Billing Clerk

** The purpose of this modification is to extend the proposal deadline date to 27-Aug-2015 at 1:00 Eastern** COMBINED SYNOPSIS/SOLICITATION This is a combined synopsis/solicitation ("solicitation" hereafter), which is expected to result in award of a firm-fixed- price contract for commercial items, i.e. VA Billing Clerk, as described under the paragraph below titled "Requirement." The solicitation is prepared in accordance with the format in the Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. An award, if any, will be made to the responsible offeror who submits a proposal that (1) conforms to the requirements of the synopsitation; (2) that receives a rating of "Acceptable" on the Technical Capability evaluation factor; and (3) that submits the proposal with the lowest total evaluated price (TEP), provided that the TEP is not unbalanced and is fair and reasonable. The Government reserves the right to award without discussions or make no award at all depending upon (1) the quality of proposals received and (2) the price fair and reasonableness of proposals received. Synopsitation Number: FA8601-15-T-0229 NAICS Code: 561440 Small Business Size Standard: $15,000,000.00 This solicitation incorporates FAR provisions and clauses in effect through Federal Acquisition Circular (FAC) Fac 2005-78, effective 26 Dec 14; Defense Federal Acquisition Regulation Supplement (DFARS) Publication Notice DPN 20141216, effective 16 Dec 2014; and Air Force Federal Acquisition Regulation Supplement (AFFARS) Air Force Acquisition Circular (AFAC) 2014-1001, effective 01 Oct 14. Synopsitation Closing Date: Proposals must be received not later than 1:00 pm Local (Wright-Patterson AFB) Time, Wednesday, August 26, 2015. Submit electronic proposals via Tiffany Amlin to: tiffany.amlin@us.af.mil. Any correspondence sent via e-mail must contain the subject line "Solicitation FA8601-15-T-0229." The entire proposal must be contained in a single e-mail that does not exceed 5 megabytes including attachments, if any. E-mails with compressed files are not permitted. Note that e-mail filters at Wright-Patterson Air Force Base are designed to filter e-mails without subject lines or with suspicious subject lines or contents (i.e., .exe or .zip files). Therefore, if the specified subject line is not included, the e-mail may not get through the e-mail filters. Also be advised that .zip or .exe files are not allowable attachments and may be deleted by the email filters at Wright-Patterson. If sending attachments with email, ensure only .pdf, .doc, .docx, .xls or .xlsx documents are sent. The email filter may delete any other form of attachments. Address questions regarding this solicitation to either Tiffany Amlin telephonically at (937) 522-4558 or via e-mail at tiffany.amlin@us.af.mil. Scope: The Contractor shall furnish all labor, management, and supervision of contractor staff, and the reports required to provide the services of a VA Billing Clerk listed in PWS on a non-personal services basis at the 88th Medical Group (MG), Wright Patterson Medical Center (WPMC), Wright Patterson Air Force Base (WPAFB), Ohio, also referred to as the "Medical Treatment Facility" (MTF) herein. The Contractor shall perform services in accordance with (IAW) the ethical, professional, and technical standards of the health care industry and the Air Force medical department. Performance shall be according to the requirements listed, and professional standards of practice of The Joint Commission (TJC), the Air Force Inspection Agency Office of the Health Service Inspector, and applicable Air Force regulations. The Contractor shall also cover VA billing services provided in the MTF. The Contractor shall furnish all labor, management, supervision, teaching, and reports required to provide non-personal services of a VA Billing Clerk. MTF will furnish all physical equipment necessary for the performance of duties required by this contract. Required coverage is for a full time employee (FTE), or 1,920 hours over the period of performance. The Contractor shall comply with Air Force and departmental policy along with procedure, federal and local regulations, and TJC requirements. Requirement: The Contractor shall provide billing services and collection of charges for services provided to VA patients treated at WPMC. Tasks include, but are not limited to: performing billing functions associated with services provided by WPMC to VA patients treated through the share agreement between WPMC and the VA, tracking funds recovered from the services provided as well as: �� The Contractor shall work within United States Air Force's Uniform Business Office's (UBO) two programs: Medical Services Account (MSA), and VA/DoD Resource Sharing Agreement �� The Contractor shall work with Armed Forces Health Longitudinal Technology Application (AHLTA), Composite Health Care systems (CHCS) - specific to MSA. Defense Enrollment Eligibility Reporting System (DEERS). �� The Contractor shall learn the military filing system - by sponsor social security number, terminal digit order, color-coded and blocked filing system. �� The Contractor shall learn the Carepoint and Surgery Scheduling System (S3). �� The Contractor will work with and communicates with multidisciplinary teams as it pertains to the VA/DoD Resource Sharing Agreement. The Contractor shall follow procedures and processes that follow the UBO billing website and manual, the VA/DoD Resource Sharing Agreement, and uses of other databases (internal or external to MTF) in compliance with HIPAA guidelines to identify insurance coverage. �� The Contractor shall obtain information, if necessary, through direct patient interviews or by telephone. �� The Contractor shall input and update patient information in CHCS (AHLTA) or into other databases required by the MTF. �� The Contractor shall review medical records when needed for clarification of medical treatment, history of illness, medical tests, accident information or any other clarification for billing purposes. �� The Contractor shall prepare and mail or transmit claims to Veteran Affairs using the UB-04, the HCFA 1500, Health Insurance Claim Form, or other forms required. Claims may also be processed electronically when available to the Government. �� The Contractor shall work with the facility Admissions and Dispositions Office and Referral Management Office to obtain VA authorizations and attends periodic mandatory meetings. Professional Requirements. All services shall be rendered IAW established principles and ethics of the medical profession, the national standards established by the Health Insurance Portability and Accountability Act (HIPAA) and the professional standards of the MTF. The Contractor shall certify that the following Contractor personnel have the minimum qualifications/ training indicated: �� A fully qualified typist (computer keyboard) with a minimum of 40 WPM is required. �� Have mastery of the English language, correct grammar, spelling, punctuation, capitalization, and format to prepare and edit written correspondence, reports, and transcribed material. �� Be proficient in the use of standard office equipment, such as computers, typewriters, copiers, fax machines, telephone systems and office automation systems, to perform a substantial range of medical billing support. �� Possess general medical ethics, telephone etiquette, and excellent communication and customer service skills. �� Have knowledge of Ambulatory Procedure Groupings (APGs), Diagnosis Related Groupings (DRGs), Ambulatory Payment Classification (APC) codes, International Classification of Diseases-Version 9 (ICD-9), and Current Procedural Terminology- Version 4 (CPT-4) coding. �� Be able to read, interpret medical documentation, and understand medical terminology to correctly bill both outpatient and inpatient services. �� Education and Experience: High School diploma or General Educational Development (GED) equivalency. Basic medical terminology required and at least three years relevant experience or specialized training in medical billing required. At least two years relevant experience or specialized Registered health Information Technician (RHIT) or Registered Health Information Administrator certification required. �� The contractor shall provide written documentation of the above minimum qualifications/training/experience requirements within 20 calendar days. �� Work Environment/Physical Requirements. Requirements include prolonged walking, standing, sitting or bending. Must be able to carry 50 pounds. English Language Requirement. Contractor personnel engaged in performance of this contract shall read, understand, speak, and write English. Appearance. All Contractor personnel shall be easily recognized as contractor employees. Contractor personnel shall display on the front of their civilian clothes legible Contractor-furnished identification media (badge) which lists the company's name and individual's name. Any required MTF identification will be provided by the MTF. Professional Qualities. The Contractor shall ensure contract employees interact professionally with members of the MTF and patients IAW applicable hospital regulations and guidance. Changes in Personal. When a permanent change in a contract employee is anticipated, the Contractor shall provide the Contracting Officer Representative (COR) the name of a replacement contractor employee with the same qualifications required for the initial contract employee no later than two (2) weeks prior to outgoing employee's departure date. The permanent replacement candidate should begin work within 10 business days of outgoing contract employee's departure. All replacements provided shall be at no additional expense to the Government. Existing Staff. The Contractor will support the existing staff within the Patient Administration department. The existing staff is subject to change throughout the period of the requirement. MTF Workload Estimate. Current MTF workload estimates are based on historical data and are subject to fluctuations. The MTF provides service to an estimated 15 to 20 patients per day. Hours of Operation. The normal duty hours for the MTF are between 0730 to 1630 (includes a 1 hour unbillable lunch/break), Monday through Friday. Contractor employee shall be present during normal duty hours in the duty section for no more than 40 hours per week. Alternative schedules shall be approved by the base contracting office if required prior to implementation but shall not exceed 40 hours per week. Federally Observed Holidays. The Contractor is not required to provide services the following Federal holidays: New Year's Day; Martin Luther King Day; President's Day; Memorial Day; Independence Day; Labor Day; Columbus Day; Veterans' Day; Thanksgiving Day; and Christmas Day. Work Schedule. A Contractor point of contact shall provide a schedule that lists the date, times, and names of Contractor personnel who shall be providing services. This list shall be provided to the COR by the 20th of each month for the next month. The Contractor shall submit work schedule changes in writing to the COR at least 48 hours in advance of the proposed change. Performance Evaluation Meetings. The Contractor or his representative shall meet with the COR, and other government personnel at least quarterly, and as requested. Quality Control. �� Contractor shall develop and maintain a quality control program to ensure VA billing support services are performed in accordance with processes mentioned above. The Contractor shall develop and implement procedures to identify and prevent defective services from reoccurring. Changes to this program shall be made at no additional cost to the Government. The Quality Control Plan (QCP) is to be delivered not later than 15 days after contract award to Contracting Officer (CO) for acceptance. Three copies of a comprehensive written QCP shall be submitted to the CO and COR not later than 5 working days prior when changes are made thereafter. �� Point of Contact. The Contractor shall provide a point of contact who shall be available for the performance of the work Monday thru Friday between the hours of 0730 to 1630. The point of contact shall have full authority to act for the Contractor on all matters relating to the daily operation of this contract. The Contractor shall designate this individual or individuals, in writing, to the Contracting Officer (CO), after contract award and before the period of performance starts on the contract. The Contractor shall identify the specific individual and times when different individuals will be the primary and alternate point of contact. If any changes occur in personnel the government shall be notified in writing not later than 5 calendar days of the primary point of contact's last day. Health Requirements �� Preassignment Medical Evaluation. No contract employee shall perform health care services under this contract unless a Physician has performed a pre- assignment evaluation, provided by the Contractor, no more than 30 calendar days prior to submission of credentials. The purpose of this medical evaluation is to determine if the individual, from a medical standpoint, possesses the minimum physical abilities needed to perform the proposed job without significant risk to personal health or the health and safety of others. As a minimum, the individual shall be free of physical defects or medical conditions which might reasonably be expected to place other workers, patients, or the public at risk. Not later than five (5) days prior to the commencement or performance of health care services under this contract by any employee, the Contractor shall provide the Public Health certification to the medical appointed COR that employees have completed the medical evaluation requirements identified below. This certification shall be provided annually, in October, thereafter. This certification shall state the date of which the examination was completed, the doctor's name that performed the examination and a statement concerning the physical health of the individual. Initial documentation is required for: MMR (immunization or titer levels for Rubella and rubeola), history of chicken pox disease or positive titer (varicella vaccination must be accomplished if lack of immunity). TB Mantoux skin test (IPPD) if positive, minimum requirement will be follow-up with contractor's physician and a chest x-ray. Physician must provide documentation of "no active respiratory disease", Hepatitis B vaccination/series are required for all personnel with occupational risk of exposure (declinations are not acceptable; this is a condition of employment), and if employee will be involved in exposure-prone procedures (ex: dentist, dental hygienist) they will have their surface antigen of the Hepatitis-B- Virus (HbsAg) status determined. This is to be done by providing documentation of the HbsAb, (if positive they will be referred to the MFT Credentials committee to determine scope of practice). If, in the opinion of the evaluating medical practitioner, the individual is found to be qualified for duty, the medical statement shall include the following wording: "(NAME OF EMPLOYEE) possesses the minimum physical abilities to perform the proposed duties of a (insert job title). He/she has documented proof of immunization against/immunity to rebeola, rubella, and hepatitis B and does not have an active infectious condition which might place others at risk." If, in the opinion of the evaluating medical practitioner, the individual does not possess the minimum capabilities needed to perform the proposed job or does not meet the conditions of employment or will pose a risk to others, the medical statement shall contain the following wording: "For medical reasons, (NAME OF EMPLOYEE is not qualified for employment as a (insert job title)." All documentation shall be provided to the COR. �� Preventative, Prophylactic, and Follow-Up Procedures. All Contractor employees shall comply with preventive, prophylactic, and follow-up procedures, infection control and employee health program procedures, as established by the MTF. The Contractor shall provide written verification of treatment to the COR. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government. �� Medical Records. The Contractor shall provide to the COR for this contract, all medical information for hospital records, and therefore comply with TJC, OSHA, Centers for Disease Control (CDC), DOD, and USAF health records requirements. This information shall be provided to the COR to ensure the hospital's Employee Health database is current and up-to-date. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government. �� Immunization Waivers/Exemptions. Waivers and exemptions may be granted in accordance with the governing Air Force Instructions. All waivers and exemptions must be coordinated through Public Health and the COR. �� Pregnant Employees. All Contractor pregnant employees should report the pregnancy to the Contractor. The Contractor shall notify Public Health of the pregnancy within 1 business day of notification. Public Health will provide information concerning any work hazards in that area. The Contractor shall notify their pregnant employee of any work hazards. It will be the joint decision of the Contractor and their employee whether the employee works in the environment. This is in accordance with AFI 48-148 "Ionizing Radiation Safety" and AFH 48-125 "The Air Force Dosimetry Program". �� Communicable Diseases. Contract employees with communicable diseases must be reported to the MTF contract project supervisor and the COR. Notification to Public Health shall be made by the Contractor. The Contractor shall comply with all MTF work restrictions and return-to-work requirements when performing tasks at the facility. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government. Security Requirements. �� Contractor Notification Requirements. The Contractor shall ensure that all employees start their e-Qip package (an electronic website used to process security and background checks) and submit their immunization records once recommended for hire. Once a start date has been established, the section will request a base pass for the employee after receiving their driver's license state and number, and valid email address 72 hours in advance. �� Suitability Investigations. Contractor personnel shall successfully complete, at a minimum, a National Agency Check (NAC), before operating Government- furnished workstations that have access to Air Force e-mail systems. The Government, at no additional cost to the Contractor, will perform these investigations. The Contractor shall comply with the Department of Defense (DOD) requirements of DODI 5200.2R, Personnel Security Program, and AFI 33-119, Electronic Mail (E-Mail) Management and Use. These references will be provided to the Contractor by the Government. �� Freedom of Information Act Program (FOIA). The Contractor shall comply with AFI 37-131, Freedom of Information Act Program (FOIA), requirements. The regulation sets policy and procedures for the disclosure of records to the public and for marking, handling, transmitting, and safeguarding For Official Use Only (FOUO) material. �� Reporting Requirements. The Contractor shall comply with AFI 71- 101, Volume-1, Criminal investigations, and Volume-2, Protective Service Matters, requirements. Contractor personnel shall report to an appropriate Government authority any information or circumstances of which they are aware that may pose a threat to the security of DOD personnel, contractor personnel, resources, and classified or unclassified defense information. Contractor employees shall be briefed by their immediate supervisor upon initial on-base assignment and as required thereafter. �� Physical Security. Areas controlled by contractor employees shall comply with current 88 Air Base Wing Operations Plans/instructions for FORCE PROTECTION (FPCON) procedures and Random Antiterrorism Measures (RAMS). Valuable materials including equipment and facility area shall be secured in accordance with Air Force and MTF instructions. These instructions will be provided to the Contractor by the Government. �� Key Control. The Contractor shall establish and implement methods of tracking all keys/combinations issued to the Contractor. The Contractor shall establish that all keys issued by the Government shall be used only by contractor authorized personnel. The Contractor shall not duplicate any keys issued by the Government. The Contractor shall report to the COR any occurrences of lost or duplicated keys within 24 hours of discovery to the COR. In the event keys, other than master keys, are lost or duplicated, the Contractor shall, upon written direction of the Contracting Officer shall rekey or replace the affected lock or locks without cost to the Government. The Government has the option to replace/reprogram the affected lock or locks or perform re-key and deduct the cost from the monthly payment due to the Contractor. �� Conflicts of Interest. The Contractor shall not employ any person who is an employee of the United States Government, if the employment of that person would create a conflict of interest, nor shall the Contractor employ any person who is an employee of the Department of the Air Force, either military or civilian, unless such person seeks and receives approval in accordance with DOD Directive 5500.7 and Air Force policy. �� Medical Quality Assurance/Risk Management (QA/RM). Contract employees shall participate and be evaluated in QA/RM activities per requirements in AFI 44-119 and the individual Military Treatment Facility (MTF) QA/RM plan. The Government will provide the AFI44-119 and MTF QA/RM plan. �� Orientation. All contract employees shall participate in the MTF orientation procedures for newly assigned employees to include regulations specific to their professional specialty and hospital and Air Force policy and procedures. MTF orientation classes are offered on a monthly basis and information regarding these scheduled classes will be provided to the Contractor by the Government. �� Annual Training. All contractor employees shall attend annual training classes at the MTF. Annual training shall include but not be limited to safety, QA, risk management, infection control, fire protection, security, and patient sensitivity training. Classes can be scheduled by the Government individually throughout the year as training requirements become due. The class length of time is approximately four to five hours total per individual. Training certification shall be provided to the COR within 5 business days of training completion. �� Infection Control and Safety. All contract personnel shall comply with all MTF infection control and safety procedures, practices and standards. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government. �� The Joint Commission (TJC). Contract personnel shall comply with all applicable TJC standards during the performance of this contract. MTF policies and guidelines pertaining to these requirements will be provided to the Contractor by the Government. �� Patient List. All patient lists, no matter how they are developed, shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in any way for any use outside the MTF without prior written permission by the COR. �� Patient Sensitivity. Contract providers shall respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. �� Release of Medical Information. The provider shall only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient in compliance with current Health Insurance Portability and Accountability Act (HIPAA) regulations. Environmental Requirements. �� Material Safety Data Sheets. 1.8.1.1.Material Safety Data Sheets (MSDSs) are mandated as specified by 10 CFR, 29 CFR (both DOL and OSHA), 40 CFR, AFI 40-201, AFI 48-148, and AFI 91-302, and are provided in all work centers using these materials in the MTF. Hazardous materials shall be identified to the Contractor by the Government. The Contractor shall identify all hazardous materials discovered in the course of performance. Government Furnished Equipment, Property and Services. ��Government Furnished Equipment, Property, and Services. The MTF will provide office space to include one standard telephone and service, facsimile, Internet connectivity (dependent upon existing Contractor security clearance), electronic mail, and utilities. These items shall only be used for performance of tasks related to this PWS. The MTF will provide required Government forms required in the performance of this contract. Staffing Company does not have to be locally based, however; staffing employee must reside within 2 hour drive to ensure availability for work schedule. Period of Performance: 29 September 2015- 28 September 2016 Provide, with price proposal, supporting information that the Contracting Officer can use to validate capability to meet the Performance Work Statement. Solicitations will be evaluated based on Price and Technical Capability with Technical Capability being more important than price. Delivery Destination: 88 MDSS SGSRB POC: Austin Shiplett 4881 Sugar Maple Dr Bldg 830 Wright Patterson AFB, OH 45433-5529 FOB: Destination (As defined in FAR 2.101-Definitions, the seller or consignor is responsible for the cost of shipping and risk of loss.) Inspection and Acceptance: Both inspection and acceptance will be by the Government at Destination. Provisions and Clauses: The attached provisions and clauses for the acquisition of commercial items are incorporated into the RFP. If the offeror has completed the FAR 52.212-3 provision online, the offeror shall only complete paragraph (b) of this provision with its quote. FAR 52.212-3 Paragraph (b) is attached. If the offeror has not completed the DFARS 252.209-7992 provision online, the offeror shall complete and return a copy of the provision with its quote. DFARS 252.209-7992 is attached. If the offeror has not completed the DFARS 252.225-7000 provision online, the offeror shall complete and return a copy of the provision with its quote. DFARS 252.225-7000 is attached. Consent to RFP Terms and Conditions: Submission of proposals in response to this RFP constitutes agreement by the offeror to all terms and conditions contained in this announcement and the attached solicitation document, which will be incorporated into the resulting contract. IMPORTANT NOTICE TO CONTRACTORS: All prospective awardees are required to register at the System for Award Management (SAM) and to maintain active registration during the life of the contract. SAM can be accessed at https://www.sam.gov. Any award resulting from this solicitation will include DFARS Clause 252.232-7003, Electronic Submission of Payment Requests. Section 1008 of the National Defense Authorization Act of Fiscal Year 2001 requires any claims for payment (invoices) under DoD contract to be submitted in electronic form. Wide Area Workflow- Receipt and Acceptance (WAWF-RA) is the DoD system of choice for implementing this statutory requirement. Use of the basic system is at no cost to the contractor. Contractors must complete vendor training, which is also available at no cost at http://www.wawftraining.com. Prior to submitting invoices in the production system, contractors must register for an account at http://wawf.eb.mil/. Contract financing is NOT provided for this acquisition. The Government intends to award one firm fixed price (FFP) contract resulting from this solicitation to the responsible offeror whose quote conforms to the solicitation and will be most advantageous to the Government. The Government reserves the right to award without discussions and the Government reserves the right not to make an award at all. Attachments: 1. CLINS, Provisions and Clauses 2. DFARS 252.209-7992, Representation by Corporations Regarding an Unpaid Delinquent Tax Liability or a Felony Conviction under any Federal Law-Fiscal Year 2015 Appropriations 3. FAR 52.212-3, Paragraph (b), Offeror Representations And Certifications--Commercial Items