QUESTIONS & ANSWERS RFP Medicaid Billing Services Today s Date: October 21, 2013

Transcription

1 RFP NO. RFP MEDICAID BILLING SERVICES PAGE 1 QUESTIONS & ANSWERS RFP Medicaid Billing Services Today s Date: October 21, 2013 RESPONSES MUST BE RECEIVED IN THE PURCHASING DEPARTMENT: - DEADLINE TIME - Before 2:00 PM, Tuesday, October 29, PUBLIC BID OPENING - At 2:00 PM, Wednesday, October 30, 2013 RESPONSES TO BE OPENED: Beginning 2:00 PM EST, Wednesday, October 30, 2013 DeKalb County School District Purchasing Department 1701 Mountain Industrial Boulevard Stone Mountain, GA Question #1: Can you provide the total amount of claims paid for the last 2 fiscal years for health related services under this RFP? Answer #1: None. Question #2: Can the work be done offshore outside of the US? Answer #2: No. Question #3: Would non-government reference in the US work? Question #3: No. Question #4: Does the district have an estimation for the healthcare cost under this program? Answer #4: No.

2 RFP NO. RFP MEDICAID BILLING SERVICES PAGE 2 Question #5: Will the district take a PMPM fee rate (per member per month)? Answer #5: That will be determined by the committee. Information should be submitted in proposal. Question #6: How many providers/npi numbers this will be billing for? Answer #6: One, the District s NPI number. Question #7: Is the 2 year of financial statements necessary? Answer #7: Yes. Financial statements are a mandatory requirement. Question #8: Would DCSD be able to provide a level-of-range to help offerors submit a more accurate proposal? Answer #8: DeKalb has approximately 8800 students with disabilities, many of whom have health related services as a part of their Individualized Education Programs. Actually billing numbers have not been undetermined. The selected vendor will be expected to work with the District to make this determination. Question #9: What is the budget allocated to this project? Answer #9: That information is not available at this time. Question #10: Is there a budget allocated to this project? Is this information that you normally give out? Answer #10: That information is not available at this time. Question #11: Page 20, Part III, Scope of Work, C. Scope of Work/Specifications - Does DeKalb County School District have any past history in Medicaid Billing Services? If so, what were the revenue trends and why was it discontinued? If not, why was a program not established in the past and what has changed recently? Answer #11: DeKalb previously participated in the Medicaid program until Participation was discontinued after the ACE program was discontinued in the State. Previous revenue trends are unknown at this time.

3 RFP NO. RFP MEDICAID BILLING SERVICES PAGE 3 Question #12: On page 20, Part III, Scope of Work, C. Scope of Work/Specifications, Attachment B will the percentage fee be applied to the total of DCSD s ACE Medicaid reimbursement and FFS/CISS Medicaid Reimbursement? What is the dollar range of annual revenue that DCSD has projected for this new program, split by these two areas? Answer #12: Undetermined at this time. Question #13: Page 25, Part III, Scope of Work, I. Transition Plan - Who are DCSD s existing providers being referenced and since what date has DCSD contracted with them? What contractor fees have been paid for the past three years? Answer #13: No existing providers. Question #14: Page 22, Part III, Scope of Work, C. Scope of Work/Specifications, #10 Do the DCSD therapists have hands-on experience using an on-line system like the TieNet IEP program? Do the DCSD therapists document their IEP services on paper or using TieNet or another electronic system? If so, please describe. Answer #14: DeKalb has used an online Medicaid billing system in the past, however many current staff members will not be familiar with this process. IEP services are documented on paper. Question #15: Does the District have a dedicated Medicaid staff? If so, how many members and what are their Answer #15: No. responsibilities? Question #16: Can DCSD please provide the following counts A. Special education students with one or more related services B. How many (approximate) of the District s special education students are Medicaid elegible? Answer #16: A special education students. Approximately 4000 with health-related services. B. Medicaid eligible students unknown.

4 RFP NO. RFP MEDICAID BILLING SERVICES PAGE 4 Question #17: In part III, Scope of Work, #10 What type of modifications would be required and is it the district s desire to make modifications themselves? Answer #17: Undetermined. Question #18: Can you provide a list of data elements to be extracted from the TieNet IEP Program? Answer #18: Any required Medicaid information that already exists in the TieNet program. Question #19: Will DCSD require all providers to document services online? Answer #19: Yes. Question #20: Will DCSD reuire all providers to document for all billable services? Answer #20: Yes. Question #21: Are any of DCSD s providers federally funded? Answer #21: Yes. Question #22: How many staff members will be required to receive training for A. Documenting services (therapists, aides, nurses, etc.)? B. Medicaid coordinators C. Medicaid administrators Answer #22: Therapists 140; Clerical Staff 3; Administrators 3;

5 RFP NO. RFP MEDICAID BILLING SERVICES PAGE 5 Question #23: How would the District want to receive this training? A. Vendor-led classes for all staff members? B. Train-the-Trainer approach where vendor trains a cadre of DCSD trainers who would then provide end-user training? Answer #23: Vendor led classes. Question #24: Does the district have a physician on staff who can sign all the district s IEPs? Answer #24: No. Question #25: Have you already decided if you plan to use a signed and dated LMN, WSP, Treatment Plan or POC or a combination of each as required for the provision of services? Answer #25: Not at this time. Question #26: What is the definition of Child s Primary Care Provider? Answer #26: As defined by the Georgia Department of Community Health in the Medicaid manual. Question #27: Could you please provide the forms in an editable format, such as Microsoft Word? Answer #27: The forms are available in PDF only. Question #28: Will DCSD be submitting for all available services (Audiology Speech Therapy, Occupational Therapy, Physical Answer #28: No. Therapy, Nursing Services, Counseling Services, and Nutrition Services)? Question #29: How many Speech, Occupational, and Physical Therapists does DCSD have on staff? Answer #29: 140.

6 RFP NO. RFP MEDICAID BILLING SERVICES PAGE 6 Question #30: How many speech Therapists do not have their CCC s or a Master s with a Speech certificate with DOE? Answer #30: All have the required certification. Question #31: How many COTA s does DCSD have? Answer #31: N/A. Question #32: How many Nurses are RN s? Answer #32: All. Question #33: How many providers are currently Federally Funded? Answer #33: Approximately 50%. Question #34: Will there be a Medicaid Coordinator within the administrative offices as the main contact to help with initial student information collection, parent consent and Dr referrals/rxs? Answer #34: Yes, there will be someone with these responsibilities. Question #35: How is DCSD currently collecting parental consent and Dr. referrals/rxs. Answer #35: No process in place. Question #36: Page 18, Section Q, Financial Stability What other proof of financial stability is able to be provided if the bidding organization is closely-held and historically and as a general practice has not conducted a formal process for the audit of its financial statements, and has provided this type of service outlined in the RFP since 1994? Answer #36: Financial Statements are required. Refer to Section Q, Financial Stability. Question #37: Would DCSD consider a fixed fee cost proposal instead of a percentage of Net Medicaid Dollars? Answer #37: This will be determined by the review committee.