Loren Data's SAM Daily™

FBO DAILY ISSUE OF AUGUST 02, 2009 FBO #2806
SOLICITATION NOTICE

R -- Medical Support Assistant - Haskell - waiver forms

Notice Date

7/31/2009
 

Notice Type

Combined Synopsis/Solicitation
 

NAICS

561210 — Facilities Support Services
 

Contracting Office

Department of Health and Human Services, Indian Health Service, Oklahoma City Area Office, 701 Market Drive, Oklahoma City, Oklahoma, 73114, United States
 

ZIP Code

73114
 

Solicitation Number

246-09-Q-0041
 

Archive Date

8/29/2009
 

Point of Contact

Edson Yellowfish, Phone: 405-951-3888
 

E-Mail Address

edson.yellowfish@ihs.gov
(edson.yellowfish@ihs.gov)
 

Small Business Set-Aside

Total Small Business
 

Description

"Temporary Waiver of Character Investigation” and “Declaration for Federal Employment" This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; quotes are being requested and a written solicitation will not be issued. The solicitation is issued as Request for Quotes (RFQ) 246-09-Q-0041. This procurement is 100% small business set-aside under NAICS code 561210 with a standard business size of $32.5M. The solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-33, effective June 15 2009. This acquisition may be subject to the Service Contract Act (SCA). Wage Determination No. 2005-2431, Revision No. 8 is attached at https://faaco.faa.gov/attachments/OK_05-2431_6-2-09.doc. Contractor shall provide a firm, fixed-price rate for Medical Support Assistant services. The period of performance for this requirement is September 1 2009 to August 31 2010. Estimated start date is September 1 2009. The closing date for receipt of quotes is August 14 2009. Offers shall be submitted to the Oklahoma Area Indian Health Service, 701 Market Drive, Oklahoma City, Oklahoma 73114, no later than 4:30 p.m., on August 14 2009. The offer must be submitted in a sealed envelope, addressed to this office, showing the solicitation number, and your name and address. Please do not email RFQ's. Qualified vendors will review the following and submit applicable information. MAJOR DUTIES Third Party Billing: Analyzes and maintains a portion of the total billing operation for third party programs, and acts as an advocate for the IHS in the collection of alternate resources. Responds to third party requirements on post-payment reviews, exclusions, denials and appeals. Actively performs audits and medical reviews to ensure documentation and accountability of all health insurance claims submitted for payment by conducting random sample reviews. Verifies that medical records contain proper documentation in accordance with regulations, physician/physician assistant original signature(s), accurate dates of medical care services and that primary care providers are in compliance with attestation and billing requirements. Claims Processing/Follow-up: Searches and retrieves individual patient health records to gather and compile information for outpatient services. Searches and gathers the clinical management of individual patients' condition and diagnosis to generate indicators of health status and health statistics from the ICD-CM coding volumes and CPT coding system. Maintains indentified corrective action received from fiscal intermediaries or third party payers to be shared or communicated with the Utilization Review Coordinator for review of diagnosis; coding transactions for possible reconsideration and appeal for payment. Performa daily outpatient interviews to obtain specific demographic and insurance information in a diplomatic and confidential manner. Bills the applicable agency for the services provided to a patient on an outpatient basis. Ensures that all applicable forms are submitted and adequately reflect the services rendered. Establishes day-to-day billing procedures; i.e., tickler files, individual patient files and status files for all third party programs. Maintains current documentation and guidelines pertaining to reimbursement and utilization review activities in appropriate files, binder, etc. Prepares and distributes copies to all appropriate disciplines. Completes special projects within required timeframes to ensure compatibility of project specifications. Safeguards the contents of the Alternate Resources program health insurance claims and medical records as a privileged communication with disclosure of information only within the limits of IHS policy, and therefore, at the discretion of the Service Unit Director. Files all pending and completed health insurance claims and correspondence relative to the third party and primary care provider programs. Administrative support: Maintains Medicare, Medicaid and private/commercial insurance manuals and directives. Provider reimbursement Manual, direct Dealing Providers Letters, Federal Health Insurance for the aged, transmittals of bill, vouchers, and schedules and any addendums to the ICD-9-CM coding volumes. Responds to inquiries and administrative problems brought to the service Unit Director's office by members of the staff and officials of the Area Office, State, and local governments, other hospitals and institutions, other federal agencies and various tribal officials. Notifies the appropriate staff officials of the response or follows up to ensure a timely response by others. KNOWLEDGE REQUIRED Knowledge of, and the ability to apply the Alternate Resources regulations, P.L. 93-437, "The Indian Healthcare Improvement Act". Knowledge of the total program, operation, priorities and goals of the Alternate Resources program. Ability to keep abreast of current changes in policies, regulations on eligibility, medical terminology, anatomy and physiology, diagnostic and financial coding. Participates in planning, implementation, and improvements of the Alternate Resource program. Knowledge of ICD-9-CM coding procedures, abbreviations, and terms used in the ICD-9-CM coding volumes and AMA CPT-4 coding system in order to acquire, interpret and resolve problems bases on information derived from system monitoring reports to be carried over to the HFA 1500 forms. Knowledge and understanding of established and standardized bookkeeping and accounting procedures and techniques sufficient to handle duties, such as classifying account transactions associated with the Alternate Resources procedures. Knowledge of established procedures, required forms associated with the various health insurance programs. Qualified typist is required, with knowledge of grammar, spelling, punctuation, and require formats. GUIDELINES The incumbent utilizes a number of substantive guidelines. The incumbent uses judgment in locating and selecting the most appropriate guidelines, references and procedures for application and in making minor deviations to adapt the guidelines to specific cases. Written guidelines are found in the IHS manual, circulars, technical manuals, policy and procedure manuals, JCAHO directives, Medicaid/Medicare and CHS regulations. Judgment is used in locating and selecting the most appropriate guidelines, references, and procedures. Makes minor deviations to adapt guidelines to specific cases. COMPLEXITY The work consists of duties that involve difference and unrelated processes and methods. The complexity of the work involves working with various programs, which cover different states, with each health insurance program having difference benefits, deductibles and eligibility requirements. The work involves obtaining not only demographic data, but also eligibility information and whether or not alternate resources (e.g. Medicaid, Medicare, and private insurance) are available for all patients served at this facility. Incumbent must be able to effectively communicate to the patient what specific information is needed, the reason for requesting such information, and be able to ascertain that it is as accurate as possible. Consequences of obtaining inaccurate information may delay necessary medical treatment and cause unnecessary frustration and problems. SCOPE AND EFFECT The incumbent is responsible for submitting insurance claims and follow up on denied claims. The successful efforts of the incumbent directly affect the funds collected. PERSONAL CONTACTS The incumbent has regular and recurring contacts with patients, employees, in the same agency, State and local Welfare agencies, health insurance carriers, Fiscal Intermediaries, etc. PURPOSE OF CONTRACTS The purpose of these contacts are to plan and coordinate the work of the office, resolving problems regarding billing claims and following up to ensure that required actions are completed and resolving differences in costs of initial awards presented for the clinic services. PHYSICAL DEMANDS The work is primarily sedentary with some carrying of computer reports and ledgers. Some walking is required since interaction between all disciplines with the IHS facility is required. WORK ENVIRONMENT The work is usually performed in an office setting. WORK SCHEDULE The contract work schedule shall not exceed 40 hours a week. Work days are Monday-Friday. Work hours are 8:00am - 5:00pm or as directed by the project monitor. Project Monitor: Ann Blackbird, Business Office Manager, is the designated Project Monitor. Ms. Blackbird is responsible for monitoring contract performance/compliance, funds status and if necessary, recommending contract changes to the Contracting Officer. OTHER FACTORS The Privacy Act of 1974 mandates that the incumbent shall maintain complete confidentiality of all administrative, medical, and personnel records, and all other pertinent information that comes to his/her attention or knowledge. The Privacy Act carries both civil and criminal penalties for unlawful disclosure of records. Violations of such confidentiality shall be cause for adverse action. CLAUSES INCORPORATED BY FULL TEXT: Please note that due to character limitation in FedBizOpps, full text of the Federal Acquisition Regulation (FAR) and Health and Human Services Acquisition Regulations (HHSAR) can be accessed on the Internet at http://www.farsite.hill.af.mil. The provisions of 52.212-1, Instructions to Offerors-Commercial Items (Nov 2007), applies to this acquisition. In addition to the information required in FAR 52.212-1, Contractors shall provide the following: (1) completed "Temporary Waiver of Character Investigation" and "Declaration for Federal Employment" form (2) two past performance references to include the contact name phone number, contract number, company name, brief description of project (3) All-inclusive hourly rate for services, approximate number of hours is 2080 for the period September 1 2009 to August 31 2010 (4) Dun and Bradstreet Number (note: Contractors must be registered in the Central Contractor Registration to be eligible for award. This can be done at http://www.ccr.gov). The provisions of 52.212-2, Evaluation - Commercial Items (Jan 1999) applies to this acquisition. The Government intends to award one from this solicitation to the responsible offeror(s) whose offer conforming to the solicitation will be the most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate quotes: (1) Price; (2) Qualifications; (3) Past Performance; (4) compliance with Indian Child Protection requirements. If items 2,3,and 4 are all within the bid, then item 1 (price) will be the determining factor for award. Quotes shall include a completed copy of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Items (Nov 2007) or indicate certifications in ORCA at https://orca@bpn,gov. The clause at FAR 52.212-4, Contract Terms and Conditions-Commercial Items (Oct 2008), applies to this acquisition. The following FAR and HHSAR clauses apply: 52.204-7 Central Contractor Registration (July 2006), 52.204-9 Personal Identity Verification of Contractor Personnel (Sept 2007), 52.223-6 Drug-free Workplace (May 2001), 352.224-70 Confidentiality of Information (April 1984), 352.270-17 Crime Control Act-Reporting of Child Abuse (Jan 2006) and 352.270-18 Crime Control Act-Requirement for Background Checks (Jan 2006). The clause at FAR 52.212-5, Contract Terms and Conditions Required to Implement Statues or Executive Orders-Commercial Items (Jan 2009) applies to this acquisition. The following clauses apply: 52.203-6, Restriction on Subcontractor Sales to the Government (Sept. 2006); 52.219-6, Notice of Total Small Business Set-Aside (June 2003); 52.222-3, Convict Labor (June 2003); 52.222-21, Prohibition of Segregated Facilities (Feb 1999); 52.222-26, Equal Opportunity (Mar 2007); 52.222-36, Affirmative Action for Workers with Disabilities (June 1998); 52.222-50, Combating Trafficking in Persons (Aug 2007); 52.232-33, Payment by Electronic Funds Transfer-Central Contractor Registration (Oct 2003); 352-270-18 Crime Control Act-Requirement for Background Checks (Jan 2006). EVALUATION CRITERIA Technical as well as price will be a deciding factor for award of a purchase order. The due date for this requirement is August 14 2009. THE INDIAN HEALTH SERVICE WILL NOT CONSIDER YOUR QUOTE FOR AWARD IF YOU FAIL TO RESPOND TO THESE EVALUATION CRITERIA AS FOLLOWS: A) registration in the Central Contracting Registration (CCR) database (reference www.ccr.gov) B) Propose and provide an all inclusive hourly rate for services. The estimated quantity is 2080 hours from the period September 1 2009 to August 31 2010. The estimated start date of award is September 1 2009. C) Provide a "Temporary Waiver of Character Investigation" and "Declaration for Federal Employment" (this will be attached with the solicitation) D) Certifications in ORCA at https://orca@bpn.gov. E) Two past performance references to include the contact name phone number, contract number, company name, brief description of project
 

Web Link

FBO.gov Permalink
(https://www.fbo.gov/spg/HHS/IHS/IHS-Oklahoma/246-09-Q-0041/listing.html)
 

Place of Performance

Address: Haskell Indian Health Center, 2415 Massachusetts Street, Lawrence, Kansas, 66046, United States

Zip Code: 66046
 

Record

SN01895117-W 20090802/090801000029-3f2ee1276d617458c1ab14437d141159 (fbodaily.com)
 

Source

FedBizOpps Link to This Notice
(may not be valid after Archive Date)

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