing? Only machine printed claims shall be submitted to the Clearinghouse.

4 Will the tiff images received from the FSC have red background dropout? Yes.

5 How will the VA instruct providers to send electronic claims to the vendor (i.e. how will connectivity be established)? The FSC will include new instructions for submitting electronic claims to the new vendor. The new vendor shall provide these instructions to the FSC.

6 Please clearly define your definition of "clearinghouse" in context to the required processes that is expected of the vendor. Receive EDI claims directly from provider and receive scanned images of paper claims; conduct OCR of scanned images; convert EDI claims and scanned images to an 837 file; send the 837 file to FSC for processing.

7 How many providers will be sending electronic claims? Can a list of providers be provided?

5000 - 5500 providers…list will be provided after award upon offeror's completion of all security requirements.

8 What Geographic areas of the US will the claims originate?

o By type

o By volume Nationwide, not specific to one geographic location.

9 Is there geographic preference as to Contractors facility for services? Is offshore processing acceptable, or do the services need to be domestic? Please reference all applicable security appendices and applicable documents in the PWS.

10 P.20 Provide a detailed definition and tasks associated with the 835 process. Electronic transaction which provides claim payment information in the HIPAA mandated ACSX12 005010X221A1 format. These files are used by practices, facilities, and billing companies to autopost claim payments into their systems. Adhere to CORE Operating Rules.

11 P.20 Can the VA provide examples of validation "edits"? Valid dates used throughout claims submission, admit dates, patient name, patient address, Status, condition codes, principal diag code required, valid diag codes, etc.

12 P.21 What is the volume breakout of HCFA/UB volumes from providers? Approximately 60% HCFA and 40% UBs

13

P.21 What is the volume breakout of HCFA/UB volumes of 837 files coming from FSC? FSC does not send 837s, the FSC sends only scanned images to the clearinghouse. The clearinghouse will OCR the scanned images; convert them to 837s; and send the 837s to the FSC. In addition, the clearinghouse will receive EDI claims directly from the provider; convert those claims to 837s; and send the 837s to the FSC.

14 P.21 What is the defined process for the 835 HC Claim Payment relative to this RFP? Payment acknowledgement in accordance with CORE Rules.

15 P.30 Is a dedicated network required, or not? Yes…VA data cannot be co-mingled with non-VA data.

NOTICE-The Solicitation for the Clearinghouse Services is posted under the original sources sought and can be found under VA118-14-I-0607