SOLICITATION NOTICE
R -- BUSINESS OFFICE CONSULTANT - FAR provision 52.212-3
- Notice Date
- 2/2/2011
- Notice Type
- Combined Synopsis/Solicitation
- NAICS
- 541611
— Administrative Management and General Management Consulting Services
- Contracting Office
- Department of Health and Human Services, Indian Health Service, Billings Area Office, 2900 4th Avenue North, PO Box 36600, Billings, Montana, 59107
- ZIP Code
- 59107
- Solicitation Number
- RFQ-10-11-019-REL
- Archive Date
- 3/4/2011
- Point of Contact
- Rita E Langager, Phone: 406.247.7293
- E-Mail Address
-
rita.langager@ihs.gov
(rita.langager@ihs.gov)
- Small Business Set-Aside
- Total Small Business
- Description
- Federal Acquisition Regulation (FAR) 52.212-3, Offeror Representations and Certifications - Commercial Items (JAN 2011) that must be completed and submitted with the offer. This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice. This procurement is being conducted under Simplified Acquisition procedures pursuant to the authority of FAR Subpart 13.5, Test Program for Certain Commercial Items (10 U.S.C. 2304(g) and 2305 and 41 U.S.C. 253(g) and 253a and 253b); FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994 (Public Law 103-355)); and FAR 37.104, Personal Services Contracts (Public Law 103-332, Department of the Interior and Related Agencies Appropriation Act, Title II, September 30, 1994, 108 Stat. 2530, as implemented by 5 U.S.C. 3109). This announcement constitutes the only solicitation; therefore, a written solicitation will not be issued. The Billings Area Indian Health Service (IHS) intends to award a fixed-price commercial item contract in response to Request for Quotation (RFQ)-10-11-019-REL. This solicitation is restricted to 100% Small Business concerns. The solicitation documents and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2005-49. The associated North American Industry Classification System code is 541611 and the small business size standard is $7.0 million. PRICE SCHEDULE - BUSINESS OFFICE CONSULTANT: Potential offerors shall propose an all inclusive hourly rate. CONTRACT LINE ITEM NUMBER (CLIN) ONE: 1225 hours @ $____________________ per hour = $_________________________; CLIN TWO: OPTION YEAR ONE: 2080 hours @ $____________________ per hour = $_________________________; CLIN THREE: OPTION YEAR TWO: 2080 hours @ $____________________ per hour = $_________________________; CLIN FOUR: OPTION YEAR THREE: 2080 hours @ $____________________ per hour = $_________________________; CLIN FIVE: OPTION YEAR FOUR: 2080 hours @ $____________________ per hour = $_________________________; GRAND TOTAL = $_________________________. PURPOSE OF THE CONTRACT: The purpose of this acquisition is to contract for a Business Office Consultant for the Wind River Service Unit, PHS Indian Health Center, Fort Washakie, Wyoming. WORK SCHEDULE: Full-time, Monday through Friday, 8:00 am to 4:45 pm. STATEMENT OF WORK: This contract position is stationed at the Wind River Service Unit located in central Wyoming. The primary purpose of this position is to assess and evaluate current Business Office functions, review revenue enhancement possibilities and provide the following professional review of service: medical billing, generation of revenue, cost management, financial project and budget development with financial planning related in assisting the Service Unit's profits. The key element to this position will be assisting with implementation of Business Office outsourcing, which will include working with local tribal entities and other private and professional organizations with a clear understanding of third party requirements. This will require extensive knowledge of electronic data interchange (EDI) requirements, HIPAA regulations, standard Business Office practices as well as Wind River Service Unit internal policies and procedures, Medicare and Medicaid regulations and will require working with private insurance on a professional level with good oral and written skills. Prepare and implement a comprehensive billing system defined to identify revenue generation and expenditures occurring within the Service Unit by using the most cost-effective and advantageous approach that will include a complete assessment and deployment of electronic submission of claims and electronic remits. Provides a complete business plan addressing Business Office, Accounts Receivable, Patient Registration, and providing onsite training. Design and implement plan with procedures to take over the Wyoming State Medicaid, ACS, Billing and reimbursement and maintain at the Service Unit level in order to monitor and correct denials, which will improve revenue. Assessment and audit of current business office practices and provide the Service Unit with a written plan for implementation to improve current practices and improve revenue enhancement working in the capacity of Business Manager functions. Evaluate the current Medical Record coding/coding review processes for claim generation to ensure claims are accurately coded and that incoming revenue is appropriate for the services provided. Give a written plan for implementation if findings are not favorable. Implements change to increase revenue and service satisfaction among patients, providers and tribes. Financial programs adhere to generally acceptable public accounting principles. Will report the collection, analysis, correlation and reporting of financial and other administrative data; reviews, interprets, analyzes and communicates financial data to the Chief Executive Officer and Administrative Officer with an audit of past Wind River Service Unit practices in the capacity of a Financial Officer. Resolve current backlog of claims, which will include on-site training for staff in areas of Billing, Accounts Receivable, Patient Registration and other areas as identified, in order to remain current in billing throughout the assessment. Will assist and help evaluate and address problems with dollar discrepancies and trouble shoot system problems interfering with the collection, proper expenditures of assets and/or allocation of services including audits. Assist Administrative Officer with Financial Planning and other budgetary requests or requirements based on final assessment of revenue data. Help identify long-range needs that will impact the Service Units revenue cycle to help meet the needs of the Indian Health Service patients medical services and possibly adding additional services. Work to decrease Accounts Receivable bringing the greater than thirty (30) days up to date. Provide and implement an appeal process for outstanding claims. KNOWLEDGE REQUIRED BY THE POSITION: Degree in Business Management/Accounting. Must be proficient in Business Office Practices. Must have experience with government work systems in Business Office policies and procedures. Must have experience with and the ability to communicate and provide customer service in a professional manner to the general public and other outside agencies. Must have coding experience and good working knowledge in ICD-9, CPT, and HCPCS coding. Must have knowledge of program requirements from Medicare, Medicaid, Private Insurance, Kidcare and other alternate resources which patients are eligible. SUPERVISION: The contract will be monitored by the Chief Executive Officer/Administrative Officer/Project Officer. The contractor works independently, referring unusual problems or situations to the Chief Executive Officer/Administrative Officer/Project Officer. The contractor's work is reviewed in terms of overall accomplishments of goals and objectives, keeping the Chief Executive Officer/Administrative Officer/Project Officer informed of any unusual situations that may have an impact on the Service Unit. SUPERVISOR: Michelle Antone, Administrative Officer; ALTERNATE: Richard Brannan, Chief Executive Officer. GUIDELINES: Guidelines include federal, state and local laws, as well as I.H.S. circulars and procedures manuals. The contractor uses independent judgment in interpreting and adapting guidelines to unique situations. The contractor develops local policies, procedures and guidelines. And, provides Business Office training as requested. COMPLEXITY: The work involves processing a wide variety of transactions and compiling reports for third party activities and accounts. The work requires identifying the type of transactions; extracting, compiling and verifying utilization of billing data; computing and adjusting account balances; preparing required forms and records; and submitting and maintaining current assignment of benefits. SCOPE AND EFFECT: The contractor is responsible for the collection of all third party resources within the facility. The contractor is also responsible for the timeliness and accuracy of the third party billing activities. Failure to implement and monitor the provisions of P.L. 99-272 and resolve billing problems or issues on a continuous basis could adversely affect the I.H.S. budgetary process. The completion of correspondence and release of medical information to third party health insurance carriers in a timely and accurate manner will have a distinct bearing on dollars recovered and the ability to meet the goals and objectives of the facility. PERSONAL CONTACTS: The contractor has daily contact with facility administration staff, members of the medical profession, field attorneys, private sector health professionals, the general public, insurance company representatives and personnel of other local, state, and federal agencies. PURPOSE OF CONTACTS: The purpose of these contacts is to resolve non-payment or partial payment of insurance claims and to assure maximum reimbursements for third party billing to the service unit. Sets up depositions with attorneys through the District Counsel's Office relating to third party liability, Workers Compensation cases and tort claims. Responds to telephonic and written inquires from attorneys, insurance company representatives and patient representatives. Provide guidance to Resource Management Team and Administration Staff with reports. PHYSICAL DEMANDS: There is a considerable amount of sitting, walking and bending to retrieve medical information. WORK ENVIRONMENT: Work is normally performed in an office setting, which is adequately lighted, heated and ventilated. PERIOD OF PERFORMANCE: Date of Award (March 2011) through September 30, 2011, with four 12-month options. GOVERNMENT FURNISHED PROPERTY: The IHS shall provide all necessary equipment and supplies. The Wind River Service Unit will be responsible for getting the Contractor access and clearance to all pertinent computer services necessary to carry out his/her duties. REPORTING REQUIREMENTS: The contractor shall provide the Contracting Officer with evidence that payment of employment taxes has been made 15 days after each quarter. COMPUTER SECURITY: Pursuant to the Federal Information Security Management Act of 2002 (FISMA), the contractor will be required to complete a course in Computer Security Awareness Training (CSAT). This training must be completed annually by all employees including all contractors, volunteers, students, and summer externs. The Contractor will be required to comply with the Federal Information Processing Standards Publication (FIPS PUB) Number 201, "Personal Identity Verification of Federal Employees and Contractors," and the associated Office of Management and Budget (OMB) implementation guidance for personal identity verification for all affected contractor and subcontractor personnel. CONTRACTING OFFICER AUTHORITY: Authority to negotiate changes in the terms, conditions or amounts cited in this contract is reserved for the Contracting Officer. PROJECT OFFICER: The project officer shall be responsible for: (1) Monitoring the Contractors technical progress, including surveillance and assessment of performance and recommending technical changes; (2) Interpreting the Statement of Work; (3) Technical evaluation as required; (4) Technical inspections and acceptance; and (5) Assisting the Contractor in the resolution of technical problems encountered during performance of this contract. INVOICE SUBMISSION AND PAYMENT: The Contractor shall submit its invoice to the Project Officer at the Wind River Service Unit, PHS Indian Health Center, P.O. Box 128, Fort Washakie, Wyoming 82514. The Contractor agrees to include the following information on each invoice: (1) Contractor's name, address, telephone number and e-mail address; (2) Contract Number; (3) Invoice number and date; (4) Cost or price; (5) Dates of Service including the number of hours worked; and (6) Remit to address. Payment shall be made by the Billings Area Financial Management Branch, P.O. Box 36600, Billings, Montana 59107. PRO-CHILDREN ACT OF 1994: The Contractor certifies that it will comply with the provisions of Public Law 103-227, Pro-Children Act of 1994, which imposes restrictions on smoking where federally funded children's services are provided. CHILD CARE NATIONAL AGENCY CHECK AND INVESTIGATION (CNACI). A CNACI must be completed for all Indian Health Service (IHS) contractor personnel within the Billings Area. Public Law (P.L.) 101-630, Indian Child Protection and Family Violence Prevention Act and P.L. 101-647, Crime Control Act of 1990, require the IHS to conduct a character and criminal history background investigation on all contractors performing services in IHS facilities. The character and background investigations will be conducted by the Wind River Service Unit. In addition, fingerprint checks must occur as part of the pre-employment process and must be completed before the Business Office Consultant is allowed to work. The fingerprint checks should be coordinated with the Service Unit. Please contact the Administrative Officer at the Service Unit to complete this process. PROVISIONS AND CLAUSES: The following provisions and clauses apply to this acquisition. The FAR provision 52.212-1 Instructions to Offerors Commercial Items; and 52.212-3 Offeror Representations and Certifications Commercial Items are incorporated by reference. The provision at 52.212-2 applies to this acquisition and is provided in full text. FAR 52.212-2 EVALUATION-COMMERCIAL ITEMS (JAN 1999): (a) The Government will award a contract resulting from this solicitation to the responsible offeror whose offer conforming to the solicitation will be most advantageous to the Government, price and other factors considered. The following factors shall be used to evaluate offers: (1) PROFESSIONAL EDUCATION = 10 POINTS (Offeror must provide evidence of degree in Business Management/Accounting); (2) PROFICIENT IN BUSINESS OFFICE PRACTICES = 10 POINTS (Offeror must describe in detail quality and quantity of past and current Business Office work experience, including development of Business Office processes and reporting systems); (3) GOVERNMENT WORK EXPERIENCE = 10 POINTS (Offer must describe experience with Government work systems in Business Office policies and procedures); (4) PAST PERFORMANCE = 30 POINTS. The offeror must demonstrate its record of successful performance in past contracts and/or jobs, Government and/or commercial. Each offeror will be evaluated on its performance under existing and prior contracts/jobs. The offeror must list at least three contracts/jobs and include the following information. (1) Name of Government agency/Company; (2) Contract number, if applicable; (3) Dates of Service/Employment; (4) Total contract value/Hourly wage; (5) Description of contract work/Job duties; (6) Contracting Officer/Company Manager and telephone number; (7) Program Manager and telephone number, if applicable; (5) CODING EXPERIENCE = 20 POINTS. (Offeror must describe experience in ICD-9, CPT and HCPCS coding; and (6) KNOWLEDGE OF ALTERNATE RESOURCES = 20 POINTS. (Offeror must describe knowledge of program requirements from Medicare, Medicaid, Private Insurance, Kidcare and other alternate resource programs which patients are eligible for.) Technical and past performance, when combined, are considered approximately equal to cost or price. (b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the Government to exercise the option(s). (c) A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award. The following FAR and Health and Human Services Acquisition Regulation (HHSAR) clauses are applicable: 52.204-4, 52.204-9, 52.212-4, 52.212-5, 52.215-5, 52.217-8, 52.217-9, 52.223-5, 52.223-6, 52.224-1, 52.224-2, 52.227-14, 52.227-17, 52.228-5, 52.229-3, 52.232-3, 52.232-18, 52.237-2, 52.237-3, 52.242-15, 52.242-17, 52.245-1, 52.249-12, 52.251-1, 52.251-2, 352.201-70, 352.202-1, 352.203-70, 352-215-1, 352.215-70, 352.222-70, 352.223-70, 252.224-70, 352.227-70, 352.231-71, 352.237-70, 352.237-71, 352.237-72, 352.239-73, 352.242-71, 352.242-72, 352.242-73, 352.270-2, and 352.270-3. The following FAR clauses cited in 52.212-5 are applicable to the acquisition: 52.203-6 with Alternate I, 52.219-6, 52.219-8, 52.222-3, 52.222-21, 52.222-26, 52.222-35, 52.222-36, 52.222-37, 52.223-18, 52.225-13 and 52.232-33. Upon request, the Contracting Officer will provide full text copies of the FAR and HHSAR provisions and clauses. The provisions and clauses may also be accessed electronically at https://www.acquisition.gov/ and http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&sid=3524d214210697effd2fd5c77848a806&rgn=div5&view=text&node=48:4.0.1.8.33&idno=48. PROPOSAL SUBMISSION INSTRUCTIONS: The Contractor shall provide evidence of, or submit a written response to, the technical evaluation factors in FAR 52.212-2. In addition, the Contractor shall submit a completed copy of FAR 52.212-3 with its offer. CONTRACTORS INTENDING TO CONDUCT BUSINESS WITH THE FEDERAL GOVERNMENT MUST REGISTER WITH THE DEPARTMENT OF DEFENSES CENTRAL CONTRACTOR REGISTRATION (CCR) DATABASE. THE CCR IS THE PRIMARY GOVERNMENT REPOSITORY, WHICH RETAINS INFORMATION ON GOVERNMENT CONTRACTORS. YOU MAY REGISTER VIA THE INTERNET AT HTTPS://WWW.BPN.GOV/CCR/DEFAULT.ASPX OR BY CALLING (888) 227-2423. All responsible offerors may submit a proposal, which shall be considered by the Agency. Offers shall be submitted to the Billings Area Indian Health Service, 2900 Fourth Avenue North, Room 304, Billings, Montana 59101, no later than 2:00 p.m., on February 17, 2011. The offer must be submitted in a sealed envelope, addressed to this office, showing the time specified for receipt, the solicitation number, and your company's name and address. Offers will also be accepted by e-mail at Rita.Langager@ihs.gov or by fax at (406) 247-7108. ACCEPTANCE PERIOD: Your proposal must stipulate that it is predicated upon all the terms and conditions of this RFQ. In addition, it must contain a statement to the effect that it is firm for a period of at least 90 days from the date of receipt by the Government.
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