Patient Business Office and Denial Management Services, Phoenix Indian Medical Center
ID: RFQ-25-PHX-016Type: Solicitation
Overview

Buyer

HEALTH AND HUMAN SERVICES, DEPARTMENT OFINDIAN HEALTH SERVICEPHOENIX AREA INDIAN HEALTH SVCPHOENIX, AZ, 85004, USA

NAICS

Other Management Consulting Services (541618)

PSC

SUPPORT- MANAGEMENT: OTHER (R799)

Set Aside

Buy Indian Set-Aside (specific to Department of Health and Human Services, Indian Health Services) (BICiv)
Timeline
    Description

    The Department of Health and Human Services, through the Phoenix Area Indian Health Service, is soliciting proposals for Patient Business Office and Denial Management Services at the Phoenix Indian Medical Center in Arizona. This procurement aims to address an accounts receivable backlog exceeding $28 million by enhancing accounts receivable, collections, and denial management processes, ultimately improving patient access and expediting payments. The contract is exclusively set aside for Indian Small Business Economic Enterprises (ISBEE)/Native American-owned Small Businesses, with proposals required to comply with IPv6 network standards and include detailed technical and pricing submissions. Interested parties should contact Dekovan Cook at Dekovan.Cook@ihs.gov or 602-364-5018, with proposals due by the specified deadline in the solicitation.

    Point(s) of Contact
    Files
    Title
    Posted
    The Indian Health Service (IHS) document outlines the requirements associated with the Buy Indian Act, mandating that Offerors self-certify as an “Indian Economic Enterprise” when responding to solicitations or requests for information. The certification must be valid at three key points: during the offer submission, upon contract award, and throughout the contract period. If eligibility criteria are not met at any time, immediate notification to the Contracting Officer is required. Additionally, those submitting offers must be registered with the System of Award Management (SAM), and any false information can lead to severe legal penalties under U.S. law. The document requests information regarding the ownership percentage of tribal entities, requiring the signature of the 51% owner of the firm and details about the business, including its Unique Entity Identifier (UEI) number. Overall, this document emphasizes compliance and eligibility verification for Indian Economic Enterprises participating in federally funded contracts under the Buy Indian Act, underscoring the importance of truthful representation and regulatory adherence.
    The Phoenix Indian Medical Center (PIMC) of the Indian Health Service (IHS) seeks to address an accounts receivable backlog exceeding $28 million through a contract with a third-party provider. The contractor will enhance Accounts Receivable, Collections, and Denial Management processes, aiming to expedite payments and improve patient access. Key tasks include training PIMC staff, verifying patient eligibility, and managing claim denials primarily for Medicare, Medicaid, and private insurance. The contractor will categorize aging claims, resubmit, appeal denials, and provide ongoing training and tracking mechanisms to enhance productivity and accountability. Deliverables include weekly and monthly status reports on claims, financial metrics, and identified issues. The contract will last one year, requiring significant experience with IHS's Resource and Patient Management System and adherence to Privacy Act regulations. This RFP emphasizes improving operational efficiency in patient billing and claim resolution, critical for sustaining PIMC’s financial health and service delivery to Indian health beneficiaries.
    This document outlines a structured proposal for contracting medical billing and consulting services for a healthcare entity over a base year and four option years. It lists various service categories including outpatient and inpatient medical billing, insurance verification, accounts receivables management, revenue cycle consulting, clinical applications coordination, monthly revenue cycle management reports, and education and training. Each service is quantified with an estimated quantity of 8 hours per month or 12 months for reports, though specific unit prices and total prices remain unspecified. The billing for most services is set to occur monthly. The document is formatted to capture costs over the base year and subsequent option years, indicating a long-term service commitment with annual totals noted but not itemized. This proposal reflects a typical government request for proposals (RFP) structure, addressing essential healthcare operations and fiscal management while ensuring contractual clarity in the procurement process.
    The Department of Health and Human Services’ Phoenix Area Indian Health Service (IHS) is soliciting proposals for Patient Business Office and Denial Management Services at the Phoenix Indian Medical Center, Arizona. This request is exclusively for Indian Small Business Economic Enterprises (ISBEE)/Native American-owned Small Businesses. Proposals must be submitted electronically, detailing both technical aspects and pricing, as the government will award a firm fixed-price contract. Submissions need to comply with IPv6 network standards as mandated by the OMB. Proposal evaluation will consider technical capability, delivery timelines (service must go live within 30 days of kickoff), past performance (with a minimum of three examples required), and price, with non-price factors given greater importance. A successful proposal must score "Acceptable" across all non-price criteria to be considered further. Invoicing under the resulting contract will follow electronic procedures set by the Department of Treasury's Invoice Processing Platform (IPP). The solicitation emphasizes compliance with federal regulations and standards, aiming to select the most advantageous offer for delivering required services efficiently and effectively.
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