Chief A&MMS (90C), Hunter Holmes McGuire VA Medical Center, 1201 Broad Rock Blvd, Richmond, VA 23249

R -- HEALTH CARE CLAIMS OVERPAYMENT RECOUPMENT SERVICES SOL RFQ 652-73-00 DUE 123099 POC Diane Campbell, Contracting Officer, (804) 675-5485; Fax Ph. (804) 675-5588 The Hunter Holmes McGuire VA Medical Center is seeking a contractor who is interested in establishing a Basic Ordering Agreement to identify cases of overpayment and recoup dollars for health care claims previously paid. Cases to be reviewed are DRG inpatient encounters during the past seven years. The contractor may require data from outside the period covered but will limit the recovery to claims paid during the seven years. The contractor will recover dollars using the Richmond VAMC's claims payment rules and benefits. Under no circumstances will the veteran be liable for any financial recovery. The recovery of health care costs includes the processing of adjustments to the claims and the recoupment or offsetting of the health care dollars. The contractor will be responsible for analyzing inpatient DRG reimbursed charts; working with internal and external audit personnel; reviewing intermittent and final results with the Richmond VAMC's management; perform the recoupment of recoverable amounts at the direction of the Richmond VAMC; prepare recommendations regarding the elimination of future overpayments; and identification of cases to pursue. The contractor will provide the Richmond VAMC with updates of the findings according to time frames determined by the Richmond VAMC. The contractor will develop recommendations for the elimination of the causes of overpayment. Recommendations will be presented to the Richmond VAMC management team as data elements in determining the appropriate course of action for the resolution of future overpayments. Contractor shall be responsible for any postage and copying costs incurred for this service. If recoupment is in the form of a credit (offset), the Richmond VAMC will pay the contractor within 120 days of the initial establishment of the offset or at the time the credit is used, whichever is earlier. When there is a recoupment, the Richmond VAMC will pay the contractor 30 days in arrears from the month of the receipt of the recoupment. The offset and recoupment amounts will be determined by the Richmond VAMC and verified by the contractor. The BOA will be for a period of a base year plus 4 renewable option years. The award will be based upon the contractor's professional fee rate (percentage) of the health care costs offset or recouped. Contractor's interested in receiving a bid package should request a copy of the solicitation package in writing. No telephone requests will be accepted. You may fax your requests to Fax No. (804) 675-5588. The VA will not be responsible for legibility of facsimile copies received. Issue date is approximately 12/6/99. SIC is 6411. Size Standard is $5.0 million. Posted 11/29/99 (W-SN404052). (0333)

Loren Data Corp. http://www.ld.com (SYN# 0050 19991201\R-0004.SOL)