MODIFICATION
Q -- Certified Medical Coders,Certified Coding Specialists, Certified Coding Specialists Physician Based, Certified Professional Coders, Registered Health Information Administrators, and Registered Health Information Technicians
- Notice Date
- 11/12/2004
- Notice Type
- Modification
- NAICS
- 621111
— Offices of Physicians (except Mental Health Specialists)
- Contracting Office
- Medcom Contracting Center North Atlantic, ATTN: MCAA NA Bldg T20, 6900 Georgia Avenue NW, Washington, DC 20307-5000
- ZIP Code
- 20307-5000
- Solicitation Number
- W91YTZ-05-T-0026
- Response Due
- 11/17/2004
- Archive Date
- 1/16/2005
- Small Business Set-Aside
- N/A
- Description
- SOURCES ARE BEING SOUGHT to provide Certified Medical Coders, Certified Coding Specialists, Certified Coding Specialists - Physician Based, Certified Professional Coders, Registered Health Information Administrators, and Registered Health Information Technicians to code, abstract, analyze and assemble medical record data. Coders will assign diagnoses and procedure codes for Inpatient Treatment Records, Inpatient Rounds, Ambulatory Procedure Visits, and Outpatient Clinical Data. The Contractor shall provide services in Government-supplied facilities at Womack Army Medical Center, Fort Bragg, North Carolina and, when required, shall code for other regional Medical Treatment Facilities. SITE MANAGER: The Contractor shall designate a Site Manager. The Site Manager shall be responsible for the performance of the work activities of all contracted coding staff. The Site Manager shall have full authority to act on behalf of the contractor on all matters relating to the daily operation of this contract. Th e Site Manager may be a lead contract coder providing services in accordance with this Statement of Work. The Contractor shall designate this individual in writing to the Contracting Officer before the contract start date. An alternate may be designated; however, the Contractor shall identify those times when the alternate shall be the primary point of contact. The Site Manager will have sufficient experience in the medical coding area and the following specific skills: Extensive knowledge for understandi ng and applying the official coding clinic guidelines; Knowledge of medical terminology and usage, including general medical, surgical, pharmaceutical, hospital terms and abbreviations and abstracting techniques; Knowledge of a broad range of references su ch as the ICD-9-CM, CPT, HCPCS, medical dictionaries, manuals related to coding textbooks and glossaries; Knowledge of legal and regulatory requirements of medical records; Knowledge of medical records procedures, regulations and principles to carry out a variety of medical records functions such as analysis, coding, ensuring compliance, and compiling data; Knowledge of data collection methods for basic health care, research information and statistical reporting; Knowledge of laws and regulations on the con fidentiality of medical records and Skill in effective oral and written communication. AVAILABILITY AND HOURS OF OPERATION: Womack Army Medical Center would like to develop a long-term partnership with a company, which can be relied upon to provide continu ity of coders. The Contractor shall provide services on a regular standard duty hour base on a Monday through Friday, (7:30 A.M. - 4:30 P.M.), with one-hour non-working, non-paid lunch break Monday through Friday. Lunch breaks usually start at 11:00 AM o r 12:00 noon (45 minutes). Contractor however, will be permitted to suggest alternate work schedules to accommodate as many hours as may be necessary to fulfill obligations under this agreement. Womack Army Medical Center shall determine the number of cod ers however; send no more than four (4) to begin the delivery order for coding Inpatient Treatment Records, four (4) to support Inpatient Rounds, two (2) to support Ambulatory Precedure Visits; ten (10) for outpatient clinical encounters with a maximum of forty-eight (48) hours to dispatch their staff to begin the task order. The requirement for clinical outpatient and inpatient rounds, coding support can possibly increase up to (22 - 30) or greater coders. ARRANGEMENT FOR REPLACEMENT STAFF: The Contractor Site Manager shall arrange for credentialed and trained coding coverage when schedule coder will be unavailable to provide services for one (1) or more consecutive scheduled tour(s). WORK ROSTER: The contractor Site Manager shall provide a monthly schedul e of the names of coders for the dates the coding services shall be provided. This list shall be provided to the Contract Officer Representative (COR) by the 2 0th of each month of the preceding month. Proposed work schedule changes shall be submitted to the COR at least forty-eight (48) hours in advance. REQUIREMENTS OF THE CONTRACT CODER: Contractor must provide copies of credentials and a resume to include t hree years of current coding experience within the last five years for all personnel prior to assignment at Womack Army Medical Center. Annual reporting of accreditation certification is a requirement and should be provided without request. Reference fro m previous healthcare facilities will be made to determine compatibility with Womack Army Medical Center needs. Coders are required to have extensive knowledge of the Official ICD-9-CM, CPT and HCPCS Coding Guidelines for Coding and Reporting. Personnel s hall read, understand, speak, and write English. PERSONAL APPEARANCE: Contractor personnel shall maintain a neat, clean and professional appearance at all times to facilitate credibility with the professional staff. They must be easily recognized as Contr act Employees by displaying the Womack Army Medical Center identification badge. Contract employees are required to wear the identification badge at all times. PHYSICAL SECURITY AND CONFIDENTIALITY OF MEDICAL INFORMATION: The Contractor shall be responsib le for safeguarding all medical information provided for Contractor use. The Contractor shall not retain any copies, paper or electronics of the information once the work is completed. The Contractor and contract employees shall be aware that proven vio lation of confidentiality of patient information shall be cause for termination and access to future patient data and or termination of this contract agreement. This policy shall be made known to all employees assigned to this contract at the time of assi gnment. The Government reserves the right to remove any contract employee found by the COR to be unfit to perform on the contract. In that event the contractor must provide a replacement cAmbulatorontract employee. OBJECTIVE: Provide accurate and compreh ensive on-going Inpatient, Ambulatory Patient Visits, Ambulatory Clinical Coding and Inpatient Rounds appointments followed by the following: Provide direct training and feedback to providers and clinical staff, as needed; Improve identification of potent ial monetary reimbursements; Improve billing and accounting processes; Improve methodology and management; Improve collection from third party payers the cost of medical service provided to Department of Defense (DOD) beneficiaries to the fullest extent al lowed. Improve Physicians Evaluation and Management (E/M) and Current Procedural Terminology (CPT) documentation requirements. QUALITY ASSURANCE: Those actions taken by the Government to assure services meet the requirements of the Statement of Work. Ther e will not be direct Government supervision of contract coders. The Government Task Manager, however, is responsible for the surveillance of Contractor performance. QUALITY CONTROL: Those actions taken by the Contractor to control the performance of servic es so that they meet the requirements of the Statement of Work. PERFORMANCE OF SERVICE: Contractor shall enter codes on coding worksheets or using the Encoder Grouper, ADM and coding system, which interface with CHCS. The completed clinical cover-sheet (D A Form 3647- Attestation) is generated, reviewed for proper sequencing of diagnoses, procedures and DRG assignment. Due to fluctuating availability of medical records, contractor will be relieved from hourly wages when the workload does not require servic es, with no additional charge to the Government. Alternatively, coders will stand ready to assemble and analyze medical records in addition to coding them if the Government shall deem this to be necessary. SPECIFIC TASKS: The Inpatient and Outpatient Medi cal Record Coding duties shall include but not be limited to: Reviews and verifies component parts of medical record to ensure completeness and accuracy of diag nosis, operations, and special therapeutic procedures that must conform to Health Care Financing Administration and Depart of Defense Coding Guidelines. Codes principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, suppli es, materials, injections, and drugs, etc. with ICD-9-CM, CPT and HCPCS - all levels, and any other coding classification systems that may be required by the DOD. Contract personnel must identify the correct principal diagnosis and principal procedure bas ed on physician's attestation record documentation and established sequencing rules and guidelines. Ensure proper sequencing of ICD-9-CM codes to obtain optimal resource allocation based on the DRG. Identify additional diagnoses/procedures to optimize re imbursement; i.e., complications, co-morbidities, therapeutic procedures and diagnostic procedures. Analyzes medical records for consistency and completeness for coding purposes using established criteria and regulations. Examines all documents in the rec ord for authorized signature and patient identification to ensure all documents contain sufficient documentation to support the diagnosis and treatment administered, and that results obtained are adequately described. Determines who the responsible attend ing staff physician is. Contact medical staff for clarification and additional information to ensure accurate coding and DRG assignment. Interprets and verifies the reason for the encounter, including cause(s), principal diagnosis, principal procedure(s), performed and significant related diseases to assure record contents meets JCAHO and Army regulation requirements for the highest attainable quality. The contract personnel shall be responsible for validating and making code corrections of the diagnosis, evaluation and management, procedures or any other codes required for the complete and accurate preparation of the SADR/SIDR and to support the Uniformed Business Office (as needed) to ensure they have the documentation to submit a claim. When documentation of the medical record is not adequate to identify the appropriate code, the contractor shall indicate to the specific information concerning the additional documentation required. The contract personnel shall contact the transcription s ervices in cases related to missing operation reports to ensure proper coding of visit. The contract personnel shall provide documentation training with clinic providers/staff as directed by COR or appointed representative. The contract personnel shall p rovide Womack Army Medical Center with reports of cases determined to have incomplete information. Inpatients discharges unable to be approved due to administrative errors shall be placed aside and the error is communicated to the Patient Administration D epartment (A&D) staff for correction within 48 hours. Inpatients discharges with A&D errors are to be placed in Release (R) status to enable the A&D staff to make corrections. Clinic encounters unable to be coded due to administrative errors shall be retu rned to the specific Departments for correction. Codes for APV encounters may be indicated in the APV record as a cover sheet. The specific Department administrative staff shall make corrections and return the case to the contract personnel for final cod ing. Maintains current reference material. Ensures that changes and updates are posted for coding and analysis of medical records accurately and as updates are received. Identifies potential or existing medico-legal problems to Site Manager; i.e. malinge ring cases, therapeutic misadventures, child abuse, and therapeutic abortions. The contract personnel must ensure that the record be secured due to medical-legal potential. The contract personnel shall be responsible for safeguarding both the record and i ts informational content against loss, defacement and tempering, and from use by unauthorized individuals. When using the coding worksheet the contractor must enter data abstra cted from the medical record and provide to government employees specifically hired as coders for entry into the CHCS. If CHCS access is granted in the future the contractor inputs data abstracted from medical record into the Composite Healthcare System ( CHCS) utilizing the Inpatient Encoder Grouper and Ambulatory Data Module (ADM). Utilizes appropriate data codes and system commands for data entry. Performs edit checks on data entered prior to transmittal and corrects errors as indicated. Allocations a nd bio-statistical research data collection supports the facility's risk management assessments and/or utilization review processes. Contract personnel shall inform the government COR of any corrections that need to be made to the medical records or comput er systems if errors are detected. The COR shall then forward discrepancies to the provider and correct as appropriate. Any worksheets with individually identifiable information shall be disposed of according to MTF guidelines. The contractor shall comp ly with the Privacy Act, 38 USC 5701 and USC 7332. Initial training and orientation shall be conducted the first week of the contract coder's assignment to WAMC at no additional cost to the Government. The contractor will provide internal monitoring and f eedback for providers and staff of compliance related issues. STANDARDS: Daily productivity standard for coding of ITRs is no less than (3) per hour or twenty-four medical records per day. APV daily standard is no less than (5) per hour or 40 per day. Outpatient Encounters daily standard is no less than (11) per hour or 88 per day or greater; inpatient rounds is (5) per hour or 40 per day or greater. For data quality monthly reporting purposes, the target for data quality is 100%. Areas requiring perc entage: 95% and above = Compliance. Below 95% = Non-compliance. DELIVERABLES: a. Deliverable 1 - Monthly audit of inpatient and outpatient records in accordance with Army regulation/instructions to include Data Quality Audits. b. Deliverable 2 - Monthly/Fiscal Year report outlining training activity. CONTINUING EDUCATON UNITS (CEU) REQUIREMENTS: Contractor employees are required to maintain continuing education units (CEU) in accordance with the American Health Information Management Association and/or the American Academy of Professional Coders standards. NGLISH LANGUAGE REQUIREME NT: Contract personnel shall read, understand, speak and write English. HEALTH REQUIREMENTS: Contract personnel shall receive a pre-employment physical examination before commencement of work and other physical examinations required thereafter by the MTF p ublic health service. Contractor must have received all WAMC required vaccinations before commencement of work. Routine medical care, including shots/immunizations must be obtained from the contractor's physician. WAMC will provide emergency healthcare for contract personnel for injuries occurring while on duty in the hospital. These services will be billed to the contractor at the full reimbursable rate unless the contract employee is eligible for care in the Military Treatment Facility (MTF). LOAD RE PORT: The Contractor is responsible for submitting a monthly workload report to Supervisor, Medical Records. Health Insurance Portability Accountability Act (HIPAA) a. PRIVACY OF PROTECTED HEALTH INFORMATION (DEC 2002) The Contractor agrees to not use or further disclose Protected Health Information other than as permitted or required by the Contract or as Required by Law. The Contractor agrees to use appropriate safeguards to prevent use or disclosure of the Protected Health Information other than as pro vided for by this contract. The Contractor agrees to mitigate, to the extent practicable, any harmful effect that is known to the Contractor of a use or disclosure of Protected Health Information by the Contractor in violation of the requirements of this contract. The Contractor agrees to report to the Government any use or disclosu re of the Protected Health Information not provided for by this contract. The Contractor agrees to ensure that any agent, including a subcontractor, to whom it provides Protected Health Information received from, or created or received by the Contractor o n behalf of the Government agrees to the same restrictions and conditions that apply through this contract to the Contractor with respect to such information. The Contractor agrees to provide access, at the request of the Government, and in the time and m anner designated by the Government to Protected Health Information in a Designated Record Set, to the Government or, as directed by the Government, to an Individual in order to meet the requirements under 45 CFR 164.524. The Contractor agrees to make any a mendment(s) to Protected Health Information in a Designated Record Set that the Government directs or agrees to pursuant to 45 CFR 164.526 at the request of the Government or an Individual, and in the time and manner designated by the Government. The Cont ractor agrees to make internal practices, books, and records relating to the use and disclosure of Protected Health Information received from, or created or received by the Contractor on behalf of, the Government, available to the Government, or at the req uest of the Government to the Secretary, in a time and manner designated by the Government or the Secretary, for purposes of the Secretary determining the Government's compliance with the Privacy Rule. The Contractor agrees to document such disclosures of Protected Health Information and information related to such disclosures as would be required for the Government to respond to a request by an Individual for an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528. The Contractor agrees to provide to the Government or an Individual, in time and manner designated by the Government, information collected in accordance with this Clause of the Contract, to permit the Government to respond to a request by an Individual fo r an accounting of disclosures of Protected Health Information in accordance with 45 CFR 164.528. General Use and Disclosure Provisions. Except as otherwise limited in this Agreement, the Contractor may use or disclose Protected Health Information on beh alf of, or to provide services to, the Government for the following purposes, if such use or disclosure of Protected Health Information would not violate the Privacy Rule or the Department of Defense Health Information Privacy Regulation if done by the Gov ernment. Specific Use and Disclosure Provisions. Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information for the proper management and administration of the Contractor or to carry out the legal responsibilities o f the Contractor. Except as otherwise limited in this Agreement, the Contractor may disclose Protected Health Information for the proper management and administration of the Contractor, provided that disclosures are required by law, or the Contractor obtai ns reasonable assurances from the person to whom the information is disclosed that it will remain confidential and used or further disclosed only as required by law or for the purpose for which it was disclosed to the person, and the person notifies the Co ntractor of any instances of which it is aware in which the confidentiality of the information ahs been breached. Except as otherwise limited in this Agreement, the Contractor may use Protected Health Information to provide Data Aggregation services to the Government as permitted by 45 CFR 164.504 (e) (2) (i) (b). Contractor may use Protected Health Information to report violations of law to appropriate Federal and State authorities, consistent with 45 CFR 164.502 (k) (1). Obligations of the Government. P rovisions for the Government to Inform the Contractor of Privacy Practices and Restrictions. Upon request the Government shall provide the Contractor with the notice of privacy practices that the Government produces in accordance with 45 CFR 164.520, as well as any changes to such notice. The Government shall provide the Contractor with any changes in, or revocation of, permission by Individual to use or disclo se Protected Health Information, if such changes affect the Contractor's permitted or required uses and disclosures. The Government shall notify the Contractor of any restriction to the use or disclosure of Protected Health Information that the Government has agreed to in accordance with 45 CFR 164.522. Permissible Requests by the Government. The Government shall not request the Contractor to use or disclose Protected Health Information in any manner that would not be permissible under the Privacy Rule i f done by the Government, except for providing Data aggregation services to the Government and for management and administrative activities of the Contractor as otherwise permitted by this clause. Termination. A breach by the Contractor of this clause, may subject the Contractor to termination under any applicable default or termination provision of this Contract. Effect of Termination. If this contract has records management requirements, the subject to the Clause should be handled in accordance with the records management requirements. If this contract does not have records management requirements, the records should be handled in accordance with paragraphs (2) and (3) below. If this contract does not have records management requirements, except as provi ded in paragraph (3) of this section, upon termination of this contract, for any reason, the Contractor shall return or destroy all Protected Health Information received from the Government, or created or received by the Contractor on behalf of the Governm ent. This provision shall apply to Protected Health information that is in the possession of subcontractors or agents of the Contractor. The Contractor shall retain no copies of the Protected Health Information. If this contract does not have records ma nagement provisions and the Contractor determines that returning or destroying the Protected Health Information is infeasible, the Contractor shall provide to the government notification of the conditions that make return or destruction infeasible. Upon m utual agreement of the Government and the contractor that return or destruction of Protected Health Information is infeasible, the Contractor shall extend the protections of this Contract to such Protected Health Information and limit further uses and disc losures of such Protected health Information to those purposes that make the return or destruction infeasible, for so long as the Contractor maintains such Protected health Information. NAICS CODE is 621111 and FSC is 8011. Contractor is to be registered with Centeral Contractor Registration. Sources capable of providing this support are requested to repond to this notice NLT 17 November 2004. Responses should include Company's Name, Address, Telephone and Fax Number, DUNS Number, Cage Code, and a brief description of the ability to perform required services. Responses shall be submitted via email to Cheryl.Ricker@na.amedd.army.mil or faxed to 910-907-9307.D
- Place of Performance
- Address: WOMACK ARMY MEDICAL CENTER ATTN: MCXC-CT Bldg 4-2817 REILLY RD FORT BRAGG NC
- Zip Code: 28310
- Country: US
- Zip Code: 28310
- Record
- SN00707695-W 20041114/041112211800 (fbodaily.com)
- Source
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