Montana Bids > Bid Detail

BFSU 3rd Party Claims Clearinghouse

Agency: HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Level of Government: Federal
Category:
  • D - Automatic Data Processing and Telecommunication Services
Opps ID: NBD00159335061389464
Posted Date: Apr 12, 2023
Due Date: Apr 26, 2023
Solicitation No: BFSU-23-001
Source: https://sam.gov/opp/f0891cf375...
Follow
BFSU 3rd Party Claims Clearinghouse
Active
Contract Opportunity
Notice ID
BFSU-23-001
Related Notice
Department/Ind. Agency
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Sub-tier
INDIAN HEALTH SERVICE
Office
BILLINGS AREA INDIAN HEALTH SVC
Looking for contract opportunity help?

Procurement Technical Assistance Centers (PTACs) are an official government contracting resource for small businesses. Find your local PTAC (opens in new window) for free government expertise related to contract opportunities.

General Information
  • Contract Opportunity Type: Combined Synopsis/Solicitation (Original)
  • All Dates/Times are: (UTC-06:00) MOUNTAIN STANDARD TIME, DENVER, USA
  • Original Published Date: Apr 12, 2023 09:21 am MDT
  • Original Date Offers Due: Apr 26, 2023 05:00 pm MDT
  • Inactive Policy: 15 days after date offers due
  • Original Inactive Date: May 11, 2023
  • Initiative:
    • None
Classification
  • Original Set Aside: 8(a) Set-Aside (FAR 19.8)
  • Product Service Code: DG10 - IT AND TELECOM - NETWORK AS A SERVICE
  • NAICS Code:
    • 518210 - Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services
  • Place of Performance:
    Browning , MT 59417
    USA
Description

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 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.



The Billings Area Indian Health Service (IHS) intends to award a Requirements contract in response to Request for Quotation (RFQ)-BFSU-23-001. The quantities specified in the schedule are estimates only. If the Government’s requirements do not result in orders in the quantities described as “estimated” in the Schedule, it does not constitute the basis for an equitable price adjustment.



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:






    1. Perform insurance coverage discovery

    2. Determine all-payer eligibility

    3. Conduct single clearinghouse to manage Medicare and Private Insurance billing

    4. 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.

    5. Complete up to 1,800 per month all-payer eligibility verifications.

    6. Complete up to 29,000 annual claims through Claims clearinghouse.

      1. 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:

        1. UB04/CMS 1500

        2. HIPAA 5010 Rules

        3. Payer Specific Rules

        4. MAC Regional Rules’

        5. HCPC/CPT/ICD





    7. Correct/edit claims prior to sending to payers

    8. Ensure secondary claims can be created from Primary claims.

    9. 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: (406) 338-6452



Email: Shannon.Connelly@ihs.gov



Contracting Officer (CO)



James Mayotte



Phone: (406) 247-7352



Email: James.Mayotte@ihs.gov



Contracting Officer’s Representative (COR)



Wendy Stiffarm



Phone: (406) 338-6369



Email: Wendy.Stiffarm@ihs.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 (866) 973-3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov.



Please send a courtesy copy of the invoice by email to Wendy.Stiffarm@ihs.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.



This is not a request for quotations. No solicitation package is available. 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 shannon.connelly@ihs.gov




Attachments/Links
Contact Information
Contracting Office Address
  • 2900 FOURTH AVE. NORTH - PO BOX 366
  • BILLINGS , MT 59107
  • USA
Primary Point of Contact
Secondary Point of Contact


History
  • Apr 12, 2023 09:21 am MDTCombined Synopsis/Solicitation (Original)

TRY FOR FREE

Not a USAOPPS Member Yet?

Get unlimited access to thousands of active local, state and federal government bids and awards in All 50 States.

Start Free Trial Today >