Description
I. Introductory This is a Sources Sought. This is NOT a solicitation for proposals, proposal abstracts, or quotations. The purpose of this Sources Sought is to obtain a knowledge and information on potential vendor interest for project planning purposes for a full maintenance agreement for the network server which provides subscriber and dependent coverage for claims status, submission of 837 claims for Medicare and Private insurance payers and inquiry/correction of pending claims. II. Project Description Background: The U.S. Department of Health and Human Services (HHS), Indian Health Service (IHS), is responsible for providing federal health services to American Indians and Alaska Natives. The provision of health services to members of federally recognized tribes grew out of the special government to government relationship between the federal government and Indian tribes. The IHS is the principal federal health care provider and health advocate for the Indian people. The goal is to assure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indians and Alaska Natives. The IHS currently provides health services to approximately 1.5 million American Indians and Alaska Natives who belong to more than 557 federally recognized tribes in 34 states. Navajo Area Indian Health Service (NAIHS) administers health centers and hospitals providing health care to approximately 201,583 members of the Navajo Nation. The Navajo Nation is the largest Indian tribe in the United States and has the largest reservation, which encompasses more than 25,516 square miles in northern Arizona, western New Mexico, and southern Utah, with three satellite communities in central New Mexico. The NAIHS is the primary provider of inpatient, ambulatory care, preventive and community health, and environmental health services for members of the Navajo Nation and the San Juan Southern Paiute Tribe. Requirements: Health and Human Services (HHS), Office of Mission Acquisition Solutions (OMAS) is conducting market research to prepare for the continued requirement of providing claims processing services to the Indian Health Service (IHS). The Contractor shall provide Full Preventive Maintenance services for existing Internet Server for 837 claims processing at Chinle Comprehensive Health Care Facility. The Chinle Service Unit needs a contractor to provide Medicare/Private Insurance claims processing services which allows the collections of third-party billing from IHS beneficiaries' visits at the facility. The Contractor shall provide full network server services in the delivery of IT server services to CCHCF, an IHS provider. Specific tasks include the following: Requirements: The Contractor shall maintain full network services for the delivery of IT services to CCHCF. The contractor shall provide training to CCHCF users. The contractor shall limit the amount of downtime with continuous operations. Eligible Vendors: Businesses must be Indian Economic Enterprises (IEEs) (at least 51% Indian owned and controlled). Business size and type of business (e.g., ISBEE/IEE, 8(a), SDVOSB, etc.). All respondents should be registered on the System for Award Management (SAM) located at https://www.sam.gov. Submission of Invoices: The contractor will submit invoices in accordance with FAR 52.212-4(g) on a monthly basis. Attention: Business Office, P.O. Drawer PH, Chinle, Arizona 86503. Telephone: 928-674-7030; Fax: 928-674-7705. Anticipated Period of Performance: The anticipated start of performance is early-mid May 2026 with a duration of six (6) months. Duties and Responsibility Requirements: • Patient Access. • Ability to verify multiple commercial and government payers. Results into faster/more reimbursement for the facility. • Identify additional billable insurance coverage for patients. Billing: • Electronic claims submission for Medicare, Medicaid, Veteran Administration and Private Insurance • Provides 277 and 999 reports for electronic claims submitted to Medicare. • Dashboard of Private Insurance rejection session. • Ability to run reports for denials. • Capability to correct claims, obtain denial reasons and resubmit claims to payers. FISS/DDE: • Securely connect to Medicare Direct Data Entry (DDE) • Support for multiple submitted IDs • Complete visibility to Medicare claim submissions • On-line claim corrections and ability to obtain denial reasons • Medicare Eligibility verifications • Built in EDI tracking capability Contractor Qualification Requirements: Experience: The Contractor shall possess basic knowledge, skills and abilities to maintain and provide network services on a monthly basis. The Contractor must fill out and submit the IEE Represntation Form in order to be considered. The Contractor shall be in full compliant with Health Insurance Portability and Accountability Act of 1996 (HIPAA). The contractor shall define license and all relative documents. Government Furnished Information, Property and Services: Inspection: all services rendered will be inspected, reviewed, and monitored by TBD, BOM. Contracting Officer Representative (COR): TBD Department Point of Contact: TBD