Description
The Department of Veterans Affairs is seeking information from companies that can provide third-party billing services for outpatient medical claims. The contractor will be responsible for generating and submitting claims to third-party insurance carriers, as well as responding to billing-related questions and concerns. The contractor must have experience in managing insurance billing offices with similar volumes and work projected in this Performance Work Statement (PWS). The contractor must also have knowledge of health care revenue third-party billing, including authorizing claims to third-party carriers for outpatient services and applying third-party insurance and Medicare guidelines to claims.
Some key requirements include:
* Processing a minimum of 250,000-350,000 claim encounters per month
* Demonstrating the resources, competencies, and qualified staff to fulfill the requirements of the PWS
* Being able to commit to 30% of staff being permanent staff that is not otherwise employed at CPAC
* Having staffing resources to respond to surges in workload volume within 30-60 days
* Meeting specific standards for claims processing, including timely completion, billing accuracy, and resolving claim rejections
* Participating in conference calls and training as needed to improve billing performance
* Maintaining system access for authorization and release of outpatient medical claims
* Following confidentiality standards for outpatient medical claims