SOURCES SOUGHT
R -- Medical Coding Auditing Support (CONUS & OCONUS)
- Notice Date
- 4/14/2022 9:09:27 AM
- Notice Type
- Sources Sought
- NAICS
- 541219
— Other Accounting Services
- Contracting Office
- GSA FAS AAS REGION 7 FORT WORTH TX 76102 USA
- ZIP Code
- 76102
- Solicitation Number
- 47QFA22Fxxx1
- Response Due
- 5/13/2022 1:00:00 PM
- Point of Contact
- Michael Dargan, Phone: 210-213-4697, Daniel Bresnahan, Phone: 210-306-2962
- E-Mail Address
-
michael.dargan@gsa.gov, daniel.bresnahan@gsa.gov
(michael.dargan@gsa.gov, daniel.bresnahan@gsa.gov)
- Description
- ADVANCED NOTICE AND SOURCES SOUGHT Medical Coding Auditing Support (CONUS & OCONUS) THIS SOURCES SOUGHT IS NOT A REQUEST FOR PROPOSAL Purpose: The General Services Administration (GSA) Assisted Acquisition Service (AAS) Region 7 is providing advanced notice of an upcoming opportunity to provide world-class healthcare for our beneficiaries anywhere, anytime. Medical coding provides value to the patient and supports Defense Health Agency (DHA) mission by playing an integral role in workload, reimbursement, provider currency, decision support, population health, disability services, and more. The purpose of this notice is Multi-faceted: to provide advanced notice of this requirement to the vendor community in order to better support vendor planning and prioritization efforts through early engagement; to enable any and all capable vendors to submit to the GSA their expressions of affirmative interest in supporting this requirement, which supports: a more robust competitive solicitation process; selection of the most appropriate contractual vehicle; selection of the most appropriate and effective evaluation methodology; and to enable the vendor community to understand GSA AAS Region 7�s processes so as to promote greater transparency into upcoming projects, methodologies, and processes. The DHA has a requirement to acquire high quality, professional medical coding compliance services to support all military treatment facilities (MTFs) to consist of performance of clinical documentation improvement, and medical coding compliance and revenue integrity activities and functions. GSA AAS provides custom acquisition, project, and financial management support services to federal agencies, including the DHA. GSA AAS is conducting this acquisition on behalf of the DHA, supporting the full acquisition lifecycle in support of the DHA�s core mission activities. Anticipated Scope: The scope of this work will be to provide systematic, unbiased, independent examination of medical documentation and coding to validate that all codes entered into the Military Health System (MHS) systems are in conformity with official coding policies, regulations, requirements, and standards. The task involves developing or following a disciplined, systematic process that defines what is to be audited and why, how errors are defined and reported, what documentation and official guidance is required, and how results are reported. The primary area of support is medical coding training with eight (8) specific tasks: Task 1: �Verifies the accuracy of the diagnosis, procedure, supply codes, modifiers, and sequencing for the professional and institutional (facility) components of Inpatient, External Resource Sharing Agreement (ERSA), Ambulatory Procedure Visit (APV), Observation, Emergency Department (ED), and Outpatient encounters. Codes audited include International Classification of Diseases, Clinical Modification (ICD-CM), International Classification of Diseases, Procedural Classification System (PCS), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and modifiers. Assigns errors IAW DHA MCPO policies, procedures, rules, and standards, and provides clear, concise, official coding guidance, rationale, and reasons for assigning specific errors. Ensures strict confidentiality of medical records and audit findings. Task 2: �Provides second-level review of coding assignment to ensure compliance with legal and procedural policies to ensure optimal reimbursements while adhering to regulation prohibiting unbundling and other questionable practices. Reviews encounter and/or record documentation to identify inconsistencies or discrepancies that may cause inaccurate coding, medico-legal repercussions, or impacts quality patient care. Identifies any problems with legibility, abbreviations, etc., and brings to the provider�s attention. Examines records for proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained. Task 3: �Provides each assigned MTF with coding audit accuracy data needed to complete their monthly Data Quality Review List/Statement and collaborate on the explanation and action plan to correct any measures not meeting performance standards IAW DHA MCPO policies, procedures, rules, and standards. May also perform focused audits of DHA MTFs, specialties, clinics, or providers IAW DHA MCPO guidelines, rules, and standards. Task 4: �Research, analyze, and respond to inquiries, including focused audits, inappropriate coding, and adherence to Military Health System (MHS) coding guidelines. Task 5: �Conducts or participates in reviews and evaluations of DHA MCPO operations to determine progress, conformity to program requirements and identifies deficiencies and problems affecting cost and delivery of services. Recommends corrective action and methods to resolve problems and achieve compliance with policy. Provides general consultation and technical guidance in the establishment of new or redefined DHA MCPO operating program guides, policies, and procedures. Plans and conducts projects to gather and analyze data which will improve organizational performance. Prepares reports associated with projects conducted. Prepare communication for widespread distribution within the organization. Develop reports related to productivity, operations, and utilization of resources to determine the effectiveness of programs and to resolve problems of significant consequences. Assists with developing, editing, maintaining, and updating coding compliance plans. Task 6: �Assists the DHA MCPO in developing an annual work plan of analysis, audit, and investigative items. Stays abreast of changes in Federal laws, Department of Health and Human Services Office of Inspector General (HHS- OIG), DoD, and DHA regulations, and commercial policies involving or affecting compliance. Collaborates with DHA /MAJCOM/MTF leadership and clinical staffs in identifying and resolving compliance issues. Task 7: �Assists the DHA MCPO in monitoring coding compliance through performing audits of DHA coders in a double-blind audit method IAW DHA MCPO guidelines, rules, and standards; and performing focused audits of DHA MTFs, specialties, clinics, or providers IAW DHA MCPO guidelines, rules, and standards. This involves accurately analyzing diagnosis, procedure, and supply codes for the professional and institutional (facility) components of Inpatient, External Resource Sharing Agreement (ERSA), Ambulatory Procedure Visit (APV), Observation, Emergency Department (ED), and Outpatient encounters. Codes assigned include International Classification of Diseases, Clinical Modification (ICD- CM), International Classification of Diseases, Procedural Classification System (PCS), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and modifiers. The task also involves exercising independent and objective judgment in assigning errors, providing a rational and citing official guidelines, policies, regulations, rules, or standards as reference for assignment of errors. � Task 8:� Professionally interact with MTF staff and other coders from different companies regarding coding and documentation rules, policies, procedures, and regulations. Obtain clarification of conflicting, ambiguous, or non-specific documentation. Provide advice, assistance, and technical support to MTF staff, Medical Coders, reviewers, Medical Coding Compliance Specialists, and Medical Coding Trainers as appropriate regarding official coding guidance and regulatory provisions. Anticipated Work locations: This effort is anticipated to require support within the contractor�s facility and/or remote locations. Anticipated Magnitude: GSA anticipates an increase in scope from the current awarded contract since all DHA MTFs (Across DoD) maybe included in this requirement. The below is an estimate which will be further defined at solicitation. The magnitude of this work, based upon contractual history extrapolated into the future is anticipated to be: $2M - $4M per year (Estimated based on potential scope increase) 24 Full Time Equivalent (FTE) per year (1 FTE lead medical coding auditor and 23 FTE medical coding auditors). Additional FTEs may be ordered in option years, subject to funding authorization and availability Anticipated Period of Performance (PoP): The anticipated PoP of this requirement is: 04/01/2023 � 03/31/2024 (Base) 04/01/2024 � 03/31/2025 (Option 1) 04/01/2025 � 03/31/2026 (Option 2) 04/01/2027 � 03/31/2028 (Option 3) 04/01/2028 � 03/31/2029 (Option 4) Anticipated Evaluation Methodology:� TBD History: This project was initially awarded against the OASIS Pool 2 Unrestricted contract to SERCO, Inc. via contract GS00Q14OADU219, task order (TO) � 47QFWA18F0017. The period of this TO is from October 1, 2017, thru September 30, 2022. GSA anticipates exercising the six (6) month extension of services clause and/or awarding a bridge TO in order to provide unbroken support for this work during GSA AAS Region 7�s period of market research, solicitation and award. Expressions of Interest: Vendors interested in this upcoming opportunity may submit their expressions of interest to the GSA Contracting Officer (CO) and Project Manager (PM) by providing a response that includes the following information, limited to no more than two (2) pages.� Vendor Name Vendor Address Name of any Best in Class (BIC) Contractual Vehicles held and associated Contract Numbers Name of any Joint Ventures (JVs) or Contractor Teaming Arrangements (CTAs) Name of any Best in Class (BIC) Contractual Vehicles held by JVs and CTAs and associated Contract Numbers List of Items or considerations that would make your firm more likely to bid on this requirement List of Items or considerations that would make your firm less likely to bid on this requirement Description of your firm�s capacity to support a requirement of this magnitude General description of your firm�s support on behalf of similar requirements in the past The vendor�s expression of interest response shall be in the form of an email entitled �Medical Coding Compliance Specialists FY23 Expression of Interest: �Vendor Name� to the email addresses below: The vendor will submit all responses to this sources sought notice to the Acquisition Project Manager (PM), Daniel Bresnahan, via email to daniel.bresnahan@gsa.gov, and GSA Contracting Officer, Michael Dargan, michael.dargan@gsa.gov by May 13, 2022, NLT 3:00 PM CST. Please note that GSA AAS Region 7 is not seeking generalized �marketing� materials or generalized emails in response to this notice, but specific responses that address the items indicated above in order to precisely understand vendor capabilities, contractual vehicle capacities, and intent to provide a solicitation response to this specific requirement. Generalized marketing materials or responses that do not address the specific items described above, or which do not bear the email title described above, will not be considered in the market research phase of this acquisition. Follow-On Actions: Based upon responses received in response to this notice, GSA AAS Region 7 intends to hold a pre-solicitation conference in late Q3 or early Q4 of 2022 for the purposes of more precisely discussing the scope, selected follow-on contractual vehicle selection and competitive nature of the proposed solicitation, evaluation methodology and best-value selection process, anticipated milestone dates, and vendor Question and Answer (Q&A).� Note that at this time, GSA AAS Region 7 is not requesting vendors to provide questions, but only to supply an expression of interest in the format requested above. Vendors are responsible for properly marking and clearly identifying proprietary information or trade secrets contained within their response. The Government will not be liable for or suffer any consequential damages for any proprietary information not properly marked and clearly identified. Information provided shall be treated as Business Sensitive and will not be shared outside of Government activities and agencies without the permission of the provider.
- Web Link
-
SAM.gov Permalink
(https://sam.gov/opp/b153c4a94ee74447af5d8351448831a2/view)
- Place of Performance
- Address: USA
- Country: USA
- Country: USA
- Record
- SN06298884-F 20220416/220414234151 (samdaily.us)
- Source
-
SAM.gov Link to This Notice
(may not be valid after Archive Date)
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