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Contract Opportunity

This is a Sources Sought notice. This is NOT a solicitation for proposals, proposal abstracts, or quotations. Pursuant to 48 CFR Part 326, Subpart 326.603-3 and IHM 5.5-6, Indian Health Service must use the negotiation authority of the Buy Indian Act, 25 U.S.C. 47, to give preference to Indian Economic Enterprises (IEE) whenever the use of that authority is authorized and practicable.

The Government is seeking to identify Indian Small Business Economic Enterprises (ISBEEs) capable of performing the below Indian Health Services (IHS) requirement. Any vendor responding to this notice should submit their capability statement as well as the Buy Indian Act Indian Economic Enterprise Representation Form (attached). Instructions for submission are outlined below.

Indian Small Business Economic Enterprises (ISBEEs) and other small business are highly encouraged to respond to this notice. However, firms should understand that generic capability statements are not sufficient for effective evaluation of their capacity and capability to perform the work required. Responses must directly demonstrate the company’s capability, experience, and ability to provide pharmacy, medical, dental billing claims, and third-party insurance verification services in the following Indian Health Service Area of Responsibilities: Albuquerque, Bemidji, Billings, Great Plain, Navajo, Nashville, Oklahoma, and Portland.

The scope includes, but no limited to:

• Clearinghouse will provide a single, unified user experience which means user log-on to one system.


• Clearinghouse will provide real-time point-of-service eligibility data from third party insurance databases to include commercial payers, Medicare intermediaries, and state Medicaid plans. Queries will be conducted pre-encounter. This may occur in either batches the day before or in real-time.


• Clearinghouse will provide secure data transmission of all electronic claims. Payer enrollment and ability to transmit electronic VA claims is required.


• Clearinghouse will provide initial data checks, initial data scrubbing to ensure clean claim submission to the end-payer, and claim status inquiry and response.


• Clearinghouse will ensure HIPAA Compliant transactions and password protected access and meet IHS security requirements.


• Clearinghouse will have capabilities to drop an electronic claim to paper.


• All claims with errors will be rejected to a site within the portal where rework can occur. Portal should have simple response rejections messages and intuitive interactive decision support through use of ‘help tiles’ within the portal. Claim attachment functionality is necessary. The denial workflow allows direct resubmission.


• All inquiries and responses will provide accurate and up-to-date eligibility information available to the end user. All information will be uploaded for electronic claims transmissions in order for clean claim billing and third-party revenue activities.


• Summary integrated dashboard reports with top tile metrics are needed for ongoing performance tracking, tracking aging receivables, and employee assignments.


• Adherence to Federal and State regulatory requirements.

The Government requests interested parties submit a written response to this notice, which includes:

1. Company Name.


2. Company Socioeconomic Status.


3. Company System for Award Management (SAM) Unique Entity Identifier (UEI) number.


4. Company point of contact, mailing address, and telephone number(s), and website address


5. Name, telephone number, and e-mail address of a company point of contact who has the authority and knowledge to clarify responses with government representatives.


6. DUNS Number:


7. Cage Code:


8. Tax ID


9. Date submitted.


10. Applicable company GSA Schedule number or other available procurement vehicle.


11. Company’s System for Award Management (SAM) registration status. All respondents must register on the SAM located at http://www.sam.gov/.


12. Responses must identify the Indian Health Service Area of consideration for this requirement.


13. Submit Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form (attached)

Disclaimer and Important Notes. This notice does not obligate the Government to award contract. Any information provided by industry to the Government as a result of this sources sought synopsis is strictly voluntary. Responses will not be returned. No entitlements to payment of direct or indirect costs or charges to the Government will arise as a result of contractor submission of responses, or the Government's use of such information or otherwise pay for the information provided in response. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed to allow the Government to determine the organization’s qualifications to perform the work. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. After a review of the responses received, a pre-solicitation synopsis and solicitation may be published on the Government Point of Entry by each of the IHS areas included in this notice. However, responses to this notice will not be considered adequate responses to a solicitation.

Confidentiality. No proprietary, classified, confidential, or sensitive information should be included in your response. The Government reserves the right to use any non-proprietary technical information in any resultant solicitation(s).

How to respond: Please include the notice 75H71324R00002 Clearinghouse Services in the subject line. Responses must be submitted via email to PORAOAcquisition@ihs.gov.

Capability statements will not be returned and will not be accepted after the due date. The maximum number of pages for this submission is five (5) pages.

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