D399--Health Care Clearing House (HCCH) (#2) Revenue Transactions Processing (RTP) (VA-20-00066700)

As a Health Care Provider, VHA has initiated a number of projects to increase the number of transactions that are completed electronically in order to comply with legislation and to facilitate administrative simplification. The VHA currently utilizes a Contractor to transmit the majority of its incoming and outgoing electronic transactions to and from the national Payer community. VHA routes these transactions through the Department of Veterans Affairs (VA) Financial Services Center (FSC) or other datacenters as specified by the VA prior to transfer to or from the HCCH. Various transaction formats are utilized, such as HIPAA Healthcare Claim (X12N- 5010 837) and National Council for Prescription Drug Program (NCPDP) transactions. VHA transactions are completed as batch and real-time transfers. The Contractor provides reports to VHA on transaction activity for reconciliation, auditing and billing purposes. The Veteran’s Health Administration (VHA) Office of Community Care (OCC), Revenue Operations (RO), eBusiness Solutions Office has established a Contract with a Health Care Clearing House (HCCH) to continue to increase transaction connectivity and further decrease processing time for VHA revenue operations. The VHA OCC, as a proponent of administrative simplification, currently exchanges transactions from health care entities to third (3rd) party carriers. The Contractor shall provide support for all of VHA’s current electronic transactions across the United States and its territories. The Contractor shall assist the VHA in continuing its mission to implement electronic transactions and to support printing of standard claim forms in certain situations where electronic transmission is not feasible. As such, VHA is required to comply with the Health Insurance Portability and Accountability (HIPPA) Act of 1996 Transaction and Code Set (TCS) regulations. The Contractor shall work with the Program Office (PO) and Contracting Officer Representative (COR) to provide connectivity for incoming and outgoing electronic transactions. At no time shall the Contractor direct, change, or engage in the formulation of VHA policy. The VHA is solely responsible to review the Contractor’s recommendations and to make decisions concerning the formulation of policy. The IDIQ requirement was solicted using NAICS code: 518210, The Period of Performance is for 60 Months