BFSU 3rd Party Claims Clearinghouse

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued. BFSU-23-001 is issued as a request for quotation (RFQ) for 3rd Party Claims Clearinghouse at the Blackfeet Service Unit (BFSU) in Browning, Montana. This procurement is conducted pursuant to the authority of FAR part 12, Commercial Items and FAR part 13, and FAR 37.101, Non-Personal Services Contract. The Billings Area Indian Health Service (IHS) intends to award a contract according to the Requirements in response to Request for Quotation (RFQ)-BFSU-23-001. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2022-07. The associated North American Industry Classification System code is 518210 and the small business size standard is $35 million. PRICE SCHEDULE CLIN Description Quantity Unit Unit Price Total Price 1 Installations and set-up fees 1 MO $___________ $___________ 2 Processing claims submission 12 MO $___________ $___________ 3 Claims transaction rates 12 MO $___________ $___________ 4 Eligibility transaction rates 12 MO $___________ $___________ 5 Insurance discovery 12 MO $___________ $___________ Grand Total$ _____________________ PERIOD OF PERFORMANCE / DELIVERY DATE The initial Period of Performance of this contract is intended to start May 1, 2023, through April 30, 2024 with four (4) 12-month option Years. If the Government exercises the options pursuant to Federal Acquisition Regulation (FAR) 52.217-9, Option to Extend the Term of the Contract (MAR 2000), the ordering period shall be extended in accordance with the following schedule: Year Option Period Option Year 1 May 01, 2024, through April 30, 2025 Option Year 2 May 01, 2025, through April 30, 2026 Option Year 3 May 01, 2026, through April 30, 2027 Option Year 4 May 01, 2027, through April 30, 2028 SCOPE: Services are required for processing claim submission of all Medicare and Private Insurance billed claims, Payer Eligibility, Insurance discovery and all payer claims. The contactor will be expected to have the necessary education, training, licensing, previous work experience and competence in being able to provide the services within the department. Work performance shall be performed according to the requirements and conditions contained in this Statement of Work. APPLICABLE DOCUMENTS: Electronic Healthcare Network Accreditation Commission (EHNAC); Healthcare Network Accreditation Program (HNAP); Health Insurance Portability and Accountability Act (HIPPA) TASKS: The Contractor shall have the necessary accreditation, education, training, licensing, previous work experience and competence in being able to provide the third party claims clearing hour services. The Contractor shall utilize an iinnovative solution for revenue cycle management, eligibility verification, and patient payments. The Contractor shall be industry compliant and maintain the highest level of integrity and compliance with all applicable industry standards. The Contractor shall be accredited by the Electronic Healthcare Network Accreditation Commission (EHNAC) for excellence in health data processing and transactions. The Contractor shall be accredited by the Healthcare Network Accreditation Program (HNAP). The Contractor shall: Perform insurance coverage discovery Determine all-payer eligibility Conduct single clearinghouse to manage Medicare and Private Insurance billing Complete up to 1,500 annual - searches for insurance coverage, including finding Medicare and Medicare Beneficiary Identifier (MBI), as well as must have capability to revert the social security numbers into MBI numbers. Complete up to 1,800 per month all-payer eligibility verifications. Complete up to 29,000 annual claims through Claims clearinghouse. Improve your clean claims with our industry-standard rules engine that will flag claims errors before they are sent to a payer. When a mistake is identified ... Industry standard rules engine includes scrubbing/editing for: UB04/CMS 1500 HIPAA 5010 Rules Payer Specific Rules MAC Regional Rules HCPC/CPT/ICD Correct/edit claims prior to sending to payers Ensure secondary claims can be created from Primary claims. Maintain remittance management. OTHER REQUIREMENTS SUCH AS: User dashboards, training and support as needed payer enrollments, automated and an Enrollment team that will work to make sure we are getting the files to and from the right places. PLACE OF PERFORMANCE: The Contractor shall provide services remotely. No travel is required and travel will not be reimbursed. DELIVERABLES AND DELIVERY SCHEDULE: The Contractor shall perform during weekdays Monday thru Friday from 8AM - 5PM. CONTRACTING OFFICER AUTHORITY: Authority to negotiate changes in the terms, conditions or amounts cited in this contract is reserved for the Contracting Officer. Points of Contact: Purchasing Agent (PA) Shannon Connelly Phone: +1 (555) 000-0000 Email: contact@example.gov Contracting Officer (CO) James Mayotte Phone: +1 (555) 000-0000 Email: contact@example.gov Contracting Officer's Representative (COR) Wendy Stiffarm Phone: +1 (555) 000-0000 Email: contact@example.gov CONTRACTING OFFICER'S REPRESENTATIVE (COR): The COR shall be responsible for: (1) Monitoring the Contractor's technical progress, including surveillance and assessment of performance and recommending technical changes; (2) Interpreting the Statement of Work; (3) Technical evaluation as required; (4) Technical inspections and acceptance; and (5) Assisting the Contractor in the resolution of technical problems encountered during performance of this contract. INVOICE SUBMISSION AND PAYMENT: Invoices shall be submitted through IPP, a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury's Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis. The use of IPP shall take precedence over previously established invoicing procedures in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests. The IPP website address is: https://www.ipp.gov. If you require assistance registering or require IPP account access, please contact the IPP Helpdesk at +1 (555) 000-0000 (M-F 8AM to 6PM ET), or contact@example.gov. Please send a courtesy copy of the invoice by email to contact@example.gov Failure to include the required information may delay payment. Payment shall be made by the Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107. INVOICES: The Contractor agrees to include the following information on each invoice: (1) Contractor's name, address and telephone number; (2) Contract Number (entire contract number must be included); (3) Invoice number and date; (4) Cost or price; (5) Dates of Service including the number of hours worked; and (6) Remit to address: Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107. The Billings Area Financial Management Branch shall make payment. CONTRACT CLAUSES: FEDERAL ACQUISITION REGULATION (FAR) CLAUSES 52.252-2 Clauses Incorporated by Reference (Feb 1998). This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this address: www.acquisition.gov. CLAUSES INCORPORATED BY REFERENCE: 52.204-4, Printed or Copied Double-Sided on Postconsumer Fiber Content Paper (May 2011) 52.204-9, Personal Identity Verification of Contractor Personnel (Jan 2011) 52.204-13, System for Award Management Maintenance (Oct 2018) 52.204-18, Commercial and Government Entity Code Maintenance (Aug 2020) 52.204-19, Incorporation by Reference of Representations and Certifications (Dec 2014) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (Nov 2015) 52.212-4, Contract Terms and Conditions - Commercial Products and Commercial Services (Dec 2022) 52.217-8, Option to Extend Services (Nov 1999) 52.223-6, Drug-Free Workplace (May 2001) 52.223-18, Encouraging Contractor Policies to Ban Text Messaging While Driving (Jun 2020) 52.224-2, Privacy Act (Apr 1984) 52.232-1, Payments (Apr 1984) 52.233-1, Disputes (May 2014) 52.237-2, Protection of Government Buildings, Equipment and Vegetation (Apr 1984) 52.237-3, Continuity of Services (Jan 1991) 52.243-1, Changes - Fixed Price (Aug 1987) 52.246-1, Contractor Inspection Requirements (Apr 1984) 52.249-1, Termination for Convenience of the Government (Fixed-Price) (Short Form) (Apr 1984) 52.249-8, Default (Fixed-Price Supply and Service) (Apr 1984) HHSAR CLAUSES 352.223-70, Safety and Health (Dec 18, 2015) 352.226-3, Native American Graves Protection and Repatriation Act (Dec 18, 2015) 352.237-70, Pro-Children Act (Dec 18, 2015) 352.239-74, Electronic and Information Technology Accessibility (Dec 18, 2015) SOLICITATION PROVISIONS FEDERAL ACQUISITION REGULATION (FAR) PROVISIONS 52.252-1 Solicitation Provisions Incorporated by Reference (Feb 1998). This solicitation incorporates one or more solicitation provisions by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this address: www.acquisition.gov. 52.204-7, System for Award Management (Oct 2018) 52.204-16, Commercial and Government Entity Code Reporting (Aug 2020) 52.204-17, Ownership or Control of Offeror (Aug 2020) 52.209-2, Prohibition on Contracting with Inverted Domestic Corporations-Representation (Nov 2015) 52.215-5, Facsimile Proposals (Oct 1997) 52.222-52, Exemption from Application of the Service Contract Labor Standards Contracts for Certain Services - Certification (May 2014) 52.225-25, Prohibition on Contracting with Entities Engaging in Certain Activities or Transactions Relating to Iran - Representation and Certifications (Jun 2020) HHSAR PROVISIONS PROVISIONS INCORPORATED BY REFERENCE 52.215-70, Late Proposals and Revisions (Dec 2015) 52.238-73, Electronic Information and Technology Accessibility Notice (Dec 2015) PROPOSAL SUBMISSION INSTRUCTIONS: Proposals will only be accepted via email to contact@example.gov in response to this RFQ. ACCEPTANCE PERIOD. Any response to this notice must be received by 4/26/23. No telephone inquiries will be accepted. Responses can be directed to Billings Area/Blackfeet Service Unit, Shannon Connelly, Purchasing Agent contact@example.gov