SOLICITATION NOTICE
R -- Third Party Billing Services
- Notice Date
- 6/26/2002
- Notice Type
- Solicitation Notice
- Contracting Office
- Department of Health and Human Services, Indian Health Service, Billings Area Office, 2900 4th Avenue North PO Box 36600, Billings, MT, 59107
- ZIP Code
- 59107
- Solicitation Number
- RFQ-10-02-026
- Response Due
- 7/15/2002
- Archive Date
- 7/30/2002
- Point of Contact
- Jay Windyboy, Contract Specialist, Phone 406.247.7064, Fax 406.247.7108, - Evelyn Lucero-Juneau, Contract Specialist, Phone 406.247.7063, Fax 406.247.7108,
- E-Mail Address
-
jay.windyboy@mail.ihs.gov, evelyn.juneau@mail.ihs.gov
- Small Business Set-Aside
- Total Small Business
- Description
- See the Attached Statement of Work. This procurement is enacted to provide Third Party Billing Services for the USPHS Indian Health Service Hospital in Browning, Montana. It is the contractor's responsibility to be familiar with the contents, terms, conditions and statement of work contained in this RFQ Package. This is an open market procurement that is open to all individual and/or small business interests. The estimated range of this procurement is between $25,000 to $100,000. Please request a copy of the complete Statement of Work and RFQ Package. Statement of Work (SOW) ? Personal Services Contract ? Medical Billing Clerk Acquisition Background and Objectives Introduction: The mission of the Indian Health Service (IHS) is to provide the best possible health care services to the Native American populations on the Indian Reservations throughout Montana and Wyoming. The Indian Health Service intends on hiring a contractor into a temporary duty assignment within the Business Office at the Blackfeet Service Unit, in order to achieve this mission. The contractor shall provide a number of work objectives for the department such as: Submission of executed third party claims Rebilling accounts Correction of claims Compliance with hospital billing procedures Performance Location: The contractor will be carrying out their duties and fulfilling their contract with the Indian Health Service at the following health care facility location(s): Indian Health Service Blackfeet Service Unit ? Browning Hospital 760 Hospital Circle Browning, Montana 59417 Background Information: The Billings Area IHS serves thirteen tribal nations in the States of Wyoming and Montana. The user populations are approximately 100,000 members annually; the Area Office facility is located in the south-central corner of the State of Montana. There are twelve ambulatory health care hospitals and health centers located on/around the reservations and five urban health centers in the townships of Billings, Butte, Helena, Great Falls and Missoula. Purpose of this Contract: The primary purpose of this contract is to hire a contractor to assist the department/program in meeting their daily work objectives in providing quality health care services. Currently this department does not have the necessary manpower and resources available to them in being able to complete both their short-term and long-term assigned duties. As a result, a work backlog has developed, which adversely affects the department?s level of service being provided to the Indian community. Scope of Work: The overall purpose of this contract is to temporarily recruit and hire a qualified Billing Clerk under a personal service contract for the Business Office, located at the Blackfeet Service Unit. The contractor will be expected to have the necessary education, training, licensing, insurance, 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. The contract resulting from this solicitation shall: 1.Be considered a ?Personal Services? contract, under which the contractor is considered to be an independent contractor, which in effect, makes the contractor a Government employee. 2.Allow the Government to evaluate both the professional and administrative quality of services provided by the contractor, but retains no control over the personal and professional aspects of the services that are rendered, (e.g., unprofessional conduct; assistance for specific work related tasks). 3.Require the Contractor to indemnify the Government for any liability producing act or omission by the contractor, its employees and agents occurring during any part of the contract performance period. 4.The contractor selected and utilized under this contract must submit and be able to pass their background investigation in order for them to obtain the privileges and clearances necessary to perform the requested services at the IHS facility. 5.The contractor is required to maintain current licenses, certifications and insurance credentials requested in this Statement of Work, during the entire length of this contract. The contractor will be expected to assist and provide services and duties as may be requested for the normal operational requirements and workloads for the department and personnel. Contractor shall provide work that is consistent with the guidelines and procedures of the IHS. Failure contractor to meet these standards can result in cancellation of this contract. The contractor?s performance and abilities shall be evaluated based upon performance standards that are contained in this statement of work. If appropriate and necessary, the contractor shall provide consultation to the Supervisor on better improving and enhancing the program environment and delivery of services. The contractor shall advise the project officer, contracting officer or program manager or their designated representative of any problems encountered or which may be encountered in connection with meeting the needs of the contractor?s duties. The contractor shall have at least two (2) or more years of post-secondary education (college) experience from an academic institution or be licensed in a field of study. The contractor must be proficient in writing, typing and have a basic working knowledge and understanding of computer hardware and software applications. The contractor shall have sufficient knowledge, competence and experience in providing these services on a regular schedule to the Billings Area IHS. Due to some limited driving requirements, the contractor must hold a current, valid state drivers license from any of the 50 United States or the Commonwealth of Puerto Rico. The contractor shall possess sufficient initiative, interpersonal relationship skills, social sensitivity and appropriate professional behavior such that the contractor can relate constructively to IHS employees, contractors, vendors and individuals from the Native American community. The contractor shall not have any work or health restrictions, which could directly or indirectly interfere with the performance of providing services as there will be some moderate lifting and moving of furniture as well as boxes of office supplies and equipment. The contractor shall maintain acceptable standards of personal hygiene and grooming such that their image as a Federal contract employee is compatible with the expectations of the IHS staff. This Personal Service Contract is not guaranteed to any one specific individual or business, nor does it belong to any specific individual or business. A contractor shall not be authorized to perform any services for the Federal Government until the IHS governing body has granted the contractor such privileges in writing. As a Federal contract employee, taxes, retirement, social security, insurance deductions or any other form of deduction will be withheld from their invoice or pay request. THE FEDERAL GOVERNMENT DOES NOT WITHOLD LOCAL, STATE OR FEDERAL TAXES UNDER A PERSONAL SERVICES CONTRACT. THEREFORE IT IS THE CONTRACTORS SOLE-RESPONSIBILITY TO PAY FOR THEIR OWN LOCAL, STATE, FEDERAL TAXES AND OTHER OBLIGATIONS THEY HAVE. THE FEDERAL GOVERNMENT IS NOT RESPONSIBLE FOR ANY OF THE CONTRACTORS FINANCIAL DEBTS OR COMMITMENTS. Applicable Documents: The following documents will need to be included in your proposal/application. 1.Resume or OF 612/OF 306 Applications for Federal Employment 2.College transcripts; conferred degrees and certified training in this field. 3.BIA Form 4432-Certificate of Degree of Indian Blood (CDIB) 4.Two (2) letters of reference from current or previous employers. 5.Knowledge, Skills and Abilities (KSA): Applicants must describe their present/previous experiences with the following KSA evaluation requirements in their application/proposal. 6.Best value price evaluation criteria submitted by the contractor. An indication as to what hourly rate the contractor is willing to work for. 7.Credentialing Documents and Requirements and any degrees conferred. In accordance with the Child Care National Agency Check and Investigation (CNACI) directive, implemented by the Indian Health Service. The following documents will be required from the selected contractor and all employees they utilize under an awarded contract. 1.Non-Personal Health Services Contract ? Certification Statement 2.DHHS Application Background Survey 3.DHHS/IHS Required Application Questionnaire for Child Care Positions 4.IHS Personal Services Contract ? Release of Personal Information 5.SF-85 Questionnaire for Non-Sensitive Positions 6.GSA Form 176 ? Statement of Personal History 7.FD-258 Federal Bureau of Investigation Fingerprint Analysis Chart Evaluation Criteria for Best Value: Award of this contract to a qualified contractor will be made based on price and price related factors, representing the best value to the Government. Those factors include the contractor?s knowledge of the following Knowledge, Skills and Abilities (KSA) questionnaire. 1.Knowledge and skill in Third Party Billing Procedures 2.Knowledge & skill in coding terminology 3.Knowledge of standard office equipment 4.Knowledge and skill in typing, organizing and scheduling procedures 5.College Education / Certified Training 6.Past Work Performance Work Requirements Technical Requirements: Specific duties and services the contractor shall provide include, but may not be limited to the following: Responsible for the accurate and timely preparation and submission of claims to third party payers, intermediaries and responsible parties according to established hospital policy and procedures. Responsible for maintenance and control of unbilled claims for an assigned section of patient receivables. Responsible for verification that all control functions assigned are maintained daily as set forth in hospital policy and procedures. Reviews system generated reports daily to identify claims that are ready for billing. Prepare and submit claims to third party payers, intermediaries or responsible parties within 24 hours after all information for billing becomes available. Responsible for the error correction for all rejected/suspended claims previously submitted to third party payers and intermediaries and patients according to hospital policy and procedures. Notifies supervisor of all claims deemed unbillable, along with reason(s) on a daily basis. Documents all activity performed on patient accounts in the patient financial folder. Provides supervisor an accurate accounting of all claims in the assigned section of patient receivables responsible for. Submits a Daily Billing Productivity Report reflecting the beginning inventory, claims billed and remaining balance at the end of the work shift. Knowledge and understanding of established and standardized hospital policies sufficient to handle third party billing duties. A through knowledge of all third party claim submission process is required. Working knowledge of the ICD-9-CM and CPT/HCPCS coding terminology in order to interpret and resolve problems based on information derived from system monitoring reports and UB92 and HCFA-1500 billings forms submitted to the third party payer. Knowledge of how to establish and maintain relationships with the third party payer community, necessary for resolution of outstanding claims. Knowledge of the on-line input terminal equipment and automated electronic billing systems established procedures, formats, etc., associated with the various third party payers. Knowledge of automated systems, ability to type and operate a calculator and other standard office equipment. Knowledge of and the ability to apply the Alternate Resources regulations; P.L. 94-437, Title IV of Indian Health Care Improvement Act, Indian Health Service Policy and Regulations on Alternate Resource, CFR 42-35.21 (A) and 23 (F) and P.L. 99-272, Federal Medical Care Cost Recovery Act. Contractor plans and carries out the successive steps and handles problems and minor deviations in the work assignments in accordance with instructions and hospital policies and procedures. The contractor utilizes a number of substantive guidelines. The incumbent uses judgment in locating and selecting the most appropriate guidelines, references and procedures for application and in making minor deviations to adapt the guidelines to specific cases. The contractor determines how each billing step should be performed in accordance with available guidelines and instructions and direction of supervisor. The billing process consists of duties that involve different and unrelated processes and methods. The complexity of the work involves working with various programs, covering several states and third party payers who have different benefits and remittance formats. The contractor assists in the submission of claims to third party resources and appropriate responsible parties for services rendered to Indian Beneficiaries and Non-Beneficiaries alike. The resulting funds collected and posted are used by the Service Unit and Area Office programs for projects and planning purposes, which aid the overall objective of elevating the health status of Indian beneficiaries. The successful efforts of the incumbent directly impact the funds collected. The Contractor has regular and recurring contact with employees of the IHS facility, Area Office staff, local and state agencies, third party billers and Medicare and Medicaid fiscal intermediaries. The purpose of the contacts are to plan and coordinate the work of the claims submission function of the business office, resolution of problems pertaining to billing of claims and to resolve issues for any returned claims for services rendered to Indian Beneficiaries and Non-Beneficiaries alike. The work is primarily sedentary with the following physical requirements; ability to lift up to 25 pounds, walk/stand for short periods of time as interaction between all disciplines with the facility is required, ability to stoop and pick up objects from the floor without restrictions and have full use of hands and arms, i.e., to operate office equipment such as computer, calculator, printer, fax, etc. All work functions related to this position are normally performed in the business office setting. As well as other duties not specified here The Contractor (will be will not be X ) authorized to travel during the course of their job performance. In any event, Federal Travel regulations will be in effect and the proper Travel Orders and required authorizations will be sought out prior to any travel being paid by the Government. The Contractor (will be will not be X ) authorized to take outside training activities during the course of their job performance. In an event, Federal Training regulations will be in effect and the proper T350 and required authorizations will be sought out prior to taking any training being paid by the Government. The Contractor (will be will not be X ) authorized to work beyond their normal tour of duty/core hours. The contractor will need to seek prior authorization from the Project Officer, Program Manager and/or Associate Area Director/Service Unit Director prior to working over and above their normal tour of duty. Once authorization is granted, the contractor will be paid 1 ? times their base pay. Contractors are not permitted to supervise or have any form of supervisory control over a permanent or temporary Federal employee hired through the Office of Human Resources. Monitoring, control and scheduling of contract employee work schedules is the department?s responsibility. Work shifts will be eight (8) hours in length and worked between the hours of 6:30 am and 5:30 pm. Contractors are required to work a 40-hour workweek, however work shifts shall be established at the time of award and may be adjusted when mutually agreed upon. Contract employees are not allowed to work or provide services without adequate supervisory coverage. Contractors do not accrue annual or sick leave during the performance of their contract and will not be paid for any Federally recognized holidays. Contractors are permitted to work beyond their normal eight (8) hour workday in order to make up any unscheduled leave, excused absences and Federal Holidays, as long as it is done within the same pay period and there is adequate supervisor coverage. Contractor pay requests must be signed and approved by the Project Officer. Contractors may only submit pay requests and invoices for the actual number of hours they work. Contractors are not authorized to control or monitor any Integrated Time and Attendance System (ITAS) leave requests of any permanent or temporary Federal employees, hired through the Office of Human Resources. Period of Performance: The Indian Health Service anticipates that this contract shall be in effect for 65 Days. In accordance with FAR 52.232-18 AVAILABILITY OF FUNDS, this contract is dependent upon the availability of adequate funding. Government Furnished Property, Equipment and Service: 1.The department shall provide the contractor with office space including a desk, chair and office supplies. 2.The contractor will be authorized to use all areas of the facility made available to them. 3.The contractor must request clearance in order to access Restricted areas of the facility, authorization must be granted and is to be used only for official business activities relating to job performance. 4.The contractor will be authorized to use administrative and professional support personnel in carrying out their assigned duties and objectives. 5.The contractor will be allowed to utilize copy machines, facsimile machines, libraries and telephone services and should only be utilized for official business activities relating to job performance. 6.The contractor shall be given an orientation to the IHS role and the Indian community that is being served. 7.The Purchasing Agent/Supply Technician shall provided the contractor with an initial orientation regarding all aspects that pertain to their employment as a personal service contract employee, the layout of the facility and information on the role IHS has on the Indian communities being served. 8.All Child care National Agency Check and Investigation (CNACI) Forms will be provided by IHS. 9.The department will orientate the contractor as to their specific duties and responsibilities. 10.The department will provide the contractor with standard and specialized equipment and supplies needed for the performance and delivery of services including the use of a computer. 11.The department is responsible for getting the contractor access and clearances to all pertinent ARMS; intranet; internet and computer services that are applicable to the contractor carrying out their duties. 12.The department must provide the contractor with direction and proper workloads, which are appropriate with the normal day-to-day operations in the department. Contractor Furnished Requirements; Equipment; Facilities and Services: 1.The Contractor shall furnish to the Indian Health Service all current and previous licenses, certifications, credentials, insurance requirements and any pending or previous legal action liens against them which might affect the contractor?s ability to perform the required services. 2.The Indian Health Service does not anticipate a need for contractor furnished equipment. Performance Evaluation Standards: As part of the Quality Control and monitoring of the contract, the contractor will be evaluated on their performance and will be conducted in line with permanent IHS employees of similar standing. They will be based upon the following review criteria as set forth in the solicitation and contained in this Statement of Work. Supporting Information Security: Security Standards required for the position 1.Privacy Act Compliance 2.Federal Employee Standards of Ethical Conduct Compliance 3.Indian Health Service Standards of Conduct 4.Child care National Agency Check and Investigation (CNACI) 5.Federal Security Identification Badge Request Form Administration: The following list of employees in the chain of command will assist the program supervisor in monitoring the contract and will be a designated alternate in absence of the supervisor. 1.Business Office Manager, Blackfeet Service Unit 2.Administrative Officer, Blackfeet Service Unit IHS Responsibilities: The responsibility of the Indian Health Service is to supervise, monitor and ensure that the contractor is adequately performing the requested services, deliverables, duties and responsibilities in accordance with the Statement of Work and performance standards for which they were hired to accomplish.
- Place of Performance
- Address: USPHS Indian Health Service, Blackfeet Service Unit Hospital, 760 Hospital Circle/P.O. Box 670, Browning, Montana
- Zip Code: 59417
- Country: United States
- Zip Code: 59417
- Record
- SN00099872-W 20020628/020626213155 (fbodaily.com)
- Source
-
FedBizOpps.gov Link to This Notice
(may not be valid after Archive Date)
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