R -- CODING VALIDATION SERVICES

Notice Date

December 7, 2000

Contracting Office

Veterans Administration Medical Center (N125), 1700 South Lincoln Avenue, Lebanon, PA 17042-7597

ZIP Code

17042-7597

Solicitation Number

RFQ 595-4-01

Response Due

December 27, 2000

Point of Contact

Lucille Funk, 717-228-5938

Description

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; proposals 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 97-20. This procurement is set-aside for small businesses. The applicable NAICS code is 541611, Administrative Management and General Management Consulting Services. The small business size standard is $5.0 million average annual receipts for the past three years. This is a Request for Quotation (RFQ). All RFQ's are due by December 27, 2000; 4:00 p.m. local time. If mailed, submit to: Acquisition Management (N125), VA Medical Center, 1700 S. Lincoln Ave., Lebanon, PA 17042. If hand carried, deliver to: Acquisition Management, Bldg. 18, Room 120, VA Medical Center, 1700 S. Lincoln Ave., Lebanon, PA. Item 1, Coding Validation Services; Estimated total quantity is 1,000; Unit is Hours; Unit Cost is $________/Hour; Estimated total cost is $__________. NOTE: Estimated quantity of 1,000 is an estimated total for the entire 9 month period of January 1, 2001 through September 30, 2001. Quantity is estimated and is not a guaranteed requirement. Contractor shall provide coding validation services in strict accordance with the terms conditions and schedules listed herein. The intent of this request for quotation is to provide validation of the integrity, quality and assignment of the codes to the data contained in the outpatient Patient Care Encounter (PCE) for the VA Medical Center, Lebanon, PA, for the period of January 1, 2001 through September 30, 2001. The purpose of this contract is to evaluate the quality of outpatient coding encounter data; to deliver a quantitative assessment of the validity of the diagnostic and procedural code; and evaluate and manage data for the quality of outpatient coding at the facility level. Contractor shall provide all labor, materials, and supervision necessary to perform off-site coding validation reviews, evaluating the completeness and accuracy of coding diagnoses of medical records in a simulated Medicare payment environment to include: (1) Correct sequencing of principal and secondary diagnoses and procedures; (2) Correct use of ICD-9-CM/DRG principles to classify diagnoses and procedures; (3) Correct use of ICD-9-CM coding principles for diagnoses and procedures for outpatient visits; (4) Correct use of CPT-4 coding conventions and guidelines within the outpatient section; (5) Sufficient and correct documentation in accordance with HCFA guidelines; (6) Under or missed coding (e.g., when a service was performed and documented in the medical record, but not selected for billing; (7) Comply with any hospital specific coding guidelines and/or policies; (8) Supply to the hospital, a copy of the coding specialists daily work log for each day the coding specialist performs reviews; (9) Provide a consolidated monthly report showing trends, recommendations and findings by medical center total and by unique providers, listing number of cases reviewed and number of deficiencies by type. Contractor is to be proficient with, and is responsible for providing for their staff, all computer equipment, reference materials, software/encoder tools for conducting reviews and developing training materials. Contractor shall maintain confidentiality of all patient information provided by the hospital and sign the hospital's statement of confidentiality upon request. The Lebanon VA Medical Center will furnish necessary records, either by mail or electronically, as well as copies of any hospital specific coding guidelines and/or policies, and give reasonable notice to the contractor regarding any needed coding services. If the contractor is unable to provide validation services to meet the demands of the hospital, the hospital has the option to use other validation services. Services shall be billed monthly at an hourly rate. Corrected records and consolidated reports must be returned to the VA Medical Center within 3 weeks of receipt by the contractor. It is anticipated that the volume of encounters reviewed will be approximately 1,000 per month. Offerors shall submit a completed copy of the provision at 52.212-3, Offeror Representations and Certifications -- Commercial Items, with the quotation. Clause 52.212-4, Contract Terms and Conditions -- Commercial Items applies to this acquisition. Applicable clauses can be viewed at www.arnet.gov/farloadmain52.html and www.va.gov/oa&mm/vaar

Record

Loren Data Corp. 20001211/RSOL001.HTM (W-342 SN5083H0)