DOCUMENT
R -- Evaluate inpatient, outpatient and specialty clinical documentation and coding accuracy. - Attachment
- Notice Date
- 4/8/2011
- Notice Type
- Attachment
- NAICS
- 561410
— Document Preparation Services
- Contracting Office
- Department of Veterans Affairs;VISN 6 Centralized Acquisition Service;100 Emancipation Drive;Hampton VA 23667
- ZIP Code
- 23667
- Solicitation Number
- VA24611RQ0159
- Response Due
- 4/15/2011
- Archive Date
- 6/14/2011
- Point of Contact
- Delmont Friday
- E-Mail Address
-
8-7082<br
- Small Business Set-Aside
- N/A
- Description
- The Department of Veterans Affairs Medical Center, Salem, Virginia, is seeking potential sources capable of providing Medical Review service of clinical documentation and coding accuracy services for VAMC Salem, VA. The purpose of the contract is to evaluate inpatient, outpatient and specialty clinical documentation and coding accuracy. The evaluation will ensure the appropriateness and compliance of health care claims submitted to commercial insurance companies and VA reimbursement facility is correct. The VA has developed and utilizes an integrated billing package that interfaces with the accounts receivable software, Quadramed. Claims are prepared for billable facility and professional services performed within VA Systems or purchased by VA. The integrated billing software includes a charge master with inpatient and outpatient charges. Following an episode of care, Health Information coders and/or clinicians assign appropriate ICD-9-CM, CPT-4, and HCPCS codes. Inpatient facility charges are specific to the patient's DRG and/or length of stay and include ancillary and room and board charges. Inpatient professional and outpatient facility charges are based on CPT codes. VA will provide the contractor with online access to the applicable claim forms, medical record, Quadramed, Chargemaster and patient registration information. The Offerer will develop the review sheets required for the Compliance and Business Integrity (CBI) data elements. The contractor shall provide all labor, materials, transportation, and supervision necessary to perform audit. The actual reviewer must have at least three years of experience reviewing claims in a large tertiary care hospital and outpatient health care organizations, as well as two years of education and training. Experience must include both institutional (UB-04) and professional (CMS 1500) claims. Reviewers are to have experience with the unique VA Special Category Determinations. The overall term for the initial phase of the project will be for 1 year following the award of the contract. The period of performance is from May 01, 2011 (or date of award) through April 30, 2012. Audits will be conducted on a quarterly basis. Any individual coder reviews shall be conducted during the fourth quarter of the fiscal year, reviewing the previous twelve-month's workload. The applicable NAICS Code is 561410 / Document Preparation Services / size standard $7.0Mil. No formal solicitation document exists at this time. Responses to this Sources Sought Notice should include the following: name and address of company; business size (large or small); identify whether or not firm falls into any of the following socioeconomic categories - 8(a), HUBZone, Service Disabled Veteran-Owned; firm's experience in providing Medical Review service of clinical documentation and coding accuracy services within the VAMC in a professional setting and any other pertinent information, which demonstrates ability to meet the above requirement. All responses shall be submitted in writing no later than Noon, April 15, 2011 local time to the attention of: Delmont Friday (90C), VAMC Hampton, 100 Emancipation Drive, Bldg. 27, Hampton, VA 23667. Fax number: 757-728-3132. E-mail address: delmont.friday@va.gov. If you have questions or need additional information, please contact Delmont Friday at 757-722-9961 ext 7507.
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/spg/VA/HaVAMC/VAMCCO80220/VA24611RQ0159/listing.html)
- Document(s)
- Attachment
- File Name: VA-246-11-RQ-0159 VA-246-11-RQ-0159.doc (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=189488&FileName=VA-246-11-RQ-0159-000.doc)
- Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=189488&FileName=VA-246-11-RQ-0159-000.doc
- Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
- File Name: VA-246-11-RQ-0159 VA-246-11-RQ-0159.doc (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=189488&FileName=VA-246-11-RQ-0159-000.doc)
- Record
- SN02420470-W 20110410/110408234501-1f17a66cb054772565d6a3ca55bc573f (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
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