SOLICITATION NOTICE
R -- Payer relation services to establish and supportan effective program to complement theimplementation and execution of payer agreements.
- Notice Date
- 2/22/2008
- Notice Type
- Solicitation Notice
- NAICS
- 524292
— Third Party Administration of Insurance and Pension Funds
- Contracting Office
- Department of Veterans Affairs;Health Administration Center;3773 Cherry Creek Drive North, Suite 450;Denver CO 80209
- ZIP Code
- 80209
- Solicitation Number
- VA-741-08-RI-0028
- Response Due
- 3/3/2008
- Archive Date
- 4/2/2008
- Point of Contact
- Curtis Parker Contract Specialist 303-398-5986
- E-Mail Address
-
Email your questions to Contract Specialist
(curtis.parker@va.gov)
- Small Business Set-Aside
- Service-Disabled Veteran-Owned
- Description
- The VA Health Administration Center (HAC) is seeking information from potential sources capable of meeting the following requirements: 1. Title of Project: Chief Business Office (CBO) - Payer Relations Program Management Office (PMO). 2. Description of Work: The contractor shall provide all resources necessary to accomplish the deliverables. VA has limited personnel with the expertise and background in public and private health care insurance programs and financing, particularly with respect to managed care operations, to perform the work on the scale needed to positively influence the Medical Care Collections Fund (MCCF) collections. The Contractor shall provide experienced staff to support establishing an effective payer relations program to complement the execution and implementation of payer agreements. The contractor will develop strategies for use in establishing and maintaining payer relationships, develop the tools and training materials for use by field staff and provide mentoring and guidance to additional staff as they are brought on board. Chief Business Office (CBO) National Payer Relations Office (NPRO) embarked on an ambitious project to develop regional and national agreements with Third Party Payers (TPPs). The agreements were intended to require the TPPs to pay VA as they would pay hospitals in the private sector. For the most part, these agreements were a new way of doing business for the VA and for the local medical centers and Veterans Integrated Service Network (VISNs). The development of the agreements proved successful and over 70 regional and national agreements developed by the CBO are now in place. While an agreement identified what would be paid to the VA, the billing and payment processes to be followed by the VA and the TPP were not always as clear. As several of the agreements have been in place now for more than a year, it has become apparent that the "how" with respect to working with TPPs to ensure that both sides adhere to the agreement, that billing and payment protocols are followed, and that proper communication exists between the VA and the TPP to ensure a successful relationship is lacking in the payer agreement process. Establishing a PMO within the CBO NPRO, with support in the field, would provide the foundation to begin developing guidance, training and strategies to develop the relationships with the TPPs to ensure that the agreements are operationalized to their fullest capacity and revenue is maximized based on the agreement. 3. Description of Tasks and Associated Deliverables: The contractor shall provide the specific deliverables described below. Task 1: The contractor shall provide a detailed project management plan and briefing for the VHA project team, which presents the contractor's plan for completing the work. The contractor's plan shall be responsive to the SOW and describe, in further detail, the approach to be used for each aspect of the work. At a minimum, the project management plan shall include the risk, quality and technical management approach, detailed schedule, cost requirements, and proposed personnel. The contractor shall keep the project management plan up to date throughout the period of performance. Deliverable 1 A detailed project management plan and briefing. Task 2: The Contractor shall provide experienced staff to provide support with respect to establishing an effective payer relations program to complement the execution and implementation of payer agreements. The Contractor shall: Participate in and manage project team meetings and discussions and use their technical expertise to assist CBO in the identifying and resolving the business process changes. Support and facilitate Payer Relations implementation strategy meetings with project representatives to identify implementation needs. Deliverable 2 The Contractor shall prepare and maintain an Issues and Resolution List describing the technical and business process challenges of the payer relations project. Task 3. Make contact with each regional TPP and document pertinent notification and claim processing requirements. Develop material such as checklists, tools, and/or templates of responsibilities that must be completed/conducted by VA staff/services to in order to comply with the utilization review, billing and payment processing protocols for each payer. Deliverable 3.1 The Contractor shall provide a summary report document of benefits and associated reimbursement rates; utilization review, billing and payment protocols, and other payer specific requirements/conditions for the top ten regional TPPs . Deliverable 3.2 The Contractor shall develop a standardized reference template to record the summary information and instruct facility/VISN employees how to complete the same information for other regional TPPs. Deliverable 3.3 The Contractor shall develop materials/tools that outline facility and VISN responsibilities to implement and maintain payer agreement protocols of each of the regional TPP. Task 4. The Contractor shall develop and implement an education plan to train VA PMO staff in negotiation strategies and tactics for developing and maintaining TPP relationships. Deliverable 4. The Contractor shall develop and implement an education plan with the following components: evaluating the operational components of reimbursement contracts, establishing effective relationships with payers, validating contractual payments for accuracy, negotiation skills and techniques, roles and responsibilities of facility and VISN staff for the payer relations program and strategies for dealing with non-compliant payers. Task 5. The Contractor shall develop strategies for addressing TPPs that are not in compliance. Deliverable 5. The Contractor shall develop a written plan documenting strategies for addressing TPPs that are not in compliance. These strategies shall include standard operating procedures for addressing non-compliance. 4. Place of Performance: The Contractor shall support this effort at the Department of Veterans Affairs, 1722 I Street, NW Washington, DC 20006, or at approved Contractor facilities as directed by the COTR and mutually agreed upon. The purpose of this announcement is to gather information on the available sources for this requirement and does not constitute an Invitation for Bids, a Request for Proposals, a Request for Quotations or an indication that the Government will contract for any of the items and/or services described in this notice. In submitting a response, respondents are solely responsible for any associated expenses. The information received in response may be used to create an acquisition strategy, including set aside decisions, and a detailed work statement. Accordingly, interested firms are requested to advise in their response 1) whether they can meet the requirements and 2) provide information as to the status of their firm (Service Disabled Veteran Owned Small Business, Veteran Owned Small Business, 8 (a) small business, Small Disadvantaged Business, etc.) The VA intends to set this requirement aside for Service Disabled Veteran Owned Small Business. Please provide the number of your GSA Schedule, if any. Please provide a brief statement of your capabilities, experience, an estimated cost, and technical comments. Include your company information, size status, and a name, address, phone number, fax, and email for a point of contact. Provide information on any other government contracts you have for this type of work. Responses should be sent via email only. NO TELEPHONE CALLS. This Request for Information in no way constitutes a Request for Proposal and is not to be construed as a commitment by the Government. The Government does not intend to award a contract based on this announcement. Written responses should be received no later than 4:00 p.m. MST on March 3, 2008.
- Place of Performance
- Address: Department of Veterans Affairs;1722 I Street, NW;Washington, DC 20006
- Zip Code: 20006
- Country: USA
- Zip Code: 20006
- Record
- SN01514772-W 20080224/080222223810 (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
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