TRICARE Prime/Nurse Assessment Line

FAR 52.215-3: (a) The Government does not intend to award a contract on the basis of this inquiry or to otherwise pay for the information solicited except as an allowable cost under other contracts as provided in subsection 31.205-18, bid and a proposal costs, of the Federal Acquisition Regulation. (b) Although "proposal: and "offeror" are used in the inquiry your response will be treated as information only. It shall not be used as a proposal. (c) This inquiry is for planning and market research purposes only and should not be considered as a request for proposal or as a solicitation to do business with the Government. The contractor will be responsible to provide all labor, materials, equipment, and services for providing a Request For Quote (RFQ) for a Rough Order of Magnitude from small businesses who have the capabilities to provide the following requirement: a nurse triage, 1-800 telephone-based clinical assessment and support services for the TRICARE program at the 3rd Medical Group. All calls shall be answered by Registered Nurses following nationally recognized and physician approved clinical protocols and guidelines. These nurses will have access to a board certified physician with post-residency experience who is available for consultation 24 hours a day, 7 days a week. Contractor or its principle subcontractor(s) shall hold and maintain Utilization Review Accreditation Commission (URAC) Health Care Call Center accreditation during the performance of this contract. This service shall include all information from the calls, which will be entered into a database for program assessment and documented resolution of each call. Call information shall be faxed to the 3 MDG referral center to advise the patient's healthcare provider to allow for follow-up care. This service includes: - A telephone-based clinical assessment and support service to the 3rd Medical Group. - Advice to callers needed to assist them in taking responsibility for their personal healthcare management, to include offering caller access to the contractor's automated library of healthcare information. - Telephone call services, processing, administration and management to include data collection and reporting - When indicated using approved clinical protocol, provide the beneficiary an appointment with their Primary Care Manager or other primary care provider. - This 24/7 clinic appointment setting service will be provided via the Composite Health Care System (CHCS) and remain assessable to the triage nurse at all times. Contractor must have completed a National Agency check, DOD IA and HIPAA training prior to performance start. Provide technical, operational, administrative and management support. Perform all caller interactions utilizing recognized and approved clinical protocols and guidelines. As a minimum, a staff of competent professional licensed registered Nurses to manage patient calls per protocols, maintain call/patient records, provide feedback to practices/providers as requested, provide back-up and support to each other, provide feedback to program and medical management, and maintain appropriate nursing skills. Shall employ a senior nurse with overall responsibility for all clinical function, quality improvement monitoring, directing workflow of staff, monitoring staff productivity, conducting staff performance evaluations, staff scheduling, reviewing calls for use of protocols, adequacy, and accuracy of documentation; ; acting as a resource for care givers and multidisciplinary team members; quality of service, quality assurance, and staff competency; clinical problem resolution; development and maintenance of relationships with physicians and other healthcare providers; and program representation to organizational management and related departments. use a computer software program that will collect data that can collate calls by type of call received and information delivered. Every call shall be logged into the database and contain the following minimum information: **Date**Presenting problem **Time of call **Nursing assessment **Patient name **Sponsors' Name ** Primary symptom **Sponsor's Last four digits of SSN **Primary care physician **Guideline used **Address **Disposition **Age **Reason for disposition **Telephone number **Patient/caller understanding **Birth date **Patient/call intended action **Nurse operator **Nursing note