Dept. of Veterans Affairs Medical Center, 10000 Brecksville Road, Brecksville, OH 44141

D -- ELECTRONIC BILLING SOL 541-024-00 DUE 121799 POC Jeanelle Wright, Contract Specialist This is a combined synopsis/solicitation procedure for commercial items prepared in accordance with the format in subpart 12.6 as supplemented with additional information included in this notice. Award shall be made under the Simplified Acquisition Procedures (FAR 13.5). This announcement constitutes the only solicitation; therefore, bids are being requested and a written solicitation will not be issued. This (Invitation For Bids (IFB)) solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 97-13. This solicitation is 100% set-aside for small business. The Standard Industrial Classification Code is 3579 and small business size standard is 500. The Louis Stokes Cleveland, Department of Veterans Affairs Medical Center intends to procure electronic billing services. It is the intent of this solicitation to procure services from January 1, 2000 through September 30, 2000 with one (1) option year renewal from October 1, 2000 through September 30, 2001. The Department of Veterans Affairs Medical Center is required to bill private health insurance carriers (Tricare & Bureau of Workmen's Compensation) for the cost of non-service-connected medical care provided at their medical centers. Previously, insurance bills were generated within the Decentralized Hospital Computer Program (DHCP-VISTA). The claims were either filed electronically through a third party or printed and mailed as required. The claims utilize standard billing format required by private sector firms, UB-92 and HCFA 1500. Claims that are currently being processed from the Cleveland, VAMC are for the Cleveland, Cincinnati and Columbus VA facilities. Each site initially generates billings and electronically transmits them to Cleveland, where they are processed either electronically or mailed. The contractor will also be required to provide electronic VAMC eligibility verification. Access will be available at all sites within the scope of the contract. The contractor shall install and support an electronic system capable of transferring claims generated on Digital Equipment Corporation system using the VA's DHCP software. The contractor shall receive an unmodified (as is) data stream electronically from the Department of Veterans Affairs Medical Center in Cleveland. The VA shall provide the contractor with a description of the format of the data stream. The contractor shall then perform all work required to convert the data into an electronic bill acceptable to insurance carriers (third party payers) and forward these bills electronically to insurance carriers. The contractor shall guarantee that only valid bills will be forwarded to the insurance carriers. The contractor will do all work necessary to update software, forms and formats in order to assure valid bills are forwarded to the insurance carriers. The contractor shall provide and maintain any intermediate device and associated software necessary to accomplish the electronic transfer of data on a daily basis. The contractor must maintain system updates to coincide with any VA changes to its integrated billing package. The VA will not modify it's billing package to meet the contractor's needs. The contractors system must provide immediate feedback to the VA on any erroneous claims and allow access at each remote site for correction of claims. The system must be password protected with data held in strictest confidence. Disclosure will not be made to any third party without the written consent of the Cleveland, VAMC. This agreement will not be assignable. Remote sites includes all locations listed above. Each of the sites may require multiple workstations capable of simultaneously access and updating the contractor's database. Claims processing will include UB-92 and HCFA 1500 claims. Contractor shall be responsible for errors and/or omissions due to machine or employee error. Such errors shall be corrected at no additional charge to the VA. Contractor must provide electronic billing to Medical Mutual, Tricare, Anthem, Central Benefits, Workers Compensation, and National Electronic Information Corporation (NEIC) affiliated carriers. All electronic claims are to be processed through the contractor and it's edit system and not directly to the carrier. Turn around time from the VA transmission to the carrier receipt shall be less than twenty-four (24) hours. Transmissions must be accepted daily. VA shall have access to all new services provided by the contractor. Contractor shall provide availability for telephone contact and response to problems. Pricing for services will be billed on a monthly basis. Invoices shall document daily bill transmission information and be provided to the VA no later than the 10th workday after the beginning of the following month. No charge will be included for claims that reject from the vendor. Any ancillary items and costs such as dedicated phone lines, diskettes for downloading, consultation fees, programming charges or technical support will be clearly identified on each invoice. Specific requirements for eligibility verifications will include electronic access to insurance database, allowing each site to quickly access coverage information by patient identifier. No additional equipment should be required for this option. Training shall be required at all locations and will include at a minimum, how to log onto the system, use of the software, minimal roubleshooting of the system and how to obtain assistance with questions and problems. Daily reports are required for any billing error and for all transmitted accepted claims. These reports must be available at all locations. Monthly reports must include overall claims processing statistics, errors by type, by bill number or tax identification number of each station to assure identification of each station activity. A list of carriers and transmission frequency will be provided to the VA. The software requirements include processing of approximately 20,000 claims annually. Training must be accomplished at each remote site immediately after contract award. After contract award, contractor will be required to submit within ten (10) calendar days, a detailed work schedule including timetable for software development and a outline for the final live transmission of claims, training and installation schedule. After contract award, a weekly status report shall be provided to the Cleveland, VAMC and must address any problems encountered during the previous week and steps taken to correct each problem; updated schedule of work accomplished and work yet to be completed with appropriate explanations; a summary of significant work to be completed in the current week. Contractor's bid response shall be in the following format: Per Claim Charge for an estimated quantity of 20,000 annually to include unit pricing. Start -Up Fee (Install & Initiate Program). Monthly Software Maintenance (per month). Access Fees for Additional Stations, (Cost for two (2) additional stations) National Electronic Information Corporation (NEIC) Participation Fee (per month). Electronic Benefits Verification (for an estimated quantity of 4,000 annually). Total Cost for Base Year (January 1, 2000 to September 30, 2000) and Option Year Renewal (October 1, 2000 to September 30, 2001). This procurement shall be awarded on an all or none basis. Provisions in effect for this solicitation are FAR 52.212-1, Instructions to Offerors Commercial Items; FAR 52.212-3, Offeror Representations and Certification-Commercial Items; FAR 52.212-4, Terms and Conditions-Commercial Items and 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders-Commercial Items. Other clauses in effect and can be obtained off the Internet @ www.arnet.gov./far. or by calling the Contract Specialist listed above are FAR 52.232-33-Payment by Electronic Funds Transfer (May 1999); FAR 52.217-8 -- Option to Extend Services (AUG 1989); FAR 52.217-9 -- Option to Extend the Term of the Contract (MAR 1989);FAR 52.232-18-Availability of Funds (APR 1984); FAR 52.232-19 -Availability of Funds for the Next Fiscal Year; FAR 52.233-2-Service of Protest; FAR 52.242-13- Bankruptcy; VAAR 852.233-70 -- Protest Content (JAN 1998). All equipment required for this proposed contract must be Year 2000 compliant. Pre-Bid Conference will be held on Friday, December 10, 1999 at 9:00 a.m. local time at the Louis Stokes Cleveland, Department of Veterans Affairs Medical Center, 10000 Brecksville Road, Brecksville, Ohio 44141 in Building 1, Conference Room -A104. Questions may be faxed to the attention of Jeanelle Wright @ (440) 838-6052 prior to the pre-bid conference. Posted 11/24/99 (W-SN403456). (0328)

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