Description
This presolicitation notice is to inform all vendors that the United States Department of Labor is scheduling to release the formal Request for Proposal (RFP) for "Workers' Compensation Medical Bill Processing" (WCMBP) via Federal Business Opportunities (FBO) on or about 10 January 2014. The United States Department of Labor's (DOL) Office of Workers' Compensation Programs (OWCP) is seeking a contractor to provide Workers' Compensation Medical Bill Processing and Mailroom services. The purpose of this notice under FAR 15.201 is to provide potential companies the maximum amount of time to develop proposals and to form teaming agreements if required. DOL intends to award a single firm fixed price contract with other direct cost (ODC) pass-throughs. This contract will be awarded to a single prime Contractor for execution of all tasks resulting from this solicitation. DOL will use performance-based contracting in execution of this contract. The NAICS code for this requirement is 524298 and the size standard is $7 million. The base period of performance of the proposed contract is anticipated to be one year with four one-year options, and up to two one-year award terms for outstanding performance - for a total potential performance period of seven years. The solicitation will be distributed solely through Federal Business Opportunities web site, http://www.fbo.gov. Hard copies of the solicitation document will not be available. The site provides downloading instructions. All future information about this acquisition, including solicitation amendments, will also be distributed solely through this site. Interested parties are responsible for monitoring this site to ensure that they have the most up-to-date information about this acquisition. Although DOL intends to allow the solicitation to remain open for a duration of sixty days, the closing date for this solicitation will be specified in the solicitation. All responsible sources may submit a proposal which will be considered by this agency. No collect calls will be accepted. No telephone requests for the solicitation will be accepted. PURPOSE The U.S. Department of Labor's (DOL) OWCP administers workers' compensation medical bill processing programs that mitigate the impact of work-related injury for certain workers and their families. OWCP is seeking a single Contractor to build and operate a centralized workers' compensation medical bill processing (WCMBP) solution for three OWCP programs: the Division of Federal Employees' Compensation (DFEC), the Division of Coal Mine Workers' Compensation (DCMWC) and the Division of Energy Employees Occupational Illness Compensation (DEEOIC). OWCP's medical bill processing function is currently performed as a contracted service. The Government does not own an information system that can be transferred to a follow-on Contractor. Only historical data will be transferred. This centralized solution will include the processes associated with receipt of the medical bills and attachments, review of medical bills and attachments against program-specific authorizations, handling of inquiries related to medical services from claimants and providers, and utilization of business rules established by each OWCP program for the adjudication and pricing of medical bills. Specifically, the integrated system will support the following capabilities: • Receipt and accounting for medical bills, attachments and other documents, in both hardcopy and electronic formats • Scanning and data entry of bills, attachments and other documents received. • Processing of bills to payment or denial (the Contractor will not make benefit payments, but will transfer payment files to Treasury for certification and payment) • Processing of requests for adjustment, authorization of services, suspense resolution, and appeals processing • Processing and responding to submitted correspondence received from medical providers and claimants, when applicable, and storing the responses to the correspondence in an imaging system from which the Government can retrieve for review • Enrolling new providers and managing information about existing providers • Providing claimant and provider support via a call center and self-service applications (such as user access portals and IVR) • Processing Point of Sale (POS) pharmacy bills • Providing secure on-line access, available to authorized users, to view images of bills, correspondence, and other documents. PROGRAM OBJECTIVES The goal of the WCMBP program is to acquire a standards-based medical bill processing system and processes that implement the following: • Improved mailroom, imaging, and data entry throughput, accuracy, and efficiency • Ensure a smooth and timely transition from the incumbent service provider • Ensure efficient, accurate and timely processing of medical and pharmacy bills • Ensure timely and correctly processed authorizations for covered benefits. • Provide accurate and timely responses to customer inquiries and requests. • Implement advanced medical bill processing technologies and processes • Develop robust fraud and abuse and error detection/protection processes • Use of industry-standard hosting and programming techniques to support portability among platforms • Implement robust change and configuration management process • Establish a framework for continuous improvement RFP RELEASE DATE: ON OR ABOUT 10 JANUARY 2014