SW-35875 - USA (Vermont) - Healthcare Effectiveness Data and Information Set and Additional Performance Quality Measure Reporting Service - Deadline September 18,2020

Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID: SW-35875

Government Authority located in Vermont; USA based organization looking for expert vendor for healthcare effectiveness data and information set and additional performance quality measure reporting service.

[A] Budget: Looking for proposal

[B] Scope of Service:

(1) Vendor needs to provide to the State with a contractor-supported system for performance measure production, which shall provide for the analysis of Medicaid data and calculation of healthcare effectiveness data and Information Set and other quality measures.
- Providing State’s direct employees with unlimited login ID's to access and use the Contractor’s Retrieval System during the Term of this Contract;
- Conducting necessary data quality assurances on the imported Request File in order to correctly identify Provider information (verifying provider contact data, organizing requests by group ID vs. provider ID, etc.);
- Contacting each medical Provider telephonically, by mail, or by fax (as appropriate) to request Medical Records for the appropriate dates of service and sending via fax or mail the medical record request confirmation letter and member pull list;
- Conducting necessary follow-up with Providers for the purpose of retrieving Medical Records;
- If a Provider indicates it is unwilling to mail, fax, or upload the requested Medical Records to the Contractor, the Contractor will notify the State, and the State will engage its provider relations group to contact the provider and encourage remote retrieval participation.  If the Provider is still unwilling to participate in remote retrieval efforts following the State’s provider relations engagement, the Contractor shall provide the State with written notice.  In no event shall the State pay expenses for on-site retrieval;
- Inputting status notes into the system to allow the State real-time tracking of each Request;
- Allowing for automated email alerts when additional information is needed from the State (i.e., excessive fee approval);
- Providing toll-free telephone number(s) for Provider questions and assistance;
- Providing a dedicated account manager and account team to ensure smooth transition of work, and accurate, timely work completion;
- Holding regularly scheduled conference calls between the State and the Contractor account management and operations teams;
- Handling all pre- and post-payments to medical Providers (as necessary);
- Any provider/copy service invoice will be forwarded to the State for resolution. The State shall be responsible for the resolutions of these invoices. The Contractor shall not be responsible for any delays or omitted records that result from the States failure to resolve payment;
- Processing of all incoming Medical Records, via mail, fax, provider upload portal or other mutually agreed upon electronic means;
- Imaging and associating incoming Medical Records to the appropriate Requests;
- Verifying that the imaged records meet quality standards related to clarity, and that the record is associated with the correct member. All records will be delivered in the same “as is” condition that the Medical Records are received from the Provider; and
- Making all imaged records available for download or through electronic delivery via secure file transfer protocol.
(2) All the questions must be submitted no later than August 19, 2020
(3) The contract period will be for two year.
(4) Pre-bid conference will be held on August 19, 2020  

[C] Eligibility:

Onshore (US organization Only)

[D] Work Performance:

Performance of the work will be Offsite. Vendor needs to carry work in their office premises.

Expiry Date : Friday, 18 September, 2020

Pre-proposal Conference Date : Wednesday, 19 August, 2020

Question Answer Deadline : Wednesday, 19 August, 2020

Category : Software, System and Application

Country : USA

State : Vermont

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