Loren Data's SAM Daily™

FBO DAILY - FEDBIZOPPS ISSUE OF SEPTEMBER 21, 2013 FBO #4319
DOCUMENT

R -- 618-13-3-5155-0018 - Coding and Documentation Improvement - Attachment

Notice Date

9/19/2013
 

Notice Type

Attachment
 

NAICS

611430 — Professional and Management Development Training
 

Contracting Office

Department of Veterans Affairs;VA Black Hills HCS;Fort Meade Campus;113 Comanche Rd.;Fort Meade SD 57741
 

ZIP Code

57741
 

Solicitation Number

VA26313R3777
 

Response Due

10/9/2013
 

Archive Date

1/16/2014
 

Point of Contact

Pamela Phillips
 

E-Mail Address

e-mail
(pamela.phillips@va.gov)
 

Small Business Set-Aside

Total Small Business
 

Description

This is a preliminary notice the Minneapolis VA Healthcare System is seeking offerors to submit proposals to provide Coding and documentation improvement review and services according to the following statement of work. Statement of Work Coding and Documentation Improvement Review and Training 1.INTRODUCTION: The Minneapolis VA HCS Business Office is charged with auditing, monitoring, improving and educating providers and coders for correct coding of services, diagnoses, and procedures, and on complete and accurate documentation to ensure the correct coding, as well as for communication, billing and funding of inpatient care. A VHA compliance requirement is to perform external chart audits and the goal is to improve documentation to accurately reflect care and services provided in order to more accurately and completely code and report these services. In addition, the complete and accurate documentation of diagnoses, procedures and services performed is critical to the appropriate optimal funding. Clinical documentation is the basis on which MVAHCS is funded, either through VERA or third party insurance. Physicians must be educated on documentation requirements and how their documentation impacts our financial bottom line and qualify indicators of the hospital. Financial potency is dependent on what is documented not what was performed. 2.SCOPE: The Contractor will be highly skilled, experienced and established in the medical field, (MD,DO, CNS/NP, PA, RN or other highly qualified trainers) in the education of physician level providers and medical coders. The Contractor will perform an independent review on site of inpatient medical records, based on available laboratory, radiological, treatment records, clinical notes and acceptable medical practice. Data gleaned from these reviews will be used to determine opportunities for improved coding and documentation for coding staff and physicians. The Contractor will relay findings and the opportunities for improvement back to the coding and clinical staff in an educational format to include inservice, department/service meetings, and written communication. The Contractor will also educate coding staff on identifying opportunities to query physicians for more complete and detailed documentation in order to assign more accurate diagnostic and procedure codes. The accurate and complete documentation of patient services will allow the coding staff to more accurately and completely assign diagnostic codes to services. The accurate and complete assignment of diagnostic codes classifies patients in the most appropriate DRG and/or VERA pricing group. The Contractor will review medical records based on DRG, diagnosis or VERA classification in for FY 2012 discharges encompassing the DRG, diagnoses, or VERA class most appropriate for a daily or weekly review utilizing their medical training, CMS rules and regulations, and VERA classifications to identify opportunity for coder education on pathophysiology as it relates to coding, appropriate query process of physicians, and physician education on appropriate documentation and verbiage. The VERA criteria for inclusion into many high classes is dependent on documentation of diagnoses and correct coding and sequencing. Improvement in documentation and coding would increase the number of patients in the higher price groups. For those patients with insurance, complete and accurate documentation provides assurance the patient is grouped to the appropriate level of severity DRG and the appropriate reasonable charges for the hospital stay are assigned. Improving documentation and coding impacts the amount Minneapolis is reimbursed for patients with insurance. Improved clinical documentation will result in higher DRG's which more accurately reflect the highly complex medical care delivered to our acutely ill and complex patients and a more accurate medical record. An outside consultant can assist our medical staff to concisely document the complex care delivered and work more efficiently. Service will commence within 30 days of award, initial audit, analysis and training within 30 days of start, and follow up audit, analysis and training completed no later than 90 days after completion of initial audit, analysis and training. 3.DEFINITIONS: CMS - Centers for Medicare and Medicaid Services DRG - Diagnostic Related Group VERA - Veterans Equitable Resource Allocation VISN - Veterans Integrated Service Networks ICD - International Classification of Disease CPT-Current Procedural Terminology 4.GOVERNMENT-FURNISHED PROPERTY AND INFORMATION: The Minneapolis VA will provide the Contractor the option of using certain Government owned facilities and utilities for use only in connection with this contract. This will include classroom/conference room, audio-visual equipment as needed, computer hardware and software as needed, workstation. The Minneapolis VA will provide electronic patient medical records. 5.CONTRACTOR FURNISHED ITEMS: The contractor shall provide all necessary instructional materials and handouts. The contractor shall provide a medical doctor for chart review and for education of medical and coding staff. The contractor will abide by HIPAA, Privacy and Security rules. The Physician Contractor will be responsible for providing oral and written recommendations on findings to medical center leadership, medical staff, and Business Office staff. 6.SPECIFIC TASKS: The contractor shall conduct thorough chart reviews based on Scope criteria to identify documentation omissions or ambiguities, and coding errors or omissions. The Contractor shall provide to the medical staff information based on medical doctorate training and CMS rules and regulations techniques and verbiage appropriate to improve documentation and understanding of patient's encounter and allow more accurate coding by coding staff. The contractor shall provide results of coding audits to coders, develop skill assessments and instructional material for coding staff based on audit results and provide coders additional guidance in order for coders to improve accuracy of coding and to query physicians appropriately to obtain more definitive documentation to assign more accurate codes that reflect the complex care delivered. The contractor will conduct a follow-up assessment of provider documentation and coder accuracy within a time frame agreed up with agency. The contractor will provide additional training and support as required based on results of follow up assessment to providers and coding staff. The solicitation will be posted on the Federal Business Opportunities (FBO) website on approximately September 23, 2013. Contracting Office Address: VA Black Hills Health Care System, 113 Comanche Road, Ft. Meade, SD, 57741. Point of Contact: Pamela Phillips, Contract Specialist; 605-720-7020; Pamela.phillips@va.gov
 

Web Link

FBO.gov Permalink
(https://www.fbo.gov/spg/VA/VABHHCS568/VABHHCS568/VA26313R3777/listing.html)
 

Document(s)

Attachment
 

File Name: VA263-13-R-3777 VA263-13-R-3777_1.docx (https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=1012356&FileName=VA263-13-R-3777-000.docx)

Link: https://www.vendorportal.ecms.va.gov/FBODocumentServer/DocumentServer.aspx?DocumentId=1012356&FileName=VA263-13-R-3777-000.docx

 

Note: If links are broken, refer to Point of Contact above or contact the FBO Help Desk at 877-472-3779.
 

Place of Performance

Address: 113 Comanche Road;Fort Meade, SD

Zip Code: 57741
 

Record

SN03195883-W 20130921/130920000308-a51889f29bc0ce30926c2ae5d5288f22 (fbodaily.com)
 

Source

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

---

| FSG Index  |  This Issue's Index  |  Today's FBO Daily Index Page |