RFI Comprehensive Medical Review & Audit Support

Was der Auftraggeber sucht

This Request for Information (RFI) is issued in accordance with FAR Part 10 to conduct market research. The Government's purpose is planning only; this notice does not constitute a Request for Proposal (RFP)/Request for Quotation (RFQ) nor a promise to issue one in the future. The Government will not pay any costs for responding, and any submissions become Government property and will not be returned. Not responding to this RFI does not preclude participation in any future procurement. The Government is not seeking proposals or quotes at this time. Scope of Interest / Functional Areas: The Government is assessing the market¿s capability to provide comprehensive support under the following disciplines: a. Audits for Medicare Parts A, B, D, and Medicaid medical record review and consultative services b. Audits for Medicare Part C medical record review and consultative services c. Evaluations and Inspections medical record review and consultative services d. Expert consultant and witness services in support of the Office of Investigations and/or Office of Counsel to the Inspector General A draft Performance Work Statement (PWS) is provided for industry feedback; requirements may change prior to any future solicitation. Requested Information (do not submit proposals or quotes): Please provide high level, non price specific information addressing the elements below. Do not include proprietary pricing, line item estimates, or any proposal/quote content. Section 1: Corporate Capability & Experience a. PWS Alignment: Demonstrate your organization's core capability to fulfill the functional areas outlined in the draft PWS. b. Medical Review Experience: Outline your firm's high-level experience in conducting large-volume medical claims reviews for audits and evaluations and inspections; and support services for medical expert consultants and witnesses specifically across the following five domains (as referenced in the attached PWS): 1. Audit Medicare Parts A/B/D and Medicaid 2. Audit Medicare Part C 3. Evaluations and Inspections 4. Office of Investigations 5. Office of Counsel to the Inspector General c. Geographic Reach: Describe your prior experience managing and executing nationwide or multi-jurisdictional medical claim reviews. d. Capacity & Scalability: State your organization's maximum monthly claim review capacity, including your approach to scaling operations between normal workloads and surge conditions. e Teaming & Subcontracting: Identify potential subcontracting partners or specialized vendors you would anticipate utilizing, including an estimated percentage breakdown of work performed by the prime contractor versus subcontractors. Section 2: High-Level Technical Approach & Operations a. High-Level Technical Methodology: Describe your conceptual approach to fulfilling the core tasks in PWS. Please limit this narrative to no more than 5 pages total, organized by the 5 PWS sections. Focus on your overarching claims review methodology, general sampling plan frameworks, documentation standards, and typical project timelines rather than a granular, step-by-step solution. b. Quality & Accuracy Frameworks: Outline your corporate quality assurance processes, internal review protocols, and standard strategies used to reduce error rates and ensure consistency across large volumes. b. Staffing & Key Qualifications: Provide a conceptual staffing structure or organizational chart. Identify the typical roles, credentials (e.g., MD, RN, CPC), and qualifications of the key personnel required to successfully support a PWS of this nature. Please identify whether these staff will need to be hired or if they are current employees/contractors. Also, indicate staffing availability for physicians with specialties (i.e. hospice, vascular surgeon, nephrologist, physical medicine and rehabilitation or physiatrists). c. Risk & Mitigation: Identify the primary technical or operational challenges anticipated with a medical review scope of this size…

Sprache dieser Bekanntmachung: English. Titel und Beschreibung erscheinen genau so, wie der Auftraggeber sie veröffentlicht hat.

How this compares

• Bidders were given 31 days from publication to the deadline; the median for open tenders in Vereinigte Staaten is 18 days.

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