SOLICITATION NOTICE
D -- Common Electronic Data Interchange (CEDI)
- Notice Date
- 6/13/2012
- Notice Type
- Presolicitation
- 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, Maryland, 21244-1850
- ZIP Code
- 21244-1850
- Solicitation Number
- RFP-CMS-2012-0022
- Archive Date
- 7/13/2012
- Point of Contact
- Daniel A Levenson, Phone: 4107860492
- E-Mail Address
-
DANIEL.LEVENSON@CMS.HHS.GOV
(DANIEL.LEVENSON@CMS.HHS.GOV)
- Small Business Set-Aside
- N/A
- Description
- SYNPOSIS RFP-CMS-2012-0022 Common Electronic Data Interchange (CEDI) Contractor to support Durable Medical Equipment (DME) Medicare Administrative Contractors (MACs) The Center for Medicare & Medicaid Services (CMS) intends to solicit proposals for a contractor to maintain the Common Electronic Data Interchange (CEDI) front-end application for all four Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) claims processing contractors. Currently, the CEDI front-end system provides a single front-end solution for the submission and retrieval of electronic transactions. Trading Partners submit X12 Version 5010 837 claims and 276 Claim Status Inquiry transactions and NCPDP Version D.0 transactions to CEDI. CEDI performs all front-end edits on these transactions, assigns the Claim Control Number (CCN) to claims accepted by CEDI, and creates the flat files for delivery to the appropriate DME MAC. X12 837 claims accepted by CEDI are delivered to the appropriate DME MAC based on the beneficiary state code and 276 files are delivered based on the contractor code in the header record of the file. CEDI returns all electronic front-end reports as well as the X12 835 Electronic Remittance Advice (ERA), 277 Claims Status Response, X12 999 Implementation Acknowledgment For Health Care Insurance (for X12 version 5010A1 837 and version 5010 276 transactions), TA1 Interchange Acknowledgement (for X12 version 5010A1 837 and version 5010 276 transactions if requested), and X12 277 Claim Acknowledgement (for X12 version 5010A1 837 transactions) to the Trading Partner's CEDI mailbox CEDI performs NCPDP front-end edits, assigns the CCN to accepted claims, creates flat files for delivery to the appropriate DME MAC based on the beneficiary state code, and returns the NCPDP Transmission Response Transaction for NCPDP version D.0 claims. The CEDI DME MAC front-end system shall not be integrated with any other commercial application or processing environment. The primary functions of the CEDI DME MAC front-end system generally will include: •Hosting the CMSnet MLPS (Multi Level Protocol System) connectivity to receive claims and claims related electronic transactions claims 24 hours a day, 7 days a week, except during planned downtime for system maintenance •An electronic mailbox system for suppliers to retreive claims 24 hours a day, 7 days a week, except during planned downtime for system maintenance, as well as offer customer support; •EDI translation and front end editing activities for all ANSI ASC X12 and NCPDP versions as adopted by Federal regulation promulgated by DHHS and/or CMS, using Commercial Off the Shelf (COTS) software; •EDI translation and front end activities for the following adopted formats: •X12 version 5010A1 837 claims •X12 version 5010A1 835 electronic remittance advice •X12 version 5010 276 claim status request •X12 version 5010 277 claim status response •NCPDP version 5.1 claims •NCPDP version D.0 claims •X12 and NCPDP transaction routing; •Connectivity support for EDI users; •Trading Partners/Providers/Suppliers EDI enrollment; •Free Billing Software (FBS) distribution and support; •Submitter profile changes and updates; •Transaction testing; •EDI helpdesk support; •Education and Outreach material for external users (e.g. DME MAC and Trading Partners/Providers/Suppliers). In order to be considered for this requirement an offeror must: •Be able to demonstrate their experience with the VMS shared system claims processing environment. •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. •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. •Be able to determine the best approach for transitioning the single front-end application for DME processing (approximately 77,302,091 annual claims) from the current CEDI system. •Have existing EDI staff familiar with Medicare front-end systems, or show the ability to recruit and train new staff within a short time 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 competitive solicitation for the CEDI DME MAC. It is anticipated that a contract will be awarded with a 1-year base period and four 1-year option periods. 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 June 28, 2012 and it will be available on the Federal Business Opportunities (FedBizOpps) website. The anticipated award date for this effort is December 2012. Points of Contact Dan Levenson, Contract Specialist, Phone 410-786-0492, Email Daniel.Levenson@cms.hhs.gov and Phyllis Lewis, Contracting Officer, Phone 410-786-8637, Email Phyllis.Lewis@cms.hhs.gov.
- Web Link
-
FBO.gov Permalink
(https://www.fbo.gov/spg/HHS/HCFA/AGG/RFP-CMS-2012-0022/listing.html)
- Record
- SN02774961-W 20120615/120613235853-8d0d95626f8cf92e2c6b5ccfee11f044 (fbodaily.com)
- Source
-
FedBizOpps Link to This Notice
(may not be valid after Archive Date)
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