Electronic Data Interchange (EDI) and Paper to Electronic (P2E)(EDI/P2E) Services   2

Solicitation Number: 36C10G23R0004 Notice Type: Combined Synopsis/Solicitation Synopsis: COMBINED SYNOPSIS/SOLICITATION This is a combined synopsis/solicitation for a Healthcare Clearinghouse (HCCH) for Electronic Data Interchange (EDI) and Paper to Electronic (P2E) transaction (EDIP2E) services prepared in accordance with Federal Acquisition Regulation (FAR) Part 12 Commercial Items and FAR Part 15 Contracting by Negotiation as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; proposals are being requested and a written solicitation will not be issued. Solicitation number 36C10G23R0004 is issued for this combined synopsis/solicitation; this solicitation is being issued as a Request for Proposal (RFP). This combined synopsis/solicitation incorporates provisions and clauses in effect through Federal Acquisition Circular (FAC) 2023-01 effective December 30, 2022. Requirement Description: The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Office of Integrated Veteran Care (IVC), formerly Office of Community Care (OCC), utilizes a Healthcare Clearinghouse (HCCH) to provide connectivity with community providers to support the payment for services provided to Veterans and Veteran Families via incoming and outgoing Electronic Data Interchange (EDI) and Paper to Electronic (P2E) transaction services. VHA IVC accepts both paper and electronic submissions for healthcare claims and for supporting documentation. VHA IVC has initiated multiple projects to increase the volume and overall percentage of electronic transactions versus paper or other manual transactions to comply with legislation and to facilitate administrative simplification. VHA IVC employs a HCCH to communicate incoming and outgoing EDI transactions to the over one million medical and dental providers throughout the United States and US Territories. EDI transactions consist of batch and real-time transfers of Health Insurance Portability and Accountability Act (HIPAA) ASC X12N 5010 transactions. VHA IVC also supports several hosted real-time EDI transactions. VHA IVC seeks a Health Care Clearinghouse (HCCH) contractor to support a EDIP2E capability throughout the term of this contract to provide community health care providers access to HIPAA-compliant data and processes in support of payments for care provided to Veterans and Veteran Families. This acquisition is unrestricted and is not set-aside for small business concerns. The associated North American Industrial Classification System (NAICS) code for this procurement is 518210 Data Processing, Hosting, and Related Services and the associated size standard is $40M. The FAR provision at 52.212-1, Instructions to Offerors Commercial, applies to this acquisition including attached addenda to the provision. The FAR provision at 52.212-2, Evaluation - Commercial Items, and the specific evaluation criteria in the attached addenda also applies to this acquisition. Offerors shall include a completed copy of the provision at 52.212-3, Offeror Representations and Certifications -- Commercial Items, with its offer, if not available in the System for Award Management (SAM). The FAR Provision found at 52.204-7(b)(1) requires that All interested Offerors must be registered in SAM prior to submitting an offer or quotation. SAM can be accessed at https://www.sam.gov/portal/public/SAM/ . The clause at 52.212-4, Contract Terms and Conditions -- Commercial Items, applies to this acquisition. The clause at FAR 52.212-5, Contract Terms and Conditions Required to Implement Statutes or Executive Orders - Commercial Items, applies to this acquisition. All questions regarding this combined synopsis/solicitation shall be submitted on Attachment D and are due via email no later than 12:00PM Eastern on January 25, 2023, to Justin.Sink@va.gov and Terri.Duenas@va.gov. No calls will be accepted. Proposals are due via email by 3:00PM Eastern on February 17, 2023 to Justin.Sink@va.gov and Terri.Duenas@va.gov. ATTACHMENTS:

Background
The Department of Veterans Affairs (VA), Veterans Health Administration (VHA), Office of Integrated Veteran Care (IVC) utilizes a Healthcare Clearinghouse (HCCH) to provide connectivity with community providers to support the payment for services provided to Veterans and Veteran Families via incoming and outgoing EDI transaction services. VHA IVC accepts both paper and electronic submissions for healthcare claims and for supporting documentation.
VHA IVC has initiated multiple projects to increase the volume and overall percentage of electronic transactions versus paper or other manual transactions to comply with legislation and to facilitate administrative simplification.

Work Details
This solicitation is for Electronic Data Interchange (EDI) and Paper to Electronic (P2E) services for the Department of Veterans Affairs. The contract includes tasks such as ramp-up and initial implementation, health care claim transactions, eligibility benefit inquiry and response, claim status request and response, health care services review, claim attachment, paper to electronic conversion, rejection claim plus USPS first class postage, receipt and upload to database. The solicitation also requires the offeror to demonstrate an understanding of the technical requirements, provide a plan to recruit and retain key personnel, validate previous and current accreditation by the Electronic Healthcare Network Accreditation Commission (EHNAC), maintain accreditation throughout the life of the contract, maintain certification of compliance with the current Council for Affordable and Quality Healthcare (CAQH) Committee on Operating Rules for Information Exchange (CORE) rules throughout the life of the contract.