MODIFICATION
R -- CDM for RISE Charge Description Master (CDM) for Revenue Improvement and Systems Enhancements (RISE)
- Notice Date
- 11/12/2009
- Notice Type
- Modification/Amendment
- NAICS
- 541611
— Administrative Management and General Management Consulting Services
- Contracting Office
- Department of Veterans Affairs;Technology Acquisition Center;260 Industrial Way West;Eatontown NJ 07724
- ZIP Code
- 07724
- Solicitation Number
- VA118-10-RP-0002
- Response Due
- 11/12/2009
- Archive Date
- 1/11/2010
- Point of Contact
- Iris M GelbContract Specialist
- E-Mail Address
-
Contract Specialist
(iris.gelb@va.gov)
- Small Business Set-Aside
- N/A
- Description
- VA118-10-RP-0002 Charge Description Master (CDM) for Revenue Improvement and Systems Enhancements (RISE) Sources Sought Q&As #1: Is there an incumbent vendor that provides these services currently? Or is this a new requirement? There is no incumbent currently providing these services. This is a new requirement. The VistA System has a charge master used primarily for pricing that does not have all the features of a charge description master. #2: In Project Overview, the document refers to "The CDM must integrate with the current VistA legacy system." Can the VA define integrate? The CDM solution/product must communicate with VA VistA legacy software including systems such as Integrated Billing, Laboratory, Pharmacy, and Radiology to accurately identify appropriate charges for health care claims. The selected solution must be able to receive information from VistA legacy systems as well as send information to VistA legacy systems particularly Integrated Billing (IB). #3: In Project Overview, can VA explain this bullet: Improve billing system functionality and efficiency through the full automation of the charge capture process? VA desires to record revenue as quickly and efficiently as possible by capturing services/procedures/supplies/drugs provided at the point of care. By linking these services to the CDM, the fees and all applicable billing data that are maintained in the CDM for each charge can be tied to the charge and transfer directly to the bill to expedite the billing process. This should all be done automatically and not require manual creation of the charges on the bill. #4: In Project Overview, can VA explain the need for a bi-directional interface? The charge data migrates from IB into the CDM to be priced and acquire the appropriate billing elements then the charge data returns to IB for billing. Therefore, the CDM has to be able to send and receive data in both the interim solution and in the future. #5: Need to better understand coding errors and rejections? Is the VA using the CDM to generate charges for specific visits? Yes, VA will use the CDM to generate charges for all visits (whether billable or non billable) and wants to be assured that the CDM maintains current and valid coding data (CPT/HCPCS, modifiers, revenue codes, etc.) for each charge in order to reduce the possibility of errors and rejections that could occur in pre-billing or via payer denials. VA is seeking to understand what controls and/or error messages exist in the CDM you propose to prevent invalid codes from being used in a CDM entry. #6: Page 3, Question 7. Need to better understand the term "use of panel"? Our RCM system performs this task in claim logic, not during charging. At VA, use of panel means the capability of using panel or explosion codes in the CDM. It is essential that the VA have the option of building explosion codes or panels in the selected CDM product. #7: Not sure about the statement about reviews for accuracy of coding? VA wants to ensure that there is a mechanism for the CDM to be reviewed quarterly to ensure that the codes (CPT/HCPCS, MS-DRGs, modifiers, revenue, etc.) are current and accurate with the valid description and the ability for the user to apply an effective or termination date to that item in the CDM. #8: Not sure how a CDM tracks Revenue or Usage. The question reads that the CDM supports production of Revenue and Usage reports across the system for multiple sites. Since the CDM is a repository of all services, procedures, supplies, and drugs provided at the provision of care level to a patient regardless of billing status, VA wants to record the frequency of use and associated revenue for all items listed in the CDM by department and facility. #9: Facilitate the capture of all services, procedures, supplies and drugs, regardless of billable status, in order to provide utilization data to many key systems (e.g., billing and accounts receivable, cost accounting, financial decision support). Would this include providing charge information for non-billed services provided at the VA that is not billed through to third party insurance? Yes. #10: Provide a secure bi-directional interface with the current legacy VistA systems and future revenue system. What is meant by bi-directional in terms of the data that would flow from the VistA system to the charge master system? From the Charge Master to VistA? What are the future revenue systems that are envisioned that would require interfaces? The CDM solution/product must communicate with VA VistA legacy software including systems such as IB, Laboratory, Pharmacy, and Radiology to accurately identify appropriate charges for health care claims. The selected solution must be able to receive information from VistA legacy systems as well as send information to VistA legacy systems particularly IB. An interface must be established with several VistA Legacy applications to capture point of care charges. The future revenue system that would require additional interfaces is not fully defined at this time.
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