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R499--VA Claims Processing & Customer Services Support

Awarded
36C10G26D0030Federal

Contract Overview

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

AI Contract Overview

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Contract 36C10G26D0030 is a sole-source, Firm Fixed Price IDIQ award issued by the Department of Veterans Affairs Strategic Acquisition Center Fredericksburg to Signature Choice III, LLC in the amount of 517 million dollars. Set aside for Service-Disabled Veteran-Owned Small Businesses under NAICS code 524114, this agreement ensures the continuity of critical claims processing and customer service functions for the VHA Office of Veterans Community Care. The contract was awarded to prevent a lapse in essential services while the agency transitions to a follow-on solution, citing the incumbent's unique position and the extensive onboarding time required for new vendors. The scope of work focuses on maintaining uninterrupted healthcare access for Veterans and their families by managing eligibility verification, authorizations, and the adjudication of claims for community-provided care. Key responsibilities include issuing billing guidance to minimize reimbursement delays and supporting the IT systems necessary for accurate processing. Additionally, the contractor operates customer service call centers to handle billing and eligibility inquiries, including a 24/7 emergency care notification line for Veterans in crisis, ensuring prompt payment authorization and the maintenance of care for permanently and totally service-connected disabled Veterans.

General Info

VA awarded Signature Choice III $517 million for claims processing and customer service.

Agency

Department Of Veterans Affairs → Strategic Acquisition Center Fredericksburg (36C10G)

Contract Value

$0

NAICS

524114 - Direct Health and Medical Insurance Carriers

Place of Performance

VA, USA

Set-Aside

SDVOSBC

Awardee

SIGNATURE CHOICE III, LLC

Award Issued Date

Documents

3

Award 36C10G26D0030 - VA Claims Processing & Customer Services Support

DOCX, Low priorityaward
Low

J&A - VA Claims Processing and Customer Services

PDF, Low priorityjustification-and-authorization
Low

VA Claims Processing & Customer Services Support Award Notice

DOCX, Low priorityaward
Low

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Organization & Contact Information

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AgencyDepartment Of Veterans Affairs → Strategic Acquisition Center Fredericksburg (36C10G)
Contacts1 person available
OfficeFREDERICKSBURG, VA, 22408, USA
Organization / AgencyDepartment Of Veterans Affairs → Strategic Acquisition Center Fredericksburg (36C10G)
Office AddressFREDERICKSBURG, VA, 22408, USA
Contacts
Jeffrey FithenContracting Officer
contact@example.gov
+1 (555) 000-0000

Full Description

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VHA VCC claims processing and customer service functions are critical to ensuring uninterrupted access to healthcare services for Veterans and their families. VHA s existing resources are inadequate to manage the workload required to fulfill mission requirements. These services include verifying eligibility and authorizations, adjudicating claims for community-provided care, and issuing billing guidance to prevent improper payments and minimize reimbursement delays. These functions also support the complex IT systems that enable accurate claims processing and continuity of care. Customer service needs include the operation of customer service call centers to address billing, claims, and eligibility inquiries, including a 24/7 emergency care notification line that serves Veterans in crisis, helps VHA meet reimbursement timelines and ensures Veterans can report urgent care episodes promptly for payment authorization. Timely adjudication of medical claims for services performed by community-based providers guarantees that Veterans and family members of permanent and total service-connected disabled Veterans receive uninterrupted care.

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