DHHS, Aberdeen Area Indian Health Service, 115 4th Avenue Southeast, Room 309 Federal Building, Aberdeen, South Dakota 57401

R -- REVENUE MANAGEMENT COMPLIANCE 2000 FOR OFFICE OF MANAGED CARE, ABERDEEN AREA INDIAN HEALTH SERVICE SOL RFQ-00-067 DUE 082300 POC Nichole Price, Procurement Technician or Allen Davis, Contracting Officer at 605-226-7567. The Aberdeen Area Indian Health Service is solicitating the services of a contractor to provide audit services relating to documenting, coding, and billing compliance activities for Eagle Butte, SD, Pine Ridge, SD, Rapid City, SD, Rosebud, SD, Sisseton, SD, and Winnebago, Nebr. The contractor shall assist in determining if the eight hospitals are basing their coding and billing on proper documentation with emphasis on the assignment of appropriate diagnosis codes and use of Medicare documentation guidelines. The contractor will utilize certified coding professionals with ICD-9, CPT, and Evaluation and Management (E&M) coding expertise to conduct a documenting, coding and billing compliance review on 15 inpatient charts, 30 outpatient charts, and 30 emergency room charts from each of the eight AAIHS hospitals. The 75 third party payor charts shall be reviewed using Medicare guidlines. All documenting, coding and billing compliance audits shall be conducted off-site in the contractor's facilities. The successful contractor shall show evidence to document: (1) Comprehensive understanding and extensive experience with Medicare/compliance audits, (2) Experience including an emphasis on Medicare compliance guidlines and federal billing regulations, (3) Past experience in revenue management activities in the Indian Health Service, (4) Familiarity with the Indian Health Service Resource and Patient Management System (RPMS) patient based administrative, clinical, and financial applications including the Third Party Billing software application, (5) In-house skills to make sure staff with the requisite experience, skills, and knowledge are available on short notice. The contractor shall be a fixed price type of contract for services and shall be completed by November 30, 2000. This is a Small Business Set-Aside contract. Request for RFQ-00-067 shall be in writing or telefax at (605) 226-7669 and will be made available approximatley 15 days after date of publication. Posted 07/24/00 (W-SN478178). (0206)

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