Inactive

ADVANCED NOTICE AND SOURCES SOUGHT Medical Coding Compliance Support (CONUS) THIS SOURCES SOUGHT IS NOT A REQUEST FOR PROPOSAL Purpose: The General Services Administration (GSA) Assisted Acquisition S... ADVANCED NOTICE AND SOURCES SOUGHT Medical Coding Compliance Support (CONUS) THIS SOURCES SOUGHT IS NOT A REQUEST FOR PROPOSAL Purpose: The General Services Administration (GSA) Assisted Acquisition Service (AAS) Region 7 is providing advanced notice of an upcoming opportunity to provide world-class healthcare for our beneficiaries anywhere, anytime. Medical coding provides value to the patient and supports Defense Health Agency (DHA) mission by playing an integral role in workload, reimbursement, provider currency, decision support, population health, disability services, and more. The purpose of this notice is Multi-faceted: to provide advanced notice of this requirement to the vendor community in order to better support vendor planning and prioritization efforts through early engagement; to enable any and all capable vendors to submit to the GSA their expressions of affirmative interest in supporting this requirement, which supports: a more robust competitive solicitation process; selection of the most appropriate contractual vehicle; selection of the most appropriate and effective evaluation methodology; and to enable the vendor community to understand GSA AAS Region 7’s processes so as to promote greater transparency into upcoming projects, methodologies, and processes. The DHA has a requirement to acquire high quality, professional medical coding compliance services to support all military treatment facilities (MTFs). To consist of performance of medical coding compliance and revenue integrity activities and functions. GSA AAS provides custom acquisition, project, and financial management support services to federal agencies, including the DHA. GSA AAS is conducting this acquisition on behalf of the DHA, supporting the full acquisition lifecycle in support of the DHA’s core mission activities. Anticipated Scope: The scope of this work will be to provide analysis, auditing, investigation, recommendations, research, and other support to ensure observance or conformity with official coding policies, regulations, requirements, and standards. Revenue integrity consists of providing analysis, auditing, investigation, recommendations, research, and other support to prevent or recapture lost revenue from healthcare operations. The primary area of support is medical coding compliance with seven (7) specific tasks: Task 1: Perform medical coding compliance and other system administrative function support services to include: Evaluate controls, processes, systems, and workflows impacting revenue capture to identify root causes of erroneous coding, lost revenue, revenue leakage, and service wastes. This is achieved through analysis of coding audits, provider currency and productivity reporting, Uniform Business Officer (UBO) claims and reports, managed care claims and reports, other military, Federal, and civilian sources in regards to DHA product line performance, and information gathered from DHA coding staff and MTF leadership to identify lost revenue. The task also involves communicating by phone, electronically, and in person with MTF leadership and staff, analyzing and investigating current processes and workflows through use of task analysis and other methodologies to identify bottlenecks, service wastes, and other opportunities for improving cost savings and/or revenue capture. Task 2: Evaluate software and identify root causes of systems support and make recommendation related to the medical coding system environment to include: Develop and recommend cost effective solutions to leadership that eliminates non-compliance with official coding policies and eliminates or mitigates revenue loss, and revenue leakage at the problem source. This is achieved by performing due diligence in ethically and appropriately researching and/or interpreting existing coding guidance, policy, regulations, rules, or standards, including seeking clarification from the DHA MCPO. Provide business and cost analysis support services that reflect relevant guidance, policy, regulations, rules, or standards in developing position papers, presentations, or other documents, and present recommendations verbally or in writing to the DHA MCPO or DHA or MTF leadership. Task 3: Perform process system utilization analysis for DHA MCPO projects to include: Develop an annual work plan of analysis, audit, and investigative items in collaboration with DHA MCPO. Examine documentation and assist in implementing any new requirements in Federal laws, Department of Health and Human Services Office of Inspector General (HHS-OIG), DoD, and DHA regulations, and commercial policies involving or affecting compliance. Task 4: Supports the DHA MCPO in monitoring coding compliance to include: Performing audits of DHA coders in a double-blind audit method IAW DHA MCPO guidelines, rules, and standards.; and performing focused audits of DHA MTFs, specialties, clinics, or providers IAW DHA MCPO guidelines, rules, and standards. This is achieved by reviewing encounters to ensure appropriate assignment involves accurately analyzing diagnosis, procedure, and supply codes for the professional and institutional (facility) components of Inpatient, External Resource Sharing Agreement (ERSA), Ambulatory Procedure Visit (APV), Observation, Emergency Department (ED), and Outpatient encounters. Codes assigned include International Classification of Diseases, Clinical Modification (ICD-CM), International Classification of Diseases, Procedural Classification System (PCS), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and modifiers. The task also involves exercising independent and objective judgment in assigning errors, providing a rational and citing official guidelines, policies, regulations, rules, or standards as reference for assignment of errors. Task 5: Diagnose and resolve problems associated with the medical coding system to include: Evaluate and identify root causes of non-compliance with official coding policies, regulations, requirements, and standards. This is achieved by reviewing encounters to ensure appropriate assignment of diagnosis, procedure, and supply codes for the professional and institutional (facility) components of Inpatient, External Resource Sharing Agreement (ERSA), Ambulatory Procedure Visit (APV), Observation, Emergency Department (ED), and Outpatient encounters. Codes assigned include International Classification of Diseases, Clinical Modification (ICD-CM), International Classification of Diseases, Procedural Classification System (PCS), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and modifiers. Review encounter and/or record documentation to identify inconsistencies or discrepancies that may cause inaccurate coding, medical-legal repercussions, or impacts quality patient care, identifying any problems with legibility, abbreviations, etc., proper sequence of documents, presence of authorized signatures, and sufficient data is documented that supports diagnosis, treatment administered, and results obtained. Develop written (electronic or hard copy) query IAW DHA guidelines to the provider or MTF to request clarification of provider documentation that is conflicting, ambiguous, or incomplete in regards to any significant reportable condition or procedure. Supports the DHA /MAJCOM/MTF leadership and clinical staffs in identifying and resolving compliance issues. Task 6: Serves as the third-party medical coding expert to the medical staff to include: Assist in the preparation of required documents. Respond to questions, issues, or concerns related to coding Responds to coder or provider questions and provides examples of appropriate coding and documentation reference(s) to provide clarity and understanding. Based on contacts from the medical staff, identifies training opportunities and works with coding training personnel to focus on consistency and clarity of coding advice provided. Task 7: Provide medical coding support services in contingency situations to include: Correct specific write-back errors caused by coding errors. The entry and transmittal of patient and coding data through different Government computer systems will sometimes be flagged for errors (known as “write-back errors”). Write-back errors are corrected by the MTF staff or coders and tracked through corrective action. Write-back errors generated by a patient administration error (for example, incorrect or missing demographic information) is corrected by the MTF Patient Administration section. Coding errors require review and correction by a certified medical coder. Anticipated Work locations: This effort is anticipated to require support within the following geographical locations and Other sites as directed by the Government: # of Positions Labor Category Location 2 Lead Medical Coding Compliance Specialist DHA, Lackland AFB, TX 34 Medical Coding Compliance Specialist 96th Medical Group (MDG), Eglin AFB, FL 673rd MDG, Elmendorf AFB, AK 45th MDG, Patrick AFB, FL 81st MDG, Keesler AFB, MS 59th Medical Wing (MDW), Lackland AFB, TX 633rd MDG, Langley AFB, VA 99th MDG, Nellis AFB, NV 60 MDG, Travis AFB, CA 88th MDG, Wright-Patterson AFB, OH 10th MDG, U.S. Air Force Academy, Colorado Springs, CO 55th MDG, Offutt AFB, NE 15th MDG, Hickam AFB, HI 78th MDG, MacDill, AFB, FL Anticipated Magnitude: GSA anticipates an increase in scope from the current awarded contract since all DHA MTFs (Across DoD) maybe included in this requirement. The below is an estimate which will be further defined at solicitation. The magnitude of this work, based upon contractual history extrapolated into the future is anticipated to be: $4M - $6M per year (Estimated based on potential scope increase) 18 Full Time Equivalent (FTE) per year (17 FTEs for medical coding compliance specialists and one (1) FTE for lead medical coding compliance specialists). Additional FTEs may be ordered in option years, subject to funding authorization and availability Anticipated Period of Performance (PoP): The anticipated PoP of this requirement is: 04/01/2023 – 03/31/2024 (Base) 04/01/2024 – 03/31/2025 (Option 1) 04/01/2025 – 03/31/2026 (Option 2) 04/01/2027 – 03/31/2028 (Option 3) 04/01/2028 – 03/31/2029 (Option 4) Anticipated Evaluation Methodology: TBD History: This project was initially awarded against the OASIS Pool 2 Unrestricted contract to Engility Services, LLC, currently novated to the Science Applications International Corporation (SAIC) via contract GS00Q14OADU205, task order (TO) – GSQ0717BG0070. The period of this TO is from October 1, 2017, thru September 30, 2022. GSA anticipates exercising the six (6) month extension of services clause and/or awarding a bridge TO in order to provide unbroken support for this work during GSA AAS Region 7’s period of market research, solicitation and award. Expressions of Interest: Vendors interested in this upcoming opportunity may submit their expressions of interest to the GSA Contracting Officer (CO) and Project Manager (PM) by providing a response that includes the following information, limited to no more than two (2) pages. Vendor Name Vendor Address Name of any Best in Class (BIC) Contractual Vehicles held and associated Contract Numbers Name of any Joint Ventures (JVs) or Contractor Teaming Arrangements (CTAs) Name of any Best in Class (BIC) Contractual Vehicles held by JVs and CTAs and associated Contract Numbers List of Items or considerations that would make your firm more likely to bid on this requirement List of Items or considerations that would make your firm less likely to bid on this requirement Description of your firm’s capacity to support a requirement of this magnitude General description of your firm’s support on behalf of similar requirements in the past The vendor’s expression of interest response shall be in the form of an email entitled “Medical Coding Compliance Specialists FY23 Expression of Interest: Vendor Name” to the email addresses below: The vendor will submit all responses to this sources sought notice to the Acquisition Project Manager (PM), Daniel Bresnahan, via email to daniel.bresnahan@gsa.gov, and GSA Contracting Officer, Michael Dargan, michael.dargan@gsa.gov by May 13, 2022, NLT 3:00 PM CST. Please note that GSA AAS Region 7 is not seeking generalized “marketing” materials or generalized emails in response to this notice, but specific responses that address the items indicated above in order to precisely understand vendor capabilities, contractual vehicle capacities, and intent to provide a solicitation response to this specific requirement. Generalized marketing materials or responses that do not address the specific items described above, or which do not bear the email title described above, will not be considered in the market research phase of this acquisition. Follow-On Actions: Based upon responses received in response to this notice, GSA AAS Region 7 intends to hold a pre-solicitation conference in late Q3 or early Q4 of 2022 for the purposes of more precisely discussing the scope, selected follow-on contractual vehicle selection and competitive nature of the proposed solicitation, evaluation methodology and best-value selection process, anticipated milestone dates, and vendor Question and Answer (Q&A). Note that at this time, GSA AAS Region 7 is not requesting vendors to provide questions, but only to supply an expression of interest in the format requested above. Vendors are responsible for properly marking and clearly identifying proprietary information or trade secrets contained within their response. The Government will not be liable for or suffer any consequential damages for any proprietary information not properly marked and clearly identified. Information provided shall be treated as Business Sensitive and will not be shared outside of Government activities and agencies without the permission of the provider.