R--electronic processing of disputed healthcare claims

The VAMC of Providence RI is entering into negotiations with Electronic Data Systems of Herndon,VA. All interested parties are requested to give written notificaiton including all pertinent data (descriptive literature, specifications, etc). Send information to: VAMC (90C), 830 Chalkstone Ave, Providence, RI 02908 by the close of business on March 21, 2006 EST. This proposed contract is for use contractor's automated system to electronically process disputed healthcare claims for the VAMC in Providence. The contractor program will interface with the appropriate insurance entities, in a timely and efficient manner, to facilitate faster dispute resolution and payment. The processing needs to provide informative reports that can be used to measure performance and potenetial areas of improvement for the claims preparation process. This program -database should contain the following: maintains a rules database; appeals must be sent to every level of appeal review; response timeframes; escalation procedures; reulaatory agency oversite responsibility; prefoerred format of the appeal; regular database rule updates. Submission of claim files by the VA is managed through mutual agreement between the VA and the contractor. This is HIPAA compliant and Background Investigation compliant.