Department of Veterans Affairs, Chief, ASC VISN 9/90, Alvin C, York, VA Medical Center, 3410 Lebanon Road, Murfreesboro, TN 37129

R -- CODING VALIDATION AND TRAINING SOL RFQ 249-99-01 DUE 032599 POC Sherri-Lyn Teeters, 615-867-6026 This is a combined synopsis/solicitation for commercial services prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; offers are being requested and a written solicitation will not be issued. Solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 97-10. This procurement is set-aside for small businesses and the SIC Code is 8742 and the small business size standard is $5.0 million. This solicitation is being issued as a Request for Quote (RFQ). All RFQ's are due on March 25, 1999, 4:00 p.m. local time. If mailed submit to Acquisition Service Center (VISN 9/90), Alvin C. York VAMC, 3410 Lebanon Pike, Murfreesboro, TN 37129. If hand carried deliver to: Acquisition Service Center, Alvin C. York VAMC, Building 5, 2nd Floor, Room 231. DESCRIPTION, QUANTITY, UNIT, UNIT PRICE, TOTAL: Bid Item 1: Contractor is to provide coding validation and training in strict accordance with the terms conditions and schedules listed herein. 1 JOB $_______ . Award will be based on participation of all VISN 9 VA medical centers, however for cost accounting purposes contractors must provide a breakdown for each VA Medical Center. (Huntington, WV; Murfreesboro, TN; Nashville, TN; Lexington, KY; Louisville, KY; Memphis, TN; Mtn. Home, TN). STATEMENT OF WORK: Consulting services are required for Veterans Integrated Service Network (VISN) 9, VA Medical Centers. The following description of each facility is provided to inform the contractor of the complexities and environmental impact of coding reviews: Nashville is a Level One facility for providing primary, secondary, and tertiary care in medicine, surgery, neurology and psychiatry. Nashville VAMC currently operates 160 of its 238 authorized beds. Murfreesboro's Alvin C. York VAMC provides primary and secondary care in acute medicine and surgery and a full range of psychiatric and extended care. The Level Three facility has 237 beds and an additional 135 beds in the nursing home care unit. Mountain Home's James H. Quillen VAMC is a Level Two facility providing primary, secondary, and tertiary care in medicine, surgery and psychiatry. The VAMC operates a 120 bed Nursing Home Care Unit, a 348 bed domiciliary and a modern 202 bed hospital. Memphis provides a full range of primary, secondary, tertiary care to medical, neurological, psychiatric, rehabilitation, spinal cord injury, and surgical patients, including cardiovascular and neurological surgery. Of the 341 operating beds at the Level One VAMC, 202 are acute medical and surgical beds, 30 are psychiatric, 90 are spinal cord injury, and 19 are substance abuse rehabilitation program beds. Louisville is a Level One facility providing primary, secondary, and tertiary care in medicine, surgery, neurology, and psychiatry. The VAMC has 168 beds. Lexington is a two-division, Level One (tertiary) medical center with an operating bed complement of 209 hospital and 198 nursing home care unit beds. Acute medical, neurological, surgical and psychiatric services are provided at the Cooper Drive Division. The Leestown Division, five miles from Cooper Drive, provides intermediate medical and psychiatric services as well as nursing home care. Huntington is a fully accredited 80 bed primary care facility providing acute medical, surgical, rehabilitative, and intermediate inpatient care, in addition to primary and specialized outpatient care. The VAMC has Level Two complexity and Level Three ER. The following workload is an estimate for a one year period in the following order: Hospital Name; Inpatient (Discharges); Outpatient Visits; Ambulatory Surgery. Nashville; 6,133; 207,731; 4,264. Murfreesboro; 3,383; 175,176; 1,457. Mtn Home; 6,012; 229,274; 3,463. Memphis; 8,190; 260,884; 3,537. Louisville; 4,975; 223,591; 3,043. Lexington; 6,040; 196,178; 2,858. Huntington; 3,379; 159,680; 1,038. Contractor shall provide all labor, travel, materials and supervision to perform on-site coding validation review and training for each of the VA Medical Centers in VISN 9. Coding validation reviews are required of inpatient and outpatient data collection, evaluating the completeness and accuracy of coding diagnoses and procedures in accordance with official coding guidelines. Areas of focus should include: Inpatient record review of ICD-9-CM (International Classification of Disease 9th Version-Clinical Diagnosis and Procedural Modification) codes, DRG (Diagnoses Related Group) and HCPCS (Health Care Financing Administration Common Procedural Coding System) assignments; Outpatient Record/encounter form review of ICD-9-CM and CPT-4 (Current Procedural Terminology-4) coding; and review of Ambulatory Surgery procedures. The contractor shall document all medical record reviews and provide such documentation to the VA. Within 3 weeks after completion of review, contractor shall provide VA with a written and comprehensive final report of all findings, with recommendations, and conduct, at a minimum a2 hour exit conference, and a minimum of three 1 to 2 hour education session per facility for physicians. Also, a minimum of two 4 hour education session per facility for coders is required. The Government reserves the right to videotape all training classes provided by the Contractor for future training purposes required by each medical center. The final report and exit conference shall be provided for each facility. Upon conclusion of all of the VISN reviews a combined report must be submitted detailing at a minimum the following: number of records reviewed for both inpatient and outpatients broken down into specialty for inpatients and by clinic for outpatients; trending and analysis of medical record documentation; ICD-9-CM and CPT-4, and if possible physician profiling; recommendations for improvement; strategies to implement for improvement in the capture of workload and accuracy of code assignment. Services shall be performed Monday through Friday during the hours 8:00 am to 4:30 pm, excluding FederalHolidays. It is anticipated that this contract will have a primary and an alternate Contracting Officer's Technical Representative (COTR) assigned for administrative purposes throughout the contract period. The actual dates for service shall be coordinated with the COTR. It is required that the contractor personnel providing services have actual coding consultation experience. Offerors responding to this announcement shall submit their total cost to perform services, include travel expenses, a prospectus identifying the project goals, areas of review, objectives, type of documentation provided, contents of final report and exit conference and any other information pertinent to this procurement. PERSONNEL POLICY: The contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide the following for these personnel: worker's compensation; professional liability insurance; health examinations; income tax withholdings, and Social Security payments. The parties agree that the contractor shall not be considered VA employees for any purpose and shall be considered employees of the contractor. CONFIDENTIALITY AND NON-DISCLOSURE: The contractor shall agree that: All deliverables associated with working papers, and other material deemed relevant by VA generated by the Contractor in the performance of this contract are the property of the United States Government; All individually identifiable health records shall be treated with the strictest confidentiality. Access to records shall be limited to essential personnel only. Records shall be secured when not in use. At the conclusion of the contract all copies of individually identifiable health records shall be destroyed or returned to the VA. The contractor shall comply with the Privacy Act, 38 USC 5701 and 38 USC 7332; Reviewers will be required to sign a confidentiality statement upon arrival at the facility in coordination with the COTR. Due to the complexity of this contract action, subcontracting is not allowed. This synopsis/solicitation incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. The full text of a clause may be accessed electronically at these addresses: http://www.arnet.gov/far/ (for FAR 52 Clauses) and http://www.gov/oa&;mm/vaar/ (for VAAR 852 Clauses). Provision 52.212-1, Instructions to Offerors -- Commercial, applies to this acquisition. ADDENDUM TO 52.212-1: Contractor must submit four (4) copies of their offer. Provision 52.212-2, Evaluation -- Commercial Items, is applicable. The evaluation of criteria is as follows: A. Quality of Service: Provide evidence from two references demonstrating improvement in accuracy and reimbursement; Provide a description of reporting format/mechanisms for displaying the findings and recommendations for improvement; Provide listing of current coding references utilized in coding/reimbursement reviews; Provide a description of the comprehensive plan for conducting reviews and the ability to meet the timeliness for review. As a minimum the following should be provided in the proposal: Specific timelines for completing review at each medical center; Number of days required at each medical center; Number of reviewers (including their credentials) for each medical center. B. Pricing: The Complete job pricing to provide the services required herein. Factor A and Factor B are of equal value. Offerors should submit a completed copy of the provision at 52.212-3, Offeror Representations and Certifications -- Commercial Items, with its quotation. Clause 52.212-4, Contract Terms and Conditions -- Commercial Items, applies to this acquisition and Addendum applies as follows: The following Clauses are applicable VAAR 852.219-70 Veteran Owned Small Business, 852.270-1 Representatives of the Contracting Officers; 852.270-4 Commercial Advertising and FAR Clauses 52.224-1 Privacy Act Notification, 52.224-2 Privacy Act, 52.237-2 Protection of Government Buildings, Equipment, and Vegetation, 52.252-2 Clauses Incorporated by Reference. Clause 52.212-5, Contract Terms and Conditions Required to Implement Statues or Executive Orders Commercial Items, including clauses incorporated by reference under section (b) 1, 5, and 12 through 15. The Government intends to award a firm-fixed price contract to the offeror that is determined most advantageous to the Government, price and quality of service considered. Offer documentation shall contain in sufficient detail information in order to enable government personnel to make a thorough and sound determination based on the evaluation factors listed and demonstrates that the prospective contractor has a thorough knowledge and understanding of the requirements. After receipt of offers, a determination shall be made of which offers are in the competitive range for the purpose of conducting written and/or oral discussions, if necessary. Contractors should note that award may be made on the initial offer. The Contractor with the lowest cost/price alone will not necessarily be awarded the contract. After award, the Government will determine the order in which each of the hospitals in VISN 9 will be reviewed. Also, the Government reserves the right to provide the contractor with a sample reporting format. Faxed offers will not be accepted. Posted 03/17/99 (W-SN309750). (0076)

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