Department of the Air Force, Air Mobility Command, 437th CONS, 101 E. Hill Blvd, Charleston AFB, SC, 29404-5021

R -- THIRD PARTY COLLECTOR SOL F38610-00-T-0017 DUE 051000 POC Joy Baity, Contract Specialist, Phone (843) 963-5168, Fax (843) 963-5183/2850, Email Joy.Baity@charleston.af.mil -- Shirley Blue, Contract Specialist, Phone (843) 963-5169, Fax (843) 963-5183, Email WEB: Visit this URL for the latest information about this, http://www.eps.gov/cgi-bin/WebObjects/EPS?ACode=P&ProjID=F38610-00-T-0017&LocID=514ocID=514. E-MAIL: Joy Baity, Joy.Baity@charleston.af.mil. This is a combined solicitation/synopsis for commercial items 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; Request for Quotations are being requested and a written solicitation will not be issued. Solicitation number F38610-00-T-0017 is a Request for Quote. This solicitation document and incorporated provisions are those in effect through Federal Acquisition Circular 97-15. This solicitation is 100% set-aside for small business concerns. The Standard Industrial Code (SIC) is 7322. The small business size standard is $5,000,000. The basic contract period is 1 Jun -- 30 Sep 00 with four (4) option years. A current wage determination list can be found at the website www.dol.gov. All work shall be performed in accordance with the following statement of work: A. SCOPE OF WORK: The Contractor shall provide assistance to the Third Party Collection Manager for a total Third Party Collection Program (TPCP) for the 437th Medical Group, also referred to as the _Medical Treatment Facility_ (MTF) herein. A TPCP involves collection from third party payers for the reasonable cost of medical and dental care provided to non-active duty beneficiaries who are eligible for such care and who are also covered by third party medical insurance plans. This includes outpatient and purchased care portions of the program. The TPCP is directed by Public Law 99-272, Title 10 United States Code (U.S.C.) 1095 and Title 32 Code of Federal Regulations (C.F.R.) Part 220. This program is governed by the DoD Instruction 6010.15, Third Party Collection Program. B. PERSONNEL REQUIREMENTS: 1. Communication Skill Requirement: Personnel must be able to read, write and speak fluent English. 2. Work Experience: a. Have a minimum of one year experience in an atmosphere of a medical care cost recovery program to include assisting in department procedures. b. Have extensive knowledge of the Privacy Act, federal andstate laws regarding release of medical information, and medical care cost recovery. c. Medical coding skills are required. Must possess knowledge of medical terminology, ICD-9 (International Classification of Diseases, Ninth Edition, Clinical Modification) and CPT-4 (Current Procedural Terminology, 4 Edition) coding. d. Computer skills are required. Must have good working knowledge of Windows, Microsoft, and Excel operating system. e. Type 45 WPM and have word processing experience. 3. Character and Professionalism: a. Must have an ability to work without immediate supervision in a fluid environment with staff and patients. Possesses an ability to maintain healthy, functional interpersonal relationships with co-workers and customers. Maintain professional standards of conduct and public decorum, including but not limited to dress and appearance. b. Must be able to efficiently organize and manage diverse program elements. C. EMPLOYEE HEALTH REQUIREMENTS: As a condition of employment, the contract personnel must process through the Public Health Office no later that 30 days after arrival. This is a requirement of the Occupational Safety & Health Administration (OSHA). Medical and immunizations records will be needed to inform personnel of any required immunizations, tuberculin skin tests, or laboratory work. All required immunizations and testing will be accomplished at the government expense. D. INFECTION CONTROL AND SAFETY: All contract personnel working at the MTF shall comply with all MTF infection control/safety procedures, practices, and standards. Mandatory attendance is required for a New Comer_s Briefing. E. AVAILABILITY/DUTY HOURS: Contract Personnel shall be available part-time (25 hours per week), Monday through Friday (excluding federal holidays). Hours of work will be from 9:00 a.m. _ 2:00 p.m. No vacation time will be accrued. F. IDENTIFICATION: Contract personnel working at the MTF shall be clearly identifiable while on duty. Contract personnel shall be provided with a name badge. This badge shall be worn on the outermost garment, i.e., shirt/blouse or sweater. G. SPECIFIC TASKS: a. The contract personnel shall perform all activities required to collect insurance filing information from non-active duty beneficiaries, file claims, collect all money owed the government, account for all data collection/claim filing, and conduct accounts receivable actions. b. Comply with all Department of Defense (DoD) and Air Force Patient Administration, Resource Management and Accounting and Finance directives, particularly those directives concerning release of information and collections. c. Patient lists shall be treated as privileged information. Lists and/or names of patients shall not be disclosed to or revealed in any way for the use outside of the 437th Medical Group or its associated buildings without prior written permission by the Director of Patient Administration. d. Only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient and others with proper authorization. e. Provide reports on program performance and individual patient accounts upon request. f. Assist and provide guidance to the MTF staff in preparing any patient pamphlet/handout for use in explaining the TPCP to non-active duty beneficiaries. It shall include but not be limited to the program history, an explanation of the program how the program benefits the patient and patient rights under the program. g. Collect insurance claim forms indicating insurance coverage and patient encounter forms for all patients (both those who indicate they have insurance as well as those who deny having insurance) unless a current form pertaining correct information is in the health care record. h. Submit completed UB-92 HCFA 1500 claim forms for each visit to third party payers. i. Prepare the SF544, Statement of Patient Treatment and include the original SF 544 in the medical record when any copies of pages or parts of pages or abstracts of information in the record are released from the medical record. j. Mail bills to third party payers within five (5) business days after outpatient treatment is rendered to the patient. k. The contract personnel shall pursue each claim in which the third party response is unsatisfactory (inappropriate denial or partial denial, inadequate payment amount, non-response, etc.). Sufficient follow-up activities must be conducted and documented. Those follow-up activities include telephone contacts, letters, and any other steps that might result in satisfactory resolution. The contract personnel shall mail follow-up collection letters requesting payment for delinquent letters to third party payers at intervals of less than 60 days, but shall still send letters at the 60 and 120 points. l. Respect and maintain the basic rights of patients, to include but not limited to personal dignity. H. GOVERNMENT FURNISHED PROPERTY AND SERVICES: Government furnished property under this contract will be provided to the contractor at no cost and shall only be used in performance of service under this contract. The government will provide all space, materials, equipment, and supplies necessary for performing the health services required by this contract. All documentation created or received regarding coverage, claims and receipts (to include explanation of benefits) is the property of the 437th Medical Group. I. DEFINITIONS/ACRONYMS: CPT-4 _ Current Procedural Terminology, 4 Edition coding manual; EOB _ Explanation of Benefits; HCFA1500 _ Health Care Financing Administration professional fee claim; ICD-9-CM _ International Classification of Diseases, Ninth Edition, Clinical Modification coding manual; Medical Treatment Facility (MTF) _ Air Force hospitals or clinics, including all activities providing outpatient and/or inpatient health care services for authorized personnel. This includes satellite buildings as well as the primary building; MEPRS _ Medical Expense and Performance Reporting System; Patient Lists _ A List containing patient information that is to be treated as privileged information; Patient Sensitivity _ Respecting and maintaining the basic rights of patients, to include but not limited to personal dignity; Privacy Act Statement _ This form is not a consent form to release or use health care information pertaining to individuals. The form provides the advice required by the Privacy Act of 1974. The personal information will facilitate and document health care. The Social Security Number of the individual is required to identify and retrieve health care records. J. TECHNICAL EXHIBIT 1 -- DATA REPORTING FOR THE 437th MEDICAL GROUP A. Total claims billed for the processing month; B. Total amount Collected for the Processing month; C. Total amount uncollected < 120 days: K. TECHNICAL EXHIBIT 2 -- REPORT PROCEDURES FOR THE 437th MEDICAL GROUP A. MEPRS report (AF Form 3078) _ Record complete hours worked at the end of the work shift on the AF Form 3078, Weekly Personnel Time and Salary Distribution Worksheet. Direct questions to the Resource Management Office. Forms are due on the third duty day of the following month. B. 2570 TPOC Data report due to RMO and AMC by the 15th Business day of the following month. The provision at FAR 52.212-1, "Instructions to Offerors -- Commercial Items" is applicable to this solicitation. The provision at FAR 52.212-2 " Evaluation -- Commercial Items" is applicable to the solicitation and the blanks in (a) are completed as follows: Price, technical capability, and past performance, with technical capability and past performance when combined being of greater importance than price. Offerors shall include with their offers a completed copy of the provision at FAR 52.212-3 "Offeror Representations and Certifications -- Commercial Items. FAR clause 52.212-4, Contract Terms and Conditions -- Commercial Items is applicable to this solicitation. FAR clause 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders -- Commercial Items is applicable and the following clauses are checked: 52.222-21, "Prohibition of Segregated Facilities"; 52.222-26, "Equal Opportunity"; 52.222-35, Affirmative Action for Disabled Veterans and Veterans of the Vietnam Era"; 52.222-36, Affirmative Action for Workers with Disabilities"; 52.222-37, "Employment Reports on Disabled Veterans and Veterans of the Vietnam Era"; 52.232-33, "Payment by Electronic Funds Transfer -- Central Contractor Registration"; .); 52-222-42 -- "Statement of Equivalent Rates for Federal Hires", with Employee Class and Monetary Wage completed as follows: Accounting Clerk III -- $10.65; 52.222-43 -- "Fair Labor Standards Act -- Price Adjustment (Multiple Year and Option); and 52.222-41 Service Contract Act of 1965, as amended (41 U.S.C. 351, et seq) (wage determination 94-2474 applies to this procurement only if a company will hire an employee to fill this position. It does not apply to self-employed individuals). FAR clauses 52.217-5 -- "Evaluation of Options"; 52.217-8 -- "Optionto Extend Service", with the last sentence completed as follows: "within 15 days of expiration of the contract"; 52.217-9 -- "Option to Extend Terms of the Contract", with paragraph (c) completed as follows: "52 months"; 52.232-18 -- "Availability of Funds"; and 52.219-6 -- Notice of Total Small Business Set-Aside" also apply to this procurement. DFARS clause 252.204-7004, "Required Central Contractor Registration" (CCR) is applicable to this solicitation. The full text of these clauses may be assessed electronically at this address: http://farsite.hill.af.mil/. Responses to this RFQ must be received via email, fax, mail, or delivery, by May 10, 2000 no later than 4:30 PM Eastern Standard Time at the 437th Contracting Squadron, 101 E. Hill Blvd, Charleston AFB SC 29404-5021. Responses should be marked with the solicitation number and addressed to Joy Baity or Shirley Blue. Responses should include a copy of resume with three (3) current references, and a copy of the bid sheet at Attachment 1. Vendors not registered in the Central Contractor Registration (CCR) database prior to award will not be eligible for award. Vendors may register for CCR by calling 1-800-334-3414 or register on line at www.CCR2000.com. For more business opportunities visit web site http://www.selltoairforce.org. Additional opportunities can be found at web sites http://www.sba.gov; and http://437contracting.charleston.af.mil. For questions concerning this solicitation contact Joy Baity, Contract Specialist, 843-963-5168, fax 843-963-5183, or email joy.baity@charleston.af.mil. Points of Contact Joy Baity, Contract Specialist, 843-963-5168, fax 843-963-5183, email joy.baity@charleston.af.mil. Shirley Blue, Contracting Officer, 843-963-5169, fax 843-963-5183, email shirley.blue@charleston.af.mil. Email your questions to Joy Baity at joy.baity@charleston.af.mil. ATTACHMENT 1 PRICE LIST CLIN DESCRIPTION U/I # UNITS UNIT PRICE TOTAL 0001 Basic Contract Period HR 1040 __________ ________ 1 Jun 00-30 Sep 00 0002 1st Option Period HR 1040 __________ ________ 1 Oct 00-30 Sep 01 0003 2nd Option Period HR 1040 __________ ________ 1 Oct 01-30 Sep 02 0004 3rd Option Period HR 1040 __________ ________ 1 Oct 02-30 Sep 03 0005 4th Option Period HR 1040 __________ ________ 1 Oct 03-30 Sep 04 Total All CLINs ________ Note: Only actual quantities delivered or performed will be paid. Funds for quantities not delivered or performed will be deobligated by modification to the order. Posted 05/02/00 (D-SN450306). (0123)

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