SAM #36C24C26Q0027

VA Insurance Entry and Verification Buffer Support Services for CPAC Revenue Operations

This opportunity from the Department of Veterans Affairs (VA), Veterans Health Administration, Regional Procurement Office Central, seeks Insurance Entry and Verification Buffer Support Services for CPAC Revenue Operations nationwide. - Government Buyer: - Department of Veterans Affairs (VA) - Veterans Health Administration (VHA) - Regional Procurement Office Central (RPOC) - Consolidated Patient Account Center (CPAC) Revenue Operations - Scope of Services: - Insurance entry, verification, reverification, and new policy actions (including Medicare policy actions) - Services to be performed at seven regional CPACs nationwide - Contractor must provide all personnel, supervision, management, materials, equipment, facilities, systems, and security controls - Strict quality standards: 93% timely completion, 95% data accuracy, zero privacy violations - Surveillance includes 100% report reviews, random sampling, and trend analysis - Timely, accurate, and compliant processing required; detailed monthly and weekly reporting - Key personnel must have relevant insurance and healthcare administrative experience - Quantities and Deliverables: - Estimated 2,444,000 actions over three ordering periods (643,200 reverification actions and 1,800,800 new-policy actions) - Services include establishing, updating, verifying, maintaining, sequencing, resequencing, terminating, and coordinating third-party insurance information - Contract Structure: - Firm-Fixed-Price, Indefinite-Delivery/Indefinite-Quantity (IDIQ) contract - 100% set-aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSBs) - NAICS code: 541611 (Administrative Management and General Management Consulting Services) - 36-month ordering period with task orders possibly extending performance up to 48 months - Guaranteed minimum contract value: $500,000; maximum: $5,499,000 - Unique Requirements: - Contractor must maintain system access to VA healthcare systems - Performance-based outcomes with strict quality and confidentiality standards - No specific OEMs or technology vendors are named; focus is on service delivery

Description

Insurance Entry and Verification [IV] Buffer Support Services This solicitation is a Request for Quotations [RFQ]. The Government anticipates awarding a Firm-Fixed-Price [FFP], Indefinite-Delivery/Indefinite-Quantity [IDIQ] contract for commercial services in accordance with Federal Acquisition Regulation [FAR] Parts 12 and 16. The applicable North American Industry Classification System [NAICS] code is 541611, Administrative Management and General Management Consulting Services. This procurement is a 100% set-aside for verified Service-Disabled Veteran-Owned Small Businesses [SDVOSBs]. The Department of Veterans Affairs [VA], Veterans Health Administration [VHA], Regional Procurement Office Central [RPOC], is issuing this RFQ to obtain Insurance Entry and Verification [IV] Buffer Support Services for Consolidated Patient Account Center [CPAC] Revenue Operations [RO] locations nationwide. The VA seeks commercial services in accordance with the attached Performance Work Statement [PWS]. The contractor shall provide all personnel, supervision, management, materials, equipment, and other resources necessary to perform the required services. All interested and responsible SDVOSB concerns are invited to submit quotations for the services described in the attached PWS.

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