The document is a presolicitation notice for a contract related to insurance discovery for the San Francisco Veterans Affairs Health Care System (SFVAHCS). The solicitation number is 36C26125Q0147, with a response deadline set for January 15, 2025, at 10:00 AM Pacific Time. The contracting office is located at the VA Pacific Islands Health Care System in Honolulu, Hawaii. The project is classified under the Product Service Code R612 and NAICS Code 524298. Interested parties should refer to solicitation 36C26125Q0147 for detailed information. The purpose of this presolicitation is to provide potential vendors with essential details about the upcoming request for proposals regarding insurance-related services for veterans' healthcare. The document includes specifics on the location of service delivery and relevant contact information, indicating a structured approach typical of government contracting processes to ensure compliance and transparency.

The document outlines a Request for Proposal (RFP) related to insurance discovery services for beneficiaries of the San Francisco Veterans Affairs Health Care System (SFVAHCS). The contractor will provide software and personnel to identify potential insurance coverage for eligible patients, ensuring all findings and applications are facilitated efficiently. The services are conducted at the VA Medical Center in San Francisco, operating with specified hours and adhering to federal holidays. Key responsibilities include conducting screenings, assisting with applications for Medicaid and Medicare, and providing updates on application statuses, all while maintaining security and privacy standards. The contractor personnel must meet health and security requirements, ensuring compliance with federal regulations regarding data protection. The performance work statement emphasizes the importance of identifying insured, uninsured, or under-insured beneficiaries and mandates a quality control program to ensure service standards. The contractor is accountable for maintaining accurate records and ensuring all patient data is handled confidentially according to regulatory guidelines. This RFP serves to enhance health coverage accessibility for veterans while ensuring data integrity and compliance with relevant laws and regulations.

The document outlines the workflow process for the Insurance Discovery Contract regarding patient admissions. It details the steps taken from a patient's admission—whether planned or unplanned—to insurance application submission. Initially, the Clinical Command Center coordinates with a contractor, which identifies patient eligibility and findings within 24 hours. If active coverage is confirmed, the contractor assists the patient with the application process. If not, an application is submitted to a social worker. The social worker then submits the application on behalf of the patient. This structured approach ensures timely insurance information processing and supports efficient patient care services. The document emphasizes coordination between clinical command, member services, and external contractors to facilitate coverage determination and application submissions, highlighting the workflow's importance in healthcare operations and patient support.