Q601--Health Care Clearinghouse 1 - HIPAA Electronic Transactions and Insurance Discovery (VA-27-00018291) | Maxel/Svendsen

The Department of Veterans Affairs is seeking a second Health Care Clearinghouse (HCCH) to process HIPAA 270/271 eligibility‑benefit electronic transactions and to conduct “insurance coverage discovery” for Veterans when their insurance information is missing. The contractor will receive transaction feeds from the VA’s Austin Financial Services Center, perform real‑time and batch eligibility queries to a broad payer list, and return the appropriate 271 responses. The award will be a firm‑fixed‑price contract initially for six months with an optional six‑month extension, requiring the holder of both HNAP‑EHN accreditation (or VA ATO) and CAQH‑CORE Phase II certification. The work must be performed from the contractor’s site, using a secure VPN (FIPS‑140‑2 encryption) and must comply with HIPAA, FISMA, NIST, and VA security standards. • Process high‑volume HIPAA 270/271 eligibility‑benefit transactions (≈ 2.15 million total over 6 months). • Provide “day‑one” connectivity for both standard and custom insurance‑coverage‑discovery payers. • Maintain required accreditations (HNAP‑EHN and CAQH CORE) and meet strict incident‑reporting timelines (≤ 1 hour).