Description
The Veterans Administration is conducting market research for a future contract to operate a Health‑Care Clearing House (HCCH) that will process HIPAA‑compliant electronic insurance eligibility (270/271) transactions and perform insurance‑coverage discovery (EICD) for VA patients. The contractor must provide real‑time and batch transaction processing, maintain up‑to‑date payer dictionaries, generate required monthly and ad‑hoc reports, and meet strict security and accreditation standards. The eventual contract will be a firm‑fixed‑price IDIQ with a five‑year ordering period and a $25 M ceiling, paid per transaction processed.
• Process high‑volume HIPAA 270/271 eligibility inquiries (≈ 38 million transactions over five years) and custom insurance‑coverage discovery transactions.
• Maintain payer lists, provide monthly reconciliation and response‑time reports, and issue system‑wide failure/outage notifications within stringent timelines.
• Hold EHNAC HNAP‑EHN accreditation and CAQH CORE Phase II certification, and comply with VA FISMA‑High security requirements and the 50 % subcontracting limitation.