SOLICITATION NOTICE
Q -- TRICARE Overseas Program (TOP) - J-5a Notice to Potential Offerors and Ordering Instructions for Data Files
- Notice Date
- 8/12/2014
- Notice Type
- Presolicitation
- NAICS
- 524292
— Third Party Administration of Insurance and Pension Funds
- Contracting Office
- Other Defense Agencies, Defense Health Agency, Contract Operations Division - Aurora, 16401 E. CenterTech Pkwy., Aurora, Colorado, 80011, United States
- ZIP Code
- 80011
- Solicitation Number
- HT9402-14-R-0001
- Point of Contact
- Judith Blomquist, Phone: (303) 676-3839, Debra Hatzel, Phone: (303)676-3572
- E-Mail Address
-
Judith.Blomquist@dha.mil, Debra.Hatzel@dha.mil
(Judith.Blomquist@dha.mil, Debra.Hatzel@dha.mil)
- Small Business Set-Aside
- N/A
- Description
- Request for Data Files This is the PRESOLICITATION NOTICE for the TRICARE Overseas Program (TOP). THIS IS NOT A REQUEST FOR PROPOSAL. The DRAFT RFP was posted on February 21, 2014 under a SPECIAL NOTICE for information purposes only. DHA anticipates posting the formal Request for Proposal on or about 15 days from this notice. The Information contained herein does not necessarily reflect all requirements to be found in any future solicitation. Neither unsolicited proposals nor any other kinds of offers will be considered in response to this PRESOLICITATION Notice. Responses to this notice are not offers and will not be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this PRESOLICITATION Notice. Responses to the PRESOLICITATION Notice will not be returned. Potential offerors may submit requests for confidential and protected information (Detail Level Claims Data) at this time. The ordering instructions for confidential and protected information are located in Attachment J-5a as an attachment to the notice. Upon release of the RFP, Detail Level Claims Data (in CD-ROM format) will be sent via overnight mail (to U.S. addresses only) free of charge to parties who fulfill the requirements outlined in the ordering instructions. TRICARE OVERSEAS PROGRAM (TOP) OVERVIEW The TOP contract encompasses a wide range of health care support services for TRICARE-eligible beneficiaries who reside outside the 50 United States and the District of Columbia. These services include the development of host nation provider networks, referral management activities, TRICARE eligibility verification and enrollment, medical evacuations, dental care for Active Duty Service Members (ADSMs) in remote overseas locations, medical record translation services, medical management activities, customer service/call center activities, beneficiary and provider education and marketing, and claims processing. These health care support services are necessary to supplement the health care services provided by overseas MTFs to ensure that eligible beneficiaries have access to the full range of TRICARE benefits, since the overseas MTFs do not have sufficient capability or capacity to meet the demand for services. The TOP has two primary components: (1) health care support services for ADSMs and their command-sponsored Active Duty Family Members (ADFMs) who are enrolled in the TOP Prime option and are referred by MTFs for civilian health care, and (2) health care support services for ADSMs and command-sponsored ADFMs in remote locations who are enrolled in the TOP Prime Remote option. Enrollment in TOP Prime or TOP Prime Remote may also be available to other TRICARE-eligible beneficiaries (e.g., transitional survivors) based on the specific eligibility and enrollment criteria established in the TRICARE Operations Manual (TOM), Chapter 24, Section 6. The TOP contractor is responsible for developing host nation provider networks and providing all related health care support services for TOP Prime and TOP Prime Remote enrollees. Additionally, certain TRICARE beneficiaries ("transient" beneficiaries) are eligible for TOP Prime-like benefits when they require urgent or emergent care while traveling overseas. Finally, the TOP contractor provides customer service/call center support, preauthorization services, and claims processing for TRICARE Standard beneficiaries who reside overseas. Extensive information can be found in the system of TRICARE Manuals (Policy, Reimbursement, Systems, and Operations Manuals) located at http://manuals.tricare.osd.mil. Unique TOP requirements are included in Chapter 12 of the TRICARE Policy Manual and Chapter 24 of the TRICARE Operations Manual.
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/notices/4ba539209456cb8563eb7497cc8f934b)
- Place of Performance
- Address: TBD, United States
- Record
- SN03462072-W 20140814/140813022538-4ba539209456cb8563eb7497cc8f934b (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
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