37th Contracting Squadron, 1655 Selfridge Avenue, Lackland AFB, TX 78236-5253

R -- COMPOSITE HEALTH CARE SYSTEMS (CHCS) AND THIRD PARTY OUTPATIENT COLLECTION (TPC) SYSTEM -- NEW GENERATION (TPOCS-NG) DATA ENTRY AND INSURANCE PROCESSING REQUIREMENTS SOL F41636-98-R0042 DUE 040698 POC Johnie Johnson, Voice (210)671-1762, Fax (210)671-1199 E-MAIL: Click here to contact the Contracting Officer by E-mail., johnsonjo@lakgate1.lak.aetc.af.mil. This is a combined synopsis and solicitation for commercial items (non-personal services), prepared in accordance with the format in FAR Subpart 12.6 as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. This solicitation is issued as a request for proposal (RFP). Submit written offers (no oral ones), on RFP F41636-98-R0042. All Statement of Need and Evaluation Factor requirements must be meet as they appear in this notice. This procurement is being issued as UNRESTRICTED. This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 97-04 and Defense Acquisition Circular 91-13. Standard Industrial Code 6411 applies to this procurement. The provisions at FAR 52.222-41, "Service Contract Act of 1965," as amended applies to this solicitation. The employee classes are 01117 General Clerk III and 01118 General Clerk IV. U.S. Department of Labor, Wage Determination Number 94-2521 revision 15 (11/26/1997) is applicable to this requirement. Period of performance is five and one-half (5 1/2) months to run from 16 April 1998 through 30 Sept 98. FOB: Destination for delivery to Wilford Hall Medical Center (WHMC), 2000 Berquist Drive, Lackland AFB, TX 78236. The provisions at FAR 52.212-1, Instructions to Offerors -- Commercial Items, applies to this acquisition. The provisions at FAR 52.212-2, Evaluation -- Commercial Items, applies to this solicitation. The clause at FAR 52.212-3, Offeror Representations and Certifications -- Commercial Items, applies to this solicitation and the offeror must include a completed copy of this provision with their proposal. The clause at FAR 52.212-5, Contract Terms and Conditions Required To Implement Statutes or Executive Orders -- Commercial Items, applies to this solicitation. Specifically, the following clauses, cited are applicable to this solicitation: FAR 52.222-26, Equal Opportunity; FAR 52.222-35, Affirmative Action for Disabled Veterans and Veterans of the Vietnam Era; FAR 52.222-36, Affirmative Action for Handicapped Workers; FAR 52.222-37, Employment Reports on Disabled Veterans and Veterans of the Vietnam Era; FAR 52.222-42, Statement of Equivalent Rates for Federal Hires. The clause at DFARS 252.212-7001, Contract Terms and Conditions Required to Implement Statues or Executive Orders applicable to Defense Acquisition of Commercial Items, applies to this solicitation. Specifically, the following clauses, cited are applicable to this solicitation: DFARS 252.225-7001, Buy American Act and Balance of Payment Program. The clause at FAR 52.212-4, Contract Terms and Conditions -- Commercial Items, applies to this solicitation. The clause at FAR 52.224-1, Privacy Act Notification and FAR 52.224-2, Privacy Act applies to this solicitation. The clause at FAR 52.215-1, Instructions to Offerors -- Competitive Acquisitions applies to this solicitation. Award will be based on technical capability and past performance equal to lowest price, responsible offer. The Government intends to evaluate and award without discussions on this procurement. All proposals must be mailed to POC Johnie Johnson at 37 CONS/LGCX, 1655 Selfridge Avenue, Room 204, Lackland AFB, TX 78236-5253. Proposals must be on a per month basis for the services to be provided. Proposals are required to be received no later than 4:00 PM CST, 6 April 98, a period of acceptance must be indicated on the proposal and must be good for 30 days. Award will be made on or about 13 April 98. STATEMENT OF NEED (SON) for THIRD PARTY COLLECTION SERVICES. The contractor will provide all labor services necessary to effect timely and efficient TPCs as well as train onsite Government employees. Services are to be provided Monday thru Friday with normal duty hours of 7:30 AM -- 4:30 PM. Normal Federal Holidays will be observed. 1.0 Claims Clerk Trainers: (a) Must be proficient in Composite Health Care System (CHCS) and Third Party Outpatient Collection System New Generation (TPOCS-NG) data entry and insurance processing requirements. (b) Provide hands-on training for outpatient claims processing to include all aspects of information gathering, clinic-specific diagnosis and procedure coding, data entry, claim editing, electronic billing, posting payments and adjustments, closing accounts, and reporting. (c) Train government staff (6 each) on the billing and collection procedures of various individual insurance companies, as well as federal, state, and local insurance regulations. (d) Training of government staff (6 each) on outpatient claims and individual insurance billing processes shall be completed no later than 30 September 1998. (e) Continue public relations activities in each clinic to facilitate the transition from contract to government support and to ensure the continued success of the collection program. 2.0 Contract Manager/Supervisor: (a) Must be proficient in CHCS, Ambulatory Data System (ADS) and TPOCS-NG data entry, insurance processing, and reporting requirements: fulfill role of TPOCS-NG system administrator and act as consultant to clinics on appropriateness of ADS "bubble sheet" coding templates. (b) Must be proficient in current federal, state, and local insurance regulations, to include Medicare and Medicaid. (c) Must be proficient in medical terminology, anatomy and physiology, current diagnosis and procedure coding (to include International Classification of Disease, Common Procedural Terminology, Ambulatory Procedure Group, Diagnosis Related Group, and Resource Based Relative Value Scale coding requirements). (d) Review annual projections and maintain the optimal collection rate of all third party accounts. (e) Ensure a 100% claim processing rate of all billable, coded patient encounters. (f) Ensure proficiency of all government claims clerks is achieved through a thorough training program that includes each of the skills listed above. (g) Continue established third party collection education and trainingprograms for WHMC provider and support staff. 3.0 Contractor: (a) The Contractor shall ensure that all applicable Joint Commissions on Accreditation of Health Care Organizations standards shall be met during the performance of this contract. (b) The Contractor will ensure that sufficient contractor claims clerk trainers are available for workload involved. The following four (4) Technical Evaluation Factors will be used to evaluate proposals received; they are of equal importance. FACTOR 1: ACKNOWLEDGMENT AND UNDERSTANDING OF THE STATEMENT OF NEED (SON). Required: (a) Explain in detail how the requirements of the SON will be satisfied. Description should include the offeror's understanding of the following management approach to the execution/application of that understanding: (i) Projected capability to provide TPOCS operations and training for TPC clerks; (ii) Phase-in procedure to include identifying and disposing of existing backlog; (iii) Rendering required reports; and (iv) Understanding the overall mission of the TPC Department. Required (b): A Functional Quality Control Plan explaining practices that will assure all services and training required by the SON, are performed and provided in a manner that satisfies the SON requirements. Required: (c) The offeror shall provide a detailed contingency plan along with explanations as to how coverage can be provided during emergencies or during labor problems. FACTOR 2: CAPACITY TO MEET SON REQUIREMENTS. Required: (a) The offeror shall provide evidence of the ability to obtain necessary personnel, supervision, and a training program. Required: (b) The offeror shall submit a well-defined manning chart with explanations of how daily coverage will be provided. FACTOR 3: CONTRACTOR'S PROFESSIONAL EXPERIENCE. Required: The offeror shall provide evidence outlining experience in the services as described in this solicitation. This experience can be both commercial and/or government. The outline is to list past and present contracts (for the last ten years) by contract number, address and point of contact, number of year's experience, and dollar value of each contract. FACTOR 4: ORGANIZATIONAL AND PERSONNEL QUALIFICATIONS. Required: (a) The offeror shall provide a well-defined organizational structure chart reflecting lines of management, and supervisory responsibilities, functions and labor categories (position titles). Required: (b) The offeror shall employ only qualified personnel by submission of resumes and copies of credentials. The offeror shall provide evidence showing a contract manager possessing administrative knowledge and experience as a supervisor in a same or similar type requirement. Required (c) The offeror shall state the extent of authority and role of the contract manager and any other positions of authority. Required: (d) The offeror shall describe the methods and provide examples of how the firm documents the experience and competence of TPC clerks. Required: (e) The offeror shall provide evidence of ability to plan, control, and integrate personnel necessary for successful contract performance. Offerors are cautioned that their technical proposal must not exceed 30 typed (12 pitch) pages. There is no special format for the technical proposal; however, it should be assembled in an orderly manner that can be easily followed. (0082)

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