Tricare claims review service (tcrs) -- cancelled
Closed Solicitation Posted
Not the latest version. See the latest solicitation from .
- Solicitation number
- HT940221R0002
- Agency
-
Defense Health Agency
Department of Defense
- Responses due
- Set-aside
- Total Small Business
Opportunity facts
- NAICS code
- 541611 Administrative Management and General Management Consulting Services
- PSC
- Q201 Medical- Managed Healthcare
- Place of performance
- Aurora, Colorado 80011, United States
Notice details come from SAM.gov. Updated .
About this opportunity
The Federal Contract Opportunity involves a solicitation for services related to technical evaluation, staffing/program management, quality control, transition-in, compliance reviews, and focus studies/medical record reviews. The contractor will also be expected to manage document systems, provide staffing based on requirements, and potentially maintain records in the cloud. The contract is being recompeted as the period of performance has ended, and the number of reviews and level of effort are to be determined.
Services and products to be provided:
- Technical evaluation
- Staffing/Program management
- Quality control
- Transition-In services
- Compliance reviews
- Focus studies/Medical record reviews
- Document management system maintenance
- Staffing based on requirements
- Potential cloud-based record maintenance.
Notice text
7 versions
Update #7 · Latest ·
Amendment 0007 hereby cancels the TCRS solicitation, HT940221R0002, in its entirety.
Amendment 0004 & revised Exhibit L-5 Price Proposal Template v.3 posted on 6/16/22. The solicitation submission date has hereby been extended to 6/21/22, 5pm MT. For those offerors who have already submitted a proposal, only resubmission of Exhibit L-5 Price Proposal Template is required; however, resubmission of the entire proposal by the revised submission date is also authorized at the discretion of the offeror.
Amendment 0003, conformed solicitation & revised Exhibit L-5 Price Proposal Template v2 posted on 6/10/22.
Amendment 0002 & conformed solicitation posted on 6/7/22. Final, consolidated Q&As also posted.
Amendment 0001 & conformed solicitation posted on 5/26/22. Additional Q&As and Section C attachments also posted.
Initial Q&As posted on 5/17/22.
TRICARE is a Department of Defense (DOD) healthcare program which serves active duty and retired military personnel, other uniformed service personnel, and their family members. DHA is accountable for the management and operation of the TRICARE health benefits program, which provides medical, dental and pharmacy care through the Military Health System (MHS) to over 9.6 million beneficiaries worldwide in DOD Military Treatment Facilities (MTFs). The MHS is augmented with private sector care services obtained through six contracts including two regional Managed Care Support Contracts (MCSCs), TRICARE Medicare Eligible Program (TMEP, currently TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC)), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm) Program and Active Duty Dental Program (ADDP) contracts.
TRICARE Claims Review Services (TCRS) effort assists the Improper Payment Program in validating that the TRICARE contractors are performing healthcare reimbursement determinations and healthcare claims processing services in accordance with TRICARE policies, procedures, and specific contract requirements. The TCRS contractor will be responsible for conducting compliance reviews to determine whether claim payments were appropriately adjudicated.
Update #6 ·
Amendment 0004 & revised Exhibit L-5 Price Proposal Template v.3 posted on 6/16/22. The solicitation submission date has hereby been extended to 6/21/22, 5pm MT. For those offerors who have already submitted a proposal, only resubmission of Exhibit L-5 Price Proposal Template is required; however, resubmission of the entire proposal by the revised submission date is also authorized at the discretion of the offeror.
Amendment 0003, conformed solicitation & revised Exhibit L-5 Price Proposal Template v2 posted on 6/10/22.
Amendment 0002 & conformed solicitation posted on 6/7/22. Final, consolidated Q&As also posted.
Amendment 0001 & conformed solicitation posted on 5/26/22. Additional Q&As and Section C attachments also posted.
Initial Q&As posted on 5/17/22.
TRICARE is a Department of Defense (DOD) healthcare program which serves active duty and retired military personnel, other uniformed service personnel, and their family members. DHA is accountable for the management and operation of the TRICARE health benefits program, which provides medical, dental and pharmacy care through the Military Health System (MHS) to over 9.6 million beneficiaries worldwide in DOD Military Treatment Facilities (MTFs). The MHS is augmented with private sector care services obtained through six contracts including two regional Managed Care Support Contracts (MCSCs), TRICARE Medicare Eligible Program (TMEP, currently TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC)), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm) Program and Active Duty Dental Program (ADDP) contracts.
TRICARE Claims Review Services (TCRS) effort assists the Improper Payment Program in validating that the TRICARE contractors are performing healthcare reimbursement determinations and healthcare claims processing services in accordance with TRICARE policies, procedures, and specific contract requirements. The TCRS contractor will be responsible for conducting compliance reviews to determine whether claim payments were appropriately adjudicated.
Update #5 ·
Amendment 0003, conformed solicitation & revised Exhibit L-5 Price Proposal Template v2 posted on 6/10/22.
Amendment 0002 & conformed solicitation posted on 6/7/22. Final, consolidated Q&As also posted.
Amendment 0001 & conformed solicitation posted on 5/26/22. Additional Q&As and Section C attachments also posted.
Initial Q&As posted on 5/17/22.
TRICARE is a Department of Defense (DOD) healthcare program which serves active duty and retired military personnel, other uniformed service personnel, and their family members. DHA is accountable for the management and operation of the TRICARE health benefits program, which provides medical, dental and pharmacy care through the Military Health System (MHS) to over 9.6 million beneficiaries worldwide in DOD Military Treatment Facilities (MTFs). The MHS is augmented with private sector care services obtained through six contracts including two regional Managed Care Support Contracts (MCSCs), TRICARE Medicare Eligible Program (TMEP, currently TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC)), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm) Program and Active Duty Dental Program (ADDP) contracts.
TRICARE Claims Review Services (TCRS) effort assists the Improper Payment Program in validating that the TRICARE contractors are performing healthcare reimbursement determinations and healthcare claims processing services in accordance with TRICARE policies, procedures, and specific contract requirements. The TCRS contractor will be responsible for conducting compliance reviews to determine whether claim payments were appropriately adjudicated.
Update #4 ·
Amendment 0002 & conformed solicitation posted on 6/7/22. Final, consolidated Q&As also posted.
Amendment 0001 & conformed solicitation posted on 5/26/22. Additional Q&As and Section C attachments also posted.
Initial Q&As posted on 5/17/22.
TRICARE is a Department of Defense (DOD) healthcare program which serves active duty and retired military personnel, other uniformed service personnel, and their family members. DHA is accountable for the management and operation of the TRICARE health benefits program, which provides medical, dental and pharmacy care through the Military Health System (MHS) to over 9.6 million beneficiaries worldwide in DOD Military Treatment Facilities (MTFs). The MHS is augmented with private sector care services obtained through six contracts including two regional Managed Care Support Contracts (MCSCs), TRICARE Medicare Eligible Program (TMEP, currently TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC)), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm) Program and Active Duty Dental Program (ADDP) contracts.
TRICARE Claims Review Services (TCRS) effort assists the Improper Payment Program in validating that the TRICARE contractors are performing healthcare reimbursement determinations and healthcare claims processing services in accordance with TRICARE policies, procedures, and specific contract requirements. The TCRS contractor will be responsible for conducting compliance reviews to determine whether claim payments were appropriately adjudicated.
Update #3 ·
Amendment 0001 & conformed solicitation posted on 5/26/22. Additional Q&As and Section C attachments also posted.
Initial Q&As posted on 5/17/22.
TRICARE is a Department of Defense (DOD) healthcare program which serves active duty and retired military personnel, other uniformed service personnel, and their family members. DHA is accountable for the management and operation of the TRICARE health benefits program, which provides medical, dental and pharmacy care through the Military Health System (MHS) to over 9.6 million beneficiaries worldwide in DOD Military Treatment Facilities (MTFs). The MHS is augmented with private sector care services obtained through six contracts including two regional Managed Care Support Contracts (MCSCs), TRICARE Medicare Eligible Program (TMEP, currently TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC)), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm) Program and Active Duty Dental Program (ADDP) contracts.
TRICARE Claims Review Services (TCRS) effort assists the Improper Payment Program in validating that the TRICARE contractors are performing healthcare reimbursement determinations and healthcare claims processing services in accordance with TRICARE policies, procedures, and specific contract requirements. The TCRS contractor will be responsible for conducting compliance reviews to determine whether claim payments were appropriately adjudicated.
Update #2 ·
Initial Q&As posted on 5/17/22.
TRICARE is a Department of Defense (DOD) healthcare program which serves active duty and retired military personnel, other uniformed service personnel, and their family members. DHA is accountable for the management and operation of the TRICARE health benefits program, which provides medical, dental and pharmacy care through the Military Health System (MHS) to over 9.6 million beneficiaries worldwide in DOD Military Treatment Facilities (MTFs). The MHS is augmented with private sector care services obtained through six contracts including two regional Managed Care Support Contracts (MCSCs), TRICARE Medicare Eligible Program (TMEP, currently TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC)), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm) Program and Active Duty Dental Program (ADDP) contracts.
TRICARE Claims Review Services (TCRS) effort assists the Improper Payment Program in validating that the TRICARE contractors are performing healthcare reimbursement determinations and healthcare claims processing services in accordance with TRICARE policies, procedures, and specific contract requirements. The TCRS contractor will be responsible for conducting compliance reviews to determine whether claim payments were appropriately adjudicated.
Update #1 ·
TRICARE is a Department of Defense (DOD) healthcare program which serves active duty and retired military personnel, other uniformed service personnel, and their family members. DHA is accountable for the management and operation of the TRICARE health benefits program, which provides medical, dental and pharmacy care through the Military Health System (MHS) to over 9.6 million beneficiaries worldwide in DOD Military Treatment Facilities (MTFs). The MHS is augmented with private sector care services obtained through six contracts including two regional Managed Care Support Contracts (MCSCs), TRICARE Medicare Eligible Program (TMEP, currently TRICARE Dual Eligible Fiscal Intermediary Contract (TDEFIC)), TRICARE Overseas Program (TOP), TRICARE Pharmacy (TPharm) Program and Active Duty Dental Program (ADDP) contracts.
TRICARE Claims Review Services (TCRS) effort assists the Improper Payment Program in validating that the TRICARE contractors are performing healthcare reimbursement determinations and healthcare claims processing services in accordance with TRICARE policies, procedures, and specific contract requirements. The TCRS contractor will be responsible for conducting compliance reviews to determine whether claim payments were appropriately adjudicated.
Files
Show all 27
Notice history
| Notice | Type | Posted |
|---|---|---|
| Tricare claims review service (tcrs) | Solicitation | |
| This notice | Solicitation | |
| Tricare claims review service (tcrs) synopsis | Special Notice | |
| Tricare claims review service (tcrs) draft RFP | Pre-Solicitation | |
| Tricare claims review service (tcrs) | Pre-Solicitation |
Similar open opportunities
| Opportunity | Agency | Set-aside | Responses due |
|---|---|---|---|
| TRICARE Medicare Eligible Program Second Generation (TMEP2) | Defense Health Agency | No set-aside |
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