Iowa Bids > Bid Detail

835 electronic remits and/or Pharmacy Prescription Claim Reconciliation software

Back Print
Agency: University of Iowa
Level of Government: State & Local
Category:
  • Q - Medical Services
Opps ID: NBD18081073297441480
Posted Date: Dec 22, 2023
Due Date:
Solicitation No: RFP 18063 Addendum 2

Bid Information

Type Request for Proposal - Sealed
Status Awarded
Number RFP 18063 Addendum 2 (835 electronic remits and/or Pharmacy Prescription Claim Reconciliation software)
Issue Date & Time 4/27/2023 04:35:00 PM (CT)
Close Date & Time 6/12/2023 03:00:00 PM (CT)
Duration 1 month 15 days
Notes
The University of Iowa solicits proposals from qualified Suppliers who are currently able to provide all materials, equipment, labor and services necessary for providing 1) file conversion of paper/PDF remits to 835 electronic format and/or 2) claim line item level reconciliation, reporting and analysis for monthly accounting transactions for four pharmacies. This is a 2-part bid. A Supplier may respond to Part 1, Part 2, or both. Bid Attributes apply to both Part 1 and Part 2 unless otherwise indicated. Please make it clear if the bid response you will submit is in response to Part 1, Part 2, or both.
Please be aware that this is an extensive bid. All Suppliers are cautioned to allow ample time for the submittal of RFP responses well before the due date time requirement. Bids must be submitted via the eBid system.
Questions regarding the bid may be submitted by registered Suppliers via the Questions tab within eBid prior to the question cutoff date. All Supplier questions and the University answers to those questions will be published sometime after the Questions close deadline for all interested Suppliers to review.
Contact Information
Name Doris Vaske
Address 202 PCO
Iowa City, IA 52242-2500
Phone 319 (335) 0113
Fax 319 (335) 2443
Email doris-vaske@uiowa.edu
Awarded Suppliers
Supplier Name Award Line Count Award Amount
Data pager
Data pager
Page size:
PageSizeComboBox
select
Your browser does not support inline frames or is currently configured not to display inline frames.
  • 10
  • 15
  • 20
  • 50
1 items in 1 pages
SCRIPTPRO USA INC 9
Bid Documents
Document name Format
Data pager
Data pager
Page size:
PageSizeComboBox
select
Your browser does not support inline frames or is currently configured not to display inline frames.
  • 10
  • 15
  • 20
  • 50
1 items in 1 pages
Bid Invitation Acrobat / PDF
Bid Attachments
File Name Description File Size
Data pager
Data pager
Page size:
PageSizeComboBox
select
Your browser does not support inline frames or is currently configured not to display inline frames.
  • 10
  • 15
  • 20
  • 50
3 items in 1 pages
Standard Terms and Conditions Updated.pdf University of Iowa Standard Terms and Conditions 210 KB
UIHC_HCIS_IT_Assessment_20220805.docx UIHC HCIS IT Assessment document Revised 8-05-2022 52 KB
Remit Example of actual paper remittance for 835 file conversion.pdf Remit Example of actual paper remittance for 835 file conversion 315 KB
Bid Questions
Question Please provide us with: Number of Claim Attachments
Answer This is not applicable. No hard copy paper attachments.
Submitted 5/12/2023 09:38:23 PM (CT)
Question Please provide us with: Number of Paper Claims
Answer No hard copy paper claims are submitted. The University submits electronic 1500 forms via appropriate portals, which are primarily DME claims.
Submitted 5/12/2023 09:37:15 PM (CT)
Question Please provide us with: Number of Audits
Answer The University has 2 annual audits of our financial statements. With regards to payer audits, over the past 3 years, there have been ~50-70 3rd party audits per year.
Submitted 5/12/2023 09:34:19 PM (CT)
Question For Part 1, 835 File Conversion ONLY 1. Can a sample pdf be provided? We are looking for a sample of the forms that are scanned and what data elements are captured and passed along. We are trying to determine if it’s a scanning/data capture operation or a payer application.
Answer Please see PDF titled: "Remit Example of actual paper remittance for 835 file conversion" that has been uploaded as an additional document on the Attachments tab of this RFP. Please note that the pdf is an actual paper remittance example of a remit that would need to be converted to an 835 file to be uploaded. The names are fictional however they are provided to assure Suppliers understand that name is a necessary field. Numbers have also been altered to assure de-identification of any data on this form.
Submitted 5/12/2023 08:22:47 AM (CT)
Question For Part 1, 835 File Conversion ONLY 2. Can a list of required data elements be provided
Answer National Council for Prescription Drug Programs, (NCPDP), Patient Name, Service Date, Prescription #,National Drug Codes (NDC), Paid Amount, Patient Responsible Amount/deductible/copay/coinsurance/amount not covered/adjustments/fees, Healthcare Common Procedure Coding System (HCPCS) (if exists)
Submitted 5/12/2023 08:22:41 AM (CT)
Question For Part 1, 835 File Conversion ONLY 3. Please confirm volume of documents/pages to be scanned and converted to 835 files. Is it 30% of 55,000 monthly (16,500 approximately). How many pages do these documents typically represent?
Answer Approximately 500 pages
Submitted 5/12/2023 08:22:34 AM (CT)
Question
For Part 1, 835 File Conversion ONLY 4. How do you envision your supplier working with payers to transition them to electronic payment (attribute 53)
Answer If a supplier has expertise working with payers and offers the service of also assisting the University to convert paper check payments into electronic payments, we would like information related to that service as follows: Do you have experience providing this type of service and how did it work if you have provided this service? Do you have knowledge of the required documentation and contacts at the payers? Would you coordinate between UIHC and the payers and follow-up with the payers? Supplier contacts UIHC payers that are remitting back paper remits/checks and work with the payers to convert electronically.
Submitted 5/12/2023 08:22:26 AM (CT)
Question For Part 1, 835 File Conversion ONLY 5. Do you consider Part 1, 835 File Conversion to be a payer solution or a data capture/extraction solution
Answer The University prefers to have a Supplier that is capable of helping us transition as many paper remits to electronic 835 remits as possible. Ideally the vendor would do that by working with the PBMs on our behalf. Once that is done, it will be a matter of capture/extraction for those 835 remits. For the paper remits that are not able to be converted to an 835 format, the University needs the vendor to convert those paper remits to an 835 format on an on-going basis. Data capture/extraction solution to provide UIHC with an uploadable 835 remit file.
Submitted 5/12/2023 08:22:20 AM (CT)
Question
For Part 1, 835 File Conversion ONLY 6. How long is the current process taking to manually enter data into spreadsheets/journals?

Answer Only files needing 835 conversion (not including A/R recon) - information is pulled 10 hours per week by analysts, 15 hours per week scanning remits. There is not a one to one match of prescriptions being done at this time.
Submitted 5/12/2023 08:22:13 AM (CT)
Question Please clarify payment information pertains to the payments received from the insurance carriers and not payments for patient copays. We do not apply payments for patient copays.
Answer Supplier would be expected to reconcile third party payments.
Submitted 5/11/2023 01:43:34 PM (CT)
Items 1 - 10 shown of 15 • Page 1 of 1 shown First 1 2 > Last

TRY FOR FREE

Not a USAOPPS Member Yet?

Get unlimited access to thousands of active local, state and federal government bids and awards in All 50 States.

Start Free Trial Today >