Solicitation Notice for Workers' Compensation Medical Bill Processing (WCMBP)

Added: Jul 28, 2014 11:40 am The purpose of Amendment 6 is to post the questions and responses that were inadvertently ommitted from Amendment 5. Final offers are due 12:00PM EST on August 11, 2014.

Added: Jul 21, 2014 3:12 pm The purpose of Amendment 5 is to post the second round of questions, responses and all revised solicitation documents.

Final offers are due at 12:00PM EST on August 11, 2014.

Added: May 30, 2014 9:57 am The purpose of Amendment 4 is to correct the amendment numbering scheme. Due to systematic errors in FBO, the amendments for this solicitation have been mislabeled and are hereby corrected as follows:

Amendment 1 shall be referenced as the posting dated January 14, 2014 at 12:50am
Amendment 2 shall be referenced as the posting dated March 04, 2014 at 12:38pm
Amendment 3 shall be referenced as the posting dated May 30, 2014 at 9:12am

Offerors shall ensure all documents are labeled in accordance with the amendments specified in the posted documents.

Added: May 30, 2014 9:12 am The purpose of Amendment 3 is to post the questions, responses and all revised solicitation documents.

Additional questions will be accepted through 8:00AM EST on June 13, 2014. Questions must be submitted in accordance with Section J, Attachment 6 via email to Mr. Elvis Colbert and Ms. Myla Gale.

The final offer due date will be determined in a future amendment.

Added: Mar 04, 2014 12:38 pm The purpose of this amendment is to extend the proposal submission date. The revised date is to be determined. Questions and responses are in review and will be posted in a future amendment.

Added: Jan 14, 2014 12:50 am The United States Department of Labor's (DOL) Office of Workers' Compensation Programs (OWCP) is seeking a contractor to provide Workers' Compensation Medical Bill Processing and Mailroom services. DOL intends to award a single firm fixed price contract with other direct cost (OCD) pass-throughs. The NAICS code for this requirement is 524298 and the size standard is $6.5 million. The period of performance of the proposed contract is anticipated to be one year with four one-year options, and up to two one-year award terms for outstanding performance - for a total potential performance period of seven years.

PURPOSE
The U.S. Department of Labor's (DOL) OWCP administers workers' compensation medical bill processing programs that mitigate the impact of work-related injury for certain workers and their families.
OWCP is seeking a single Contractor to build and operate a centralized workers' compensation medical bill processing (WCMBP) solution for three OWCP programs: the Division of Federal Employees' Compensation (DFEC), the Division of Coal Mine Workers' Compensation (DCMWC) and the Division of Energy Employees Occupational Illness Compensation (DEEOIC). OWCP's medical bill processing function is currently performed as a contracted service. The Government does not own an information system that can be transferred to a follow-on Contractor. Only historical data will be transferred.

This centralized solution will include the processes associated with receipt of the medical bills and attachments, review of medical bills and attachments against program-specific authorizations, handling of inquiries related to medical services from claimants and providers, and utilization of business rules established by each OWCP program for the adjudication and pricing of medical bills. Specifically, the integrated system will support the following capabilities:
• Receipt and accounting for medical bills, attachments and other documents, in both hardcopy and electronic formats
• Scanning and data entry of bills, attachments and other documents received.
• Processing of bills to payment or denial (the Contractor will not make benefit payments, but will transfer payment files to Treasury for certification and payment)
• Processing of requests for adjustment, authorization of services, suspense resolution, and appeals processing
• Processing and responding to submitted correspondence received from medical providers and claimants, when applicable, and storing the responses to the correspondence in an imaging system from which the Government can retrieve for review
• Enrolling new providers and managing information about existing providers
• Providing claimant and provider support via a call center and self-service applications (such as user access portals and IVR)
• Processing Point of Sale (POS) pharmacy bills
• Providing secure on-line access, available to authorized users, to view images of bills, correspondence, and other documents.

PROGRAM OBJECTIVES
The goal of the WCMBP program is to acquire a standards-based medical bill processing system and processes that implement the following:
• Improved mailroom, imaging, and data entry throughput, accuracy, and efficiency
• Ensure a smooth and timely transition from the incumbent service provider
• Ensure efficient, accurate and timely processing of medical and pharmacy bills
• Ensure timely and correctly processed authorizations for covered benefits.
• Provide accurate and timely responses to customer inquiries and requests.
• Implement advanced medical bill processing technologies and processes
• Develop robust fraud and abuse and error detection/protection processes
• Use of industry-standard hosting and programming techniques to support portability among platforms
• Implement robust change and configuration management process
• Establish a framework for continuous improvement

Added: Jan 13, 2014 10:05 pm Please reference Presolicitation Notice Number DOL141RI21892, which was posted on 23 December 2013.