Health Care Financing Administration 7500 Security Blvd., Baltimore, MD 21244-1850

D -- COORDINATION OF BENEFITS (COB) POC Debbie Strittmatter, Contract Specialist, (410)786-5136. The Health Care Financing Administration (HCFA) is seeking to identify sources of services to collect, manage, and provide to HCFA information on health insurance coverage in addition to Medicare on 38 million Medicare beneficiaries for the purpose of implementing an overall strategy of coordination of Medicare insurance benefits with these other insurance coverages. HCFA intends to develop a coordination of benefits operation that will provide quality customer service to providers and beneficiaries by speeding their payment while assuring the integrity of the Medicare Trust Funds. To further that goal, HCFA will seek a single entity to maintain a comprehensive insurance profile on all Medicare beneficiaries. Offerors will conduct beneficiary surveys requesting information on the existence of health insurance coverage other than Medicare, on approximately 200,000 newly enrolled Medicare beneficiaries monthly in accordance with Public Law 103.432 (Medicare Secondary Payer Reforms). Offerors will also conduct an annual survey on approximately 500,000 employers soliciting other health insurance coverage of selected Medicare beneficiaries in employer group health plans in accordance with 42 U.S.C. 1395y(b)(5) (IRS/SSA/HCFA Data Match). Offerors will tabulate and evaluate the information resulting from these surveys and forward the pertinent information to HCFA on an ongoing basis. Offerors will negotiate and maintain agreements between HCFA and other health insurers (and State Medicaid Agencies) for the exchange of eligibility and paid claims data for purposes of coordinating correct health claim benefit payments by Medicare and other insurers. Offerors will also maintain and operate the national registry currently being built by HCFA that will enumerate other payers of health insurance claims.. Offerors will bill and collect claims transfer fees from other insurers. Offerors will maintain customer service staff to validate insurance information for the purpose of resolving discrepant information and maintain electronic interfaces with HCFA to update beneficiary records with other insurance information. Offerors interested in documenting their background experience and capability to provide the services above should respond to this synopsis within 30 days of publication. The following specific information is requested: (1) company descriptive literature, (2) outline your background work experience with related work examples, especially in the process of collecting information through the use of large scale surveys and negotiating agreements (3) indicate your existing data processing capabilities and experience with large scale data collection, tabulation, and evaluation. This should include experience with the use of bar code, optical scanning and intelligent character recognition technology. This synopsis is for information purposes only, does not constitute an RFP, and is not to be construed as a commitment by the Government. The information you provide will be evaluated to identify capable potential sources if funding is allocated for this effort. Your response should be limited to 25 pages or less. Respondents will be included on any mailing list for any RFP that may result from this Sources Sought. The Government does not intend to award a contract on the basis of this notice or otherwise pay for any information solicited. Firms must specify a name and telephone number of a point of contact and indicate their size status under Standard Industrial Classification (SIC) 7374 which has a size standard of $14.5 million (see FAR 19.102). Interested firms should submit appropriate documentation on their capability to HCFA, OAG, Attn: Debbie Strittmatter, C2-21-15, 7500 Security Blvd., Baltimore, MD 21244. (0262)

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