Phoenix VA Health Care System Clinical and Medical Coding Services
This is a SOURCES SOUGHT ANNOUNCEMENT ONLY. It is neither a solicitation announcement nor a request for proposals or quotes and does not obligate the Government to award a contract.
Requests for a solicitation will not receive a response. Responses to this Sources-Sought must be in writing. The purpose of this sources sought announcement is for market research to make appropriate acquisition decisions and to gain knowledge of potential qualified Service Disabled Veteran Owned Small Businesses and Veteran Owned Small Businesses interested and capable of providing the services described below. Documentation of technical expertise must be presented in sufficient detail for the Government to determine that your company possesses the necessary functional area expertise and experience to compete for this acquisition. Responses to this notice shall include the following:
(a) company name
(b) address
(c) point of contact
(d) phone, fax, and email address
(e) DUNS number
(f) Cage Code
(g) Tax ID Number
(h) Type of small business, e.g. Services Disabled Veteran Owned Small Business, Veteran-Owned Small business, Small Business or Large Business
(i) must provide a capability statement that addresses the organizations qualifications and ability to perform as a contractor for the work described below.
The Department of Veteran Affairs, Carl T. Hayden Medical Center has a requirement for Clinical Medical Coding Services. The contractor shall provide all labor, materials, transportation, and supervision necessary to perform coding validation reviews for inpatient, observation, diagnostic tests, ambulatory surgery/medicine procedures and outpatient (clinic) data collection, evaluating the completeness and accuracy of coding diagnoses and procedures in accordance with official coding guidelines (Coding Clinics, CPT Assistant, HFCA/AMA, Ambulatory Patient Classifications [APC]) in a simulated Medicare payment environment.
obtain services to assign ICD CM, CPT, and HCPCS Level II codes based on medical record documentation of outpatient care and inpatient care provided at or under the auspices of the Phoenix Veterans Administration Health Care System (PVAHCS) facility and perform coding audits. The Contractor shall provide all resources necessary to accomplish the deliverables described in the statement of work (SOW), except as may otherwise be specified.
Assign ICD CM, CPT, and HCPCS Level II codes based on medical record documentation of outpatient and inpatient care provided at or under the auspices of a Veterans Health Administration facility.
Furnish validation of the integrity, quality, and assignment of codes to the data contained in the outpatient Patient Care Encounter (PCE), inpatient Patient Treatment File (PTF), the non-VA database and the integrated billing package.
The contractor shall specify a contact person and phone number who is available for personal contact at a minimum during regular business hours of the particular facility that owns the work, for the duration of the work. Contractor shall maintain frequent communications with the HIMS Manager or other designated medical center employee (i.e., coding supervisor/team leader) regarding progress, workload status and/or problems. The contractor shall make every effort to ensure that issues raised by the local facility are addressed in a timely manner.
Contract coders shall code in accordance with all Common Procedural Terminology /Common Procedural Coding Systems coding rules such as Correct Coding Initiative Bundling Guidelines, and use the Healthcare Common Procedural Coding Systems, level II codes, where appropriate. Contract coders must exclude coding information such as symptoms or signs characteristic of the diagnoses, findings from diagnostic studies, or localized conditions, which have no bearing on current management of the patient or as appropriate. Contract coders must clarify conflicting, ambiguous, or non-specific information appearing in the record by consulting with their supervisor who will, if necessary, discuss with the local VA contact.
Contractor shall abide by the American Health Information Management Association (AHIMA) established Code of Ethical Principles as stated in the Standards of Ethical Coding, published by AHIMA. All coding and auditing activities shall utilize VA s electronic health record
All written deliverables shall be phrased in layperson language. Statistical and other technical terminology shall not be used without providing a glossary of terms.
The latest United States editions of the International Classification of Diseases (ICD), Current Medical Information and Terminology (CMIT) and Current Procedural Terminology (CPT) of the American Medical Association (AMA) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) shall be used to provide uniform disease and operation terminology which is complete and scientifically accurate.
Code assignment shall be in accordance with National Center for Health Statistics (NCHS), Centers for Medicare and Medicaid Services (CMS), American Hospital Association (AHA), American Medical Association (AMA) and American Psychiatric Association (APA) guidelines, as appropriate. On those occasions when there is a question, VHA guidelines take precedence. Local policies will direct how coding is accomplished and what quantitative and/or qualitative reviews are performed by the facility. The American Hospital Association (AHA) Coding Clinic and other publications may be used for training and reference purposes.
All work shall be performed at the Contractor s facility unless otherwise specified and mutually agreed to by the Contractor and COR. In the instance where the Contractor is required to work at the Government site, that work shall not take place on Federal holidays unless directed by the Contracting Officer.
Important information:
The Government is not obligated to, nor will it pay for or reimburse any costs associated with responding to this Sources-Sought synopsis request. This notice shall not be construed as a commitment by the Government to issue a solicitation or ultimately award a contract, nor does it restrict the Government to a particular acquisition approach. The Government will in no way be bound to this information if any solicitation is issued. The VA is mandated by Public Law 109-461 to consider a total set-aside for Service Disabled Veteran Owned Small Business set aside. However, if response by Service Disabled Veteran Owned Small Business firms proves inadequate, an alternate set-aside or full and open competition may be determined. No sub-contracting opportunity is anticipated. The North American Classification System (NAICS) code for this acquisition 541511 Custom Computer Programming Services (Small Business Size Standards $27.5M Annual Receipts).
Notice to potential offerors:
All offerors who provide goods or services to the United States Federal Government must be registered in the System for Award Management (SAM) at www.sam.gov and complete Online Representations and Certifications Application (ORCA). Additionally, all Service Disabled Veteran Owned Businesses or Veteran Owned Businesses who respond to a solicitation on this project must be registered with the Department of Veterans Affairs Center for Veterans Enterprise VetBiz Registry located at http://vip.vetbiz.gov.
All interested Offerors should submit information by e-mail to sheri.eiri@va.gov.
All information submissions shall be received no later than 4:30 pm on Wednesday, July 17, 2019. After review of the responses to this announcement, the Government intends to proceed with the acquisition and a subsequent solicitation may be published.
Sheri Eiri, Contract Specialist
SHERI.EIRI@VA.GOV
