SOLICITATION NOTICE
D -- Common Electronic Data Interchange (CEDI) Contractor to support Durable Medical Equipment (DME) Medicare Administrative Contractors (MACs)
- Notice Date
- 8/8/2007
- Notice Type
- Solicitation Notice
- NAICS
- 541511
— Custom Computer Programming Services
- Contracting Office
- Department of Health and Human Services, Centers for Medicare & Medicaid Services, Office of Acquisition and Grants Management, 7500 Security Blvd. C2-21-15, Baltimore, MD, 21244-1850, UNITED STATES
- ZIP Code
- 21244-1850
- Solicitation Number
- RFP-CMS-2007-0021
- Response Due
- 8/23/2007
- Point of Contact
- John Webster, Contract Specialist, Phone 410-786-7229, Fax 410-786-9922,
- E-Mail Address
-
John.Webster@cms.hhs.gov
- Description
- The Center for Medicare & Medicaid Services (CMS) intends to solicit proposals for a contractor to develop a Common Electronic Data Interchange (CEDI) front-end application for all four Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) claims processing contractors. Currently, front end Electronic Data Interchange (EDI) processing for DME claims occurs in 4 separate systems. Two of these systems are operated by DME MACs and two are operated by data services contractors under direct contract with the Centers for Medicare & Medicaid Services (CMS). The front-end EDI systems perform edits on incoming Medicare DME claims and forwards the output data from transactions that pass edits to the core of the VMS shared system claims processing environment. Each of the 4 systems used for DME front end transaction processing has been developed as a proprietary system to meet its developer?s own business objectives. Logic specific to Medicare requirements was added to accommodate the Medicare claims transactions. Also, these EDI environments accept data files from the VMS shared system processing to create transactions to be sent to EDI trading partners (e.g., banks, suppliers, providers, other CMS contractors), in the form of claims payment remittance advice transactions and claims status response transactions. The National Council for Prescription Drug Programs (NCPDP) transactions currently passes through an exchange with VMS for both inbound and outbound transactions. Since each system is owned and developed by separate entities, variations exist in the way in which individual front end systems process claims and in the results they produce. Accordingly, the results of transaction editing can vary from system to system for a given transaction type and can result in similar transactions being rejected by some systems while being approved by others. This creates confusion with suppliers and beneficiaries. It can also lead to the rejection of eligible claims as well as the payment of ineligible claims depending upon which front end system processed the transaction. The CEDI DME MAC front-end system shall be discrete to the contractor and shall not be integrated with any other commercial application and processing environment. The primary functions of the CEDI DME MAC front-end system generally will include: ? An electronic mailbox system for suppliers to submit claims as well as offer customer support; ? Conducts EDI translation activities for all ANSI ASC X12 4010A1 files and future versions adopted by Federal regulation promulgated by DHHS and/or CMS. The use of Commercial Off the Shelf (COTS) software is preferred, but optional, at contract award; however, the use of COTS software is required before contract option year 2. ? NCPDP Routing and translation services (optional at contract award but required before contract option year 1); ? Connectivity support for EDI users; ? EDI enrollment; ? Free Billing Software (FBS) distribution and support; ? Submitter profile changes and updates; ? Transaction testing; ? EDI helpdesk support; and ? Misdirected claims and acknowledgement transfer service between the 4 DME MACs. In order to be considered for this requirement an offeror: ? must be able to demonstrate their experience with, and current and direct access to, VMS shared system claims processing environment. ? must currently process DME claims for adjudication and payment in an active production EDI environment. There are no exceptions to the requirements listed under the first two bullet points; offerors who do not clearly demonstrate such access and experience will not be given further consideration. ? must possess, at the minimum, Capability Maturity Model? Integration (CMMI) Level II accreditation at contract award. The offeror must be able to achieve CMMI Level III accreditation before contract option year 2. ? must be able to determine the best approach for transitioning the workload (68,850,000 annual claims) from the current four DME MAC front-end systems. ? must have existing EDI staff familiar with Medicare front-end systems, or show the ability to recruit and train new staff within a short period of time, in order to perform the functions described in this Sources Sought Notice. The CEDI system must be fully operational for all DME MAC claims in approximately four months from date of award. The Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) intends to issue a solicitation for the CEDI DME MAC. It is anticipated that a contract will be awarded with a 1-year base period and 4 option years. CMS intends to solicit this requirement as a competitive requirement. This announcement is not a request for proposal (RFP). CMS anticipates release of the RFP on or around August 30, 2007 and it will be available on the Federal Business Opportunities (FedBizOpps) website. The anticipated award date for this effort is on or before December 1, 2007. Points of Contact: John Webster, Contract Specialist, phone 410-786-7229, FAX 410-786-9643, email john.webster@cms.hhs.gov; Kathy Markman, Contracting Officer, phone 410-786-8916, FAX 410-786-9643, email Kathy.markman@cms.hhs.gov. NOTE: THIS NOTICE MAY HAVE POSTED ON FEDBIZOPPS ON THE DATE INDICATED IN THE NOTICE ITSELF (08-AUG-2007). IT ACTUALLY APPEARED OR REAPPEARED ON THE FEDBIZOPPS SYSTEM ON 14-SEP-2007, BUT REAPPEARED IN THE FTP FEED FOR THIS POSTING DATE. PLEASE CONTACT fbo.support@gsa.gov REGARDING THIS ISSUE.
- Web Link
-
Link to FedBizOpps document.
(http://www.fbo.gov/spg/HHS/HCFA/AGG/RFP-CMS-2007-0021/listing.html)
- Record
- SN01408246-F 20070916/070915204619 (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
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