Updated January 14, 2021
Notice ID: 36C77620R0016
The Veteran’s Health Administration (VHA) Office of Community Care (OCC), Revenue Operations (RO), eBusiness Solutions Office is looking to establish 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…
Health Care Transaction Services:
Task: Provide and support comprehensive version control for all mandated industry standards, specifically the capability to up or down code transactions to accommodate VHA industry compliant transactions regardless of Payer compliance status.
Task: Provide testing or certification mechanisms for validation of current batch (B) and real time (RT) transactions in the current HIPAA X12 and NCPDP versions within thirty (30) business days of award date.
Deliverable: Receive, process, and transmit health care transactions in HIPAA X12 and NCPDP formats, VHA approved formats, or any formats specifically acceptable for electronically-enabled Payers and agreed upon by VHA and the contractor. (Deliver per the instructions listed in Section 4)
Deliverable: Support and process, at a minimum, the following batch and real-time transactions and relevant code sets. (Deliver per the instructions listed in Section 4)
Batch Transaction: Primary, Secondary and Tertiary Professional Healthcare Claim (837) Health Care Claims (Institutional, Professional, and Dental).
Batch Transaction: Medicare Equivalent Remittance Advice – 835eMRA.
Batch Transaction: File Acknowledgements – 997 and 999.
Batch Transaction: Claim acknowledgement – 277CA, 277 RFAI.
Batch Transaction: Interchange Acknowledgements – TA1.
Batch Transaction: VA Proprietary file formats.
Posted October 29, 2020
Notice ID: 36C77620R0016
The Veteran’s Health Administration (VHA) Office of Community Care (OCC), Revenue Operations (RO), eBusiness Solutions Office is looking to establish 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.
