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

R -- NATIONAL 1-800 BENEFICIARY TELEPHONE CUSTOMER SERVICE INQUIRY OPERATION POC Debbie Strittmatter, Contract Specialist, (410)786-5136. The Health Care Financing Administration (HCFA) intends to award an Indefinite Delivery Indefinite Quantity (IDIQ) contract to operate a national 1-800 beneficiary telephone customer service inquiry operation. The objective of the national 1-800 telephone number is to improve service to HCFA beneficiaries by initially providing beneficiaries the convenience of one number and ultimately by standardizing customer telephone contacts. The current beneficiary call volume experienced by HCFA's existing agents exceeds 30 million annually and may increase when the 1-800 number becomes fully operational. The 1-800 number will undergo three phases of implementation: 1) Operation of a currently existing hotline to answer inquiries from beneficiaries and the general public regarding the Medicare health insurance program, especially questions regarding health insurance to supplement Medicare (Medigap policies), complaints of Medigap sales practices, reports of suspected Medicare waste, fraud and abuse, second opinions for non-emergency surgery, and distribution of requested publications. Operators will answer basic beneficiary inquiries and refer calls to appropriate Agents/Partner, including: Carriers; Fiscal Intermediaries; End Stage Renal Disease Network Organizations; Peer Review Organizations; Information, Counseling and Assistance Grantees; State Medicaid Agencies; or HCFA's Central or Regional Offices; 2) Operation of a new single point of access 1-800 beneficiary telephone number. Customer service representatives will route voice calls coming into the 1-800 number from 1 to 10 states (not yet designated) initially to the appropriate HCFA Agent/Partners. This receipt/routing function will be expanded to cover the United States, Virgin Islands, and Puerto Rico. The purpose of the single point of access is to improve customer service for Medicare beneficiaries, however, we anticipate that there will be some calls not directly related to Medicare, e.g. dual eligible beneficiary inquiries about Medicaid; and 3) Piloting approaches and potentially expanding services to deliver structured responses to non-complex, beneficiary non-claim inquiries beyond those described above. These pilots and services could include responding to inquiries through a variety of media (Internet, fax, U.S. mail, and telephone) for HCFA-related programs and information. Full expanded service capacity could result in excess of 30 million inquiries. In addition, the contractor will continue to route all beneficiary claims calls to appropriate Agents/Partners. Information and experience gained from these pilots and for the services provided under this contract will be used to develop and award contracts for full-service customer service centers. These full customer service center contracts are anticipated no earlier than FY 2000. HCFA is seeking qualified, expert customer service vendors with demonstrated abilities in national 1-800 telephone call management of a similar scale. Some knowledge of health care and HCFA is preferred, and extensive knowledge of 1-800 telephone call operations and management, as well as customer service, is necessary. The vendor must also possess experience in all logistical aspects of national 1-800 telephone startup, operations and management. It is essential that the contractor be free of all perceived or actual conflicts with HCFA's purpose in undertaking this contract such as the operation or sale of managed care plans, Medigap policies, durable medical equipment, dialysis services, or any other related provider groups, products or services. Specifically, the contractor must not have any relationships or arrangements through its business operations or its employees that could be considered as lessening the company's objectivity concerning any aspect of the referrals or information provided to the beneficiaries. The contractor must provide information that demonstrates it is free of any potential biases and disclose any potential conflicts for evaluation by HCFA. Proposals which do not comply with the conflict of interest provisions and mandatory qualification standards will not be considered. A draft Request For Proposals (RFP) is scheduled for release in mid-January 1997. A pre-solicitation conference is scheduled for January 30, 1997. Potential offerors are invited to bring no more than five representatives from each prime and each subcontractor. Expressions of interest to attend the pre-solicitation conference should be made by January 24, 1997 by contacting Debbie Strittmatter, Contract Specialist, at (410) 786-5136. Additional information regarding the logistics of the conference will be provided with the draft RFP. Vendors desiring a hard copy of the draft RFP should send their requests to be included on the bidder's list to the address listed above. All requests for the draft RFP should specify vendor size and status under SIC code 7389. Telephone requests for the RFP will not be accepted. It is anticipated that the formal solicitation will be available on or about February 25, 1997. An electronic copy of the draft and formal solicitation will also be available via the Internet at http://www.hcfa.gov/about.htm. Written questions/comments concerning the draft RFP should be submitted no later than Feb 06, 1997 and may be faxed to (410)786-9088 (Attention Debbie Strittmatter) or sent via the Internet to dstrittmatter@hcfa.gov. For technical assistance in downloading from the Internet contact Jeff Stedding at (410) 786-0754. Procurement questions can be directed to Debbie Strittmatter, Contract Specialist, at (410) 786-5136. (0358)

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