Thursday, April 25, 2024

VA to award Claims Processing System Support Task Order

Notice ID T4NG0578

Contract Award Number: VA11816D1027

Task/Delivery Order Number: 36C10B21N10270008

“Market research was conducted in October 2020 through April 2021. A request for information (RFI) was posted on the T4NG portal on February 22, 2021, including a draft Performance Work Statement (PWS), technical specifications, and specific questions related to vendor capabilities maintaining systems with a similar architecture. The draft PWS and attachments posted with the RFI stated the specific software needs and described the current solution’s architecture, including the IBM FCI requirement.

The RFI closed on March 1, 2021 resulting in 10 responses, consisting of five Service-Disabled Veteran-Owned Small Businesses (SDVOSBs) and five large businesses. Upon review of the RFI responses, technical experts deemed two of the SDVOSBs capable of meeting the Government’s requirements and confirmed they also appeared capable of providing the IBM brand name software required. The contract specialist reached out to the two capable SDVOSBs and they both confirmed that they can deliver IBM FCI as part of their proposed solution support.

Additionally, Government subject matter experts reviewed alternate brands from companies such as Thrive’s Revenue Cycle Management Technology and Accenture’s Financial Crime Analytics Utility. However, due to the interoperability requirements of the Claims Processing System and proprietary nature of the IBM FCI software, there is no other compatible software to meet the requirements or satisfy the Government’s needs. Based on the above, the Government’s technical experts have determined that only IBM FCI brand name software can meet all of the Government’s needs and maintain the operability of the Claims Processing System…”

“2. Description of Action: The proposed action is for the issuance of a firm-fixed-price Task Order under Transformation Twenty-one Total Technology Next Generation (T4NG), for a brand name International Business Machine (IBM) Financial Crimes Insight (FCI) software utilized as the workflow tool for VA Revenue users within the existing Claims Processing System. The brand name software being procured only applies to a portion of the total procurement. The overall procurement is to obtain services to support operations, maintenance and enhancement of the existing Claims Processing System…”

“3. Description of the Supplies or Services: The proposed action is for IBM FCI software, product support, security and product updates, as an enterprise-level licensed product, utilized as the workflow tool in the Community Care Claims Processing System. In June 2017, a competitive task order was awarded for the Community Care Claims Processing System. The IBM FCI software was proposed and included as part of the Claims Processing System and is now required as part of the recompete. The IBM FCI software within the Claims Processing System identifies all invoices paid by Veterans Health Administration (VHA) for Veterans or Veteran Beneficiaries who have billable other health insurance and/or are VA 1st party copayment required. The Revenue Operations team utilizes the data included on the Electronic Data Interchange 837 Coordination of Benefits transactions submitted to VA by the claims processing vendor for revenue processes. This justification for the brand name IBM FCI software only applies to a portion of the total procurement. The total estimated price of the effort is $; however, the estimated price for the brand name portion only is $. The period of performance of the overall action includes a 12 month Base, with four 12-month Option Periods and four Optional Tasks. One of the optional tasks is for the IBM FCI software renewal during the option periods. Accordingly, the approval level for this justification is based on the brand name portion of the requirement only…”

Read more here.

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Jackie Gilbert
Jackie Gilbert
Jackie Gilbert is a Content Analyst for FedHealthIT and Author of 'Anything but COVID-19' on the Daily Take Newsletter for G2Xchange Health and FedCiv.

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