This Pre-Solicitation opportunity from Department Of Veterans Affairs was posted on December 7, 2009. The submission period has ended. Browse the details below for market research, or find similar active opportunities.

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R--Medical Claims Processing

Awarded

VA-244-10-RQ-0049Federal

Submission Closed12/15/2009, 05:00:00 AM UTC

Contract Overview

Solicitation details, issuing organization, response deadlines, documents, and interested companies for this government contract opportunity.

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NAICS: 524292

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DAS Medical Plan Third-Party Administrator

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Solicitation # 2611-KP

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Solicitation # SRC0000040548

The State of Ohio, through the Department of Administrative Services, is soliciting proposals for a Third-Party Administrator to manage its self-insured Behavioral Health Benefit Plan. Starting July 1, 2027, the selected contractor will provide administrative services for approximately 43,800 employees and 104,600 total lives. Key responsibilities include managing eligibility, claims history, prior authorizations, utilization management, and data integration with the State's data warehouse. The contract runs from the date of signature through June 30, 2030, with the possibility of a one-month discretionary renewal and further mutual renewals for up to four additional years. To be eligible, offerors must be NCQA accredited and comply with the Mental Health Parity and Addiction Equity Act. The evaluation process is based on a total score derived from technical requirements, cost, and presentations, with the highest-ranking responsible offeror recommended for award. Financial terms utilize a not-to-exceed unit cost fee structure, and the contractor must provide a Benefits Fund of at least 150,000 dollars. Strict compliance is required regarding HIPAA through a Business Associate Agreement, State IT policies, and secure data transfer protocols via SFTP. Proposals must be submitted electronically through the OhioBuys portal, consisting of separate technical and cost volumes.

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Solicitation # 27-011CH-32RFP

The Tempe Union High School District is soliciting proposals under solicitation number 27-011CH-32RFP to secure a provider for the administration of employee benefits, including Basic and Voluntary Life and Accidental Death and Dismemberment, Short-Term Disability, Flexible Spending Account, Health Spending Account, and COBRA administration. The intended contract period runs from July 1, 2027, through June 30, 2032. Key requirements include the waiver of pre-existing condition limitations for initially enrolled employees and dependents, the elimination of active-at-work restrictions, and a guarantee that no employee suffers a loss of benefits during a carrier change. The selected vendor must provide a designated account management team, bilingual educational materials, and attendance at four days of annual open enrollment meetings in Tempe, Arizona. The award process utilizes a point formula system across three phases: initial evaluation, vendor interviews, and a best and final offer. Evaluation factors include responsiveness, cost, and past performance, with a minimum of 500 technical points required to proceed to price evaluation. The District intends to award the least number of vendors necessary, with contracts potentially awarded by individual product lines. Proposals must be submitted via the OpenGov portal by November 19, 2026. The contract is subject to Arizona Revised Statutes and School District Procurement Rules, featuring a zero-tolerance gift policy and net 30-day payment terms. Implementation must be completed 60 days prior to open enrollment, with a required 45-day support period following the July 1 effective date.

Business Services

POSTED

8 days ago

DEADLINE

in 22 days

AI Contract Overview

The VA Pittsburgh Healthcare System intends to award a sole source contract to Changing Billing Focus Internationally, Inc. (CBFI) for daily on-site medical claims processing. This urgent procurement is necessary to prevent serious financial injury to the government and ensure the timely payment of provider claims, which is critical to maintaining physician-directed medical services for veterans. CBFI is identified as the only responsible source capable of meeting these requirements due to their current role in processing the Fee Basis Claims backlog, their existing security clearances, and their proficiency with the Veterans Health Information Systems and Technology Architecture (VISTA) and other VA software. Under solicitation number VA-244-10-RQ-0049, the government is notifying interested parties of its intent to bypass competitive proposals. CBFI, a minority-owned 8a small business, possesses the specialized knowledge of federal, state, and VA regulations required for this complex task. Interested parties were required to submit supporting literature to the contracting officer by December 15, 2009. The final decision to proceed with the sole source procurement remains at the sole discretion of the government.

General Info

Agency

Department Of Veterans Affairs → 244-NETWORK Contract Office 4 (36C244)

Contract Value

NAICS

524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Place of Performance

7180 Highland Drive;Pittsburgh, PA 15206 15206 USA, PA, USA

Set-Aside

NONE

Awardee

CBFI LLC

Award Issued Date

01/01/2010, 12:00:00 AM UTC

Documents

No documents available

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AI Contract Breakdown

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Timeline

PhaseAwarded

PostedDec 7

Presolicitation

AwardedJan 1

Contract was awarded

Submission Closed

12/15/2009, 05:00:00 AM UTC

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Organization & Contact Information

AgencyDepartment Of Veterans Affairs → 244-NETWORK Contract Office 4 (36C244)

ContactsNo contacts available

OfficePITTSBURGH, PA, 15215, USA

Organization / AgencyDepartment Of Veterans Affairs → 244-NETWORK Contract Office 4 (36C244)

Office AddressPITTSBURGH, PA, 15215, USA

ContactsNo contact information available

Full Description

The VA Pittsburgh Healthcare System (VAPHS) intends to negotiate on a sole source basis with Changing Billing Focus Internationally, Inc. (CBFI), 1105 Graham Boulevard, Pittsburgh, PA 15235 to provide daily, on-site, claims processing, in accordance with FAR 6302.2, since "delay in award would result in serious injury, financial or other, to the Government. CBFI, a minority-owned, 8a, small business, is the current contractor to process the Fee Basis Claims backlog and has the extensive medical VA claims processing training and security clearances. It is extremely essential for VA Pittsburgh Healthcare System to pay provider claims in a timely manner. To delay payment of claims could result in termination of needed physician-directed medical services, and would be detrimental to the care of our Nation's Veterans. CBFI is the current vendor for medical claims processing and are knowledgeable in the extensive, complicated array of federal, state, and VA rules, regulations and statutes. CBFI is also currently proficient in the use of the Veterans Health Information Systems and Technology Architecture (VISTA) and claims processing VA software. For these reasons, VA Pittsburgh intends to award sole source to CBFI. This Notice of Intent is NOT a request for competitive proposals. Parties may identify their interest, accompanied by supporting literature, to the Contracting Officer no later than Tuesday, December 15, 2009, 4:30 p.m. Responses should be sent to contact@example.gov. No telephone responses will be accepted. It is the belief of the Government that there is currently only one responsible source capable of providing this urgent service to satisfy the agency requirement. A determination by the Government not to compete this proposed procurement based on responses to this notice is solely within the discretion of the Government. If no responses are received, VA Pittsburgh Healthcare System will proceed with the sole source procurement from CBFI, Inc.