SRCSGT | R | The U.S. Army Medical Command in conducting a Market Research of Industry to determine potential contractors who have the skills, experience, and knowledge required for Third Party Collection services.

FBO DAILY ISSUE OF APRIL 26, 2003 FBO #0513
SOURCES SOUGHT

R -- The U.S. Army Medical Command in conducting a Market Research of Industry to determine potential contractors who have the skills, experience, and knowledge required for Third Party Collection services.

Notice Date: 4/24/2003
Notice Type: Sources Sought
Contracting Office: MedCom Contracting Center, ATTN: MCAA C BLDG 4197, 2107 17TH Street, Fort Sam Houston, TX 78234-5015
ZIP Code: 78234-5015
Solicitation Number: DADA10-03-R-0034
Archive Date: 7/15/2003
Point of Contact: William Young, 210-295-4428
E-Mail Address: Email your questions to MedCom Contracting Center
(William.Young@amedd.army.mil)
Small Business Set-Aside: N/A
Description: NA This announcement constitutes a Sources Sought Synopsis. The following information is provided to assist the U.S. Army Medical Command in conducting a Market Research of Industry to determine potential contractors who have the skills, experience, and know ledge required to successfully complete this effort. Interested respondents should provide the following information: (a) corporate summary including your website, whether or not the business is large, small, small-disadvantaged, women-owned, veteran-owned , service-disabled veteran-owned, or HUBZone; (b) a listing of any current negotiated GSA schedule, government contract or commercial pricing rates (PLEASE DO NOT SUBMIT PROPRIETARY PRICE LISTS); and, (c) a 3-5 page summary relating experience providing Th ird Party Collection services to support our objectives as cited below. The U.S. Army Medical Command (MEDCOM) under the authority of (a) 10 U.S.C. 1095?Third Party Collection Program (TPCP)?as implemented at 32.C.F.R. 220, (b) 42 U.S.C. 2651?53?Medical Affirmative Claims (MAC)?as implemented at 28 CFR 43, and (c) Medical Serv ice Accounts (MSA) in accordance with DODI 6010?15 M, has the authority to bill third party payers, e.g., for DOD beneficiaries (and under limited circumstances, civilians) with group health plan, liability and workers? compensation coverage. As a result, uniformed services Military Treatment Facilities (MTF), generate numerous accounts receivables each year requiring follow?up or further collection activity. There are an undetermined number of prior year TPCP legally disputed, payer denied cl aims subject to statute of limitations allowing the Government to retroactively demand reimbursement through the courts if necessary of these uncollected accounts. Army annual receivables are approximately 3,431,336 current and aged claims for processing under this initiative. Services are expected to include processing a backlog of 3-4 million inpatient and outpatient current and aged receivables from potentially 46 Army MTFs. Contractor is expected to: Develop various ad hoc programs necessary to extract CHCS (inpatient billing system) and TPOCS (outpatient billing system) or PCN (alternate billing system) claims and accounts receivables data and otherwise facilitating the movement of data between MTFs, the Staff Judge Advocate?s (SJA) disputed claims database, and contractor?s TPCP management software; Develop the MTF (as deployed) TPCP claims and supporting documentation scanning system including software and hardware; provide support for medical records production and claims scanning support; Descibe process for follow-up of current employer group health plan receivables for collection on an ongoing basis from Army Medical Treatment Facilities (MTFs), medical centers, hospitals and clinics; Process aged receivables (up to 5 years) for collection; Review health insurance and other payer uniformed services health care reimbursement claims, supporting documentation, payer explanation of benefits (EOB), and other data collection; Input remaining claim collection and legal issue data into JAG disputed claims database; Prepare consolidated payer demand and litigation research legal support; Provide temporary storage of claims, digitize claims, and destroy claims and supporting documentation; Contract performance will be at the contractors' locations. The government will send paper claims, payer/health insurer explanation of benefits (EOBs) and other supporting documentation to the contractors for processing and will provide access to: electro nic claims and patient profile data, accounts receivable data, and the Army's web-based, legally disputed claims database. Contractor(s) must have: (1) a demonstrated health care claims processing management system sufficient in quality and capacity to handle the number of claims and data considered above; (2) variable edit capabilities in their claims processing managemen t system?preferably with a web?based connect ability?for aged receivable activity reporting capabilities; (3) an efficient electronic billing capability with a broad number of payer contracts?preferably through a national electronic billing clearinghouse; (4) a claims processing management system able to download required data to Government's JAG disputed claims database; (5) demonstrated past experience to handle a contract of this size and complexity; (6) Sound pricing structure; and (7) a system capable of processing the data required herein and producing the essential reports. The contractor must interface with the MTF's billing systems for downloading critical data?-especially outpatient billing data considering the overwhelming number of current accounts and/or disputed claims. Contractor must be capable of interfacing with Government's JAG web-based database system. Contractor must have an efficient electronic billing system capable of accepting and forwarding to payers MTF claims. Contractor must design an efficient interface to transfer claims follow?up and legal review (identifying legal issues involved) from their system to the Government's web?based database?-without duplicating efforts under the disputed claims function. The Center for Health Care Contracting may award multiple indefinite-task order contracts. Pricing terms will be in accordance with industry standards determined by this market research. The contracts will include the requirements of FAR clause 52.219-14, ?Limitation on Subcontracting?. Potential offerors are requested to provide a summary of the capabilities and facilities they have which will allow them to perform the services outlined herein. The offerors are also requested to provide any other information which is indicative of their capability to perform the services. An electronic submission (in MS-Word format) is preferred and should be sent to mailto: Mia.Cipriano@amedd.army.mil. Those firms wishing to respond by mail should send them to the Center for Health Care Contracting, Attn: Mia Cipriano, 2107 17th Street Bld g 4197, Fort Sam Houston, TX 78234-5068, no later that 15 working days after publication of this notice. No telephone or FAX requests will be accepted. The government does not intend to contract on the basis of this request or otherwise pay for the information solicited. Release or distribution of your response will be approved by the contracting officer.
Place of Performance: Address: MedCom Contracting Center ATTN: MCAA C BLDG 4197, 2107 17TH Street Fort Sam Houston TX; Zip Code: 78234-5015; Country: US
Record: SN00311319-W 20030426/030424213736 (fbodaily.com)
Source: FedBizOpps.gov Link to This Notice
(may not be valid after Archive Date)

| FSG Index | This Issue's Index | Today's FBO Daily Index Page |

Loren Data's SAM Daily™

R -- The U.S. Army Medical Command in conducting a Market Research of Industry to determine potential contractors who have the skills, experience, and knowledge required for Third Party Collection services.