Patient Business Office and Denial Management Services - Phoenix Indian Medical Center
ID: SS-25-PHX-005Type: Sources Sought
Overview

Buyer

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

NAICS

Other Management Consulting Services (541618)

Set Aside

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

Original Source

https://sam.gov/opp/549ab265fc1840c4aa6bcaf0a20480cc/view
Timeline
    Description

    The Department of Health and Human Services, specifically the Indian Health Service, is seeking qualified contractors to provide Patient Business Office and Denial Management Services for the Phoenix Indian Medical Center (PIMC) in Arizona. The primary objective of this procurement is to manage and reduce an aging accounts receivable backlog exceeding $28 million through enhanced training, denial management, and patient access services, while ensuring compliance with IHS guidelines. This initiative is crucial for improving the efficiency of revenue collection and patient registration processes at PIMC, with the contract performance period set for one year. Interested firms must respond with their qualifications and self-certification as Indian Economic Enterprises (IEE) or Indian Small Business Economic Enterprises (ISBEE) by the specified deadline, and can contact Dekovan Cook at Dekovan.Cook@ihs.gov or 602-364-5018 for further information.

    Point(s) of Contact
    Dekovan Cook
    (602) 364-5018
    Dekovan.Cook@ihs.gov
    Files
    Title
    Posted
    IEE Representation Form.pdf
    The Indian Health Service (IHS) document outlines regulations under the Buy Indian Act for enterprises seeking federal contracts as Indian Economic Enterprises. It emphasizes that self-certification is required for contractors claiming to meet this definition, which must be maintained throughout the solicitation, award, and performance phases of the contract. Should a contractor fail to meet eligibility at any point, they are obligated to inform the Contracting Officer immediately. The document underscores the importance of being registered in the System of Award Management (SAM) and warns against submitting false information, which could lead to legal penalties under U.S. law. Offerors must explicitly state their status regarding “Indian ownership,” and provide details such as their unique identifier and tribal entity information. This document serves as a critical notice for compliance with eligibility standards within government contracting aimed at supporting Indian-owned businesses.
    Patient Access and Denial Managment SOW rev.pdf
    The Phoenix Indian Medical Center (PIMC) intends to contract a third party to manage its Accounts Receivable (AR) situation, addressing an aging total of over $28 million. The project's objective is to decrease the backlog of aged accounts through improved training, denial management, and patient access services. The contractor will provide training to current and new staff in the Patient Business Office and denial management, ensuring compliance with Indian Health Service (IHS) guidelines. Key responsibilities include verifying patient eligibility and addressing denied claims across various insurers, processing up to 15,000 claims over a year. The contractor will also develop tracking mechanisms to aid staff productivity and produce deliverables, such as spreadsheets for resubmissions and claims status. The contract has a performance period of one year and requires the contractor to have at least ten years of experience with IHS's Resource and Patient Management System. Privacy Act considerations will also guide the contractor's operations concerning personal records. Overall, the initiative aims to enhance the efficiency and effectiveness of revenue collection and patient registration processes at PIMC.
    Sources Sought.pdf
    The document outlines a Sources Sought Notice regarding the need for Patient Business Office and Denial Management Services at the Phoenix Indian Medical Center, leveraging the Buy Indian Act to prioritize acquisitions from Indian Economic Enterprises (IEE) and Indian Small Business Economic Enterprises (ISBEE). Interested firms are instructed to respond with specific company information, certifications of eligibility, and capability statements to demonstrate qualifications. The notice emphasizes compliance with the Buy Indian Act to promote participation from Indigenous businesses, indicating the Government's intent to conduct market research for obtaining offers from multiple IEEs. Respondents must self-certify their IEE status and identify their affiliations with recognized tribes or Alaska Native Corporations. This sourcing process reflects the federal commitment to facilitate economic opportunities for Native American businesses and ensure compliance with federal acquisition policies.
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