RFP 10049743 ICD 10 Consulting April 14, 2015 Addendum #1 1. Clarification: Several times throughout the RFP document, bidding phase is referenced. This is the complete RFQ. Technical and Pricing proposals should be in separate sealed envelopes. Any mention of pricing in the Technical Proposal will result in bidder disqualification. 2. Provide Specialty Mix Oral & Maxillofacial Surgery Craniofacial Pain/Sleep Medicine Pediatric Dentistry Family Medicine OB-GYN Internal Medicine Family Nurse Practitioner Psychiatry Physical Therapy Occupational Therapy Center for Development Disabilities Medicine Social Work Medicine/Psychiatry Psychology Speech Path Nutrition Audiology 3. RFP statement: Technical proposals are to be submitted as a booklet or in a notebook form with an appropriate table of contents. (p. 5) Do you want the hard copy proposals bound? Technical Proposals can be in a notebook or bound. The intent is to keep all submittals together as they are being reviewed. 4. RFP statement: Technical proposals will address your proposed technical approach to providing and installing the program management software and will address all information, functional and general requirements of the RFP document. (p. 2) is the portion regarding installing program management software relevant to this RFP? No it is not. 5. RFP statement: Total out-of-pocket expenses, including travel not to exceed one week, such reimbursement must be made in accordance with University travel policies. (p. 7) Can this time 1
be spread across multiple weeks to accommodate provider s schedules or do you prefer all onsite be done in the same week? The initial plan is to conduct on-site the same week; however, spreading across multiple weeks is negotiable. 6. Does providers include mid-level practitioners as well as physicians (e.g., NPs, PAs)? Yes. 7. Proposals A. Technical and cost proposals shall be submitted in separate sealed envelopes. Technical proposals will address your proposed technical approach to providing and installing the program management software and will address all informational, functional and general requirements of the RFP document. Please provide clarification on the program management software referred to in the statement above. There is no software required. If there is something software related in your proposal, the above question applies. 8. 2.0 Schedule 2. General Describe your company s ability to perform each of the following functions: Required 2.1 Perform an assessment of current clinical documentation, including all orders and referrals Document Assessment will be for 5 charts per provider (up to 57 providers) Please specify, if known, the chosen specialties you are referring to in the above statement. See question #1. 9. 2.2 Conduct on-site training sessions tailored to selected providers as well as UTHSC staff Please clarify what the staff titles and if necessary, job descriptions are. Do they consist of coders, clinical documentation specialists etc.? Physicians, coders and other clinical & non-clinical administrative staff 10. Question 2.4 Eliminate wasted time, resources and money lost through inefficiencies 2.5 Avoid penalties and fines for non-compliance with ICD-10 2.6 Ensure patient information is kept confidential Does this refer to the scope of the project with regards to University of Tennessee s relevant processes, or is this in reference to our approach to the project. We expect any bidders to address these items in their proposed approach. 11. Do you have a Clinical Documentation program currently in place, and if so: How many Clinical Documentation Specialists do you have? Will they require ICD-10 training also Do you have a program leader/manager 2
What CDI software are you utilizing if any No. 12. What EMR is currently in use, and what are the plans for updates with regards to ICD-10. We have various EMR systems. Centricity, Axiom, Point & Click. We also have 2 clinics that are currently paper-based. We are currently in the process working with our IT department to ensure that all systems are upgraded and ready for the ICD-10 transition. 13. Do you have any software/tools planned to assist Physicians in documentation for ICD-10, other than the current EMR system in place. No 14. Do you have an ICD-10 Physician Advisor? Yes 15. Do you plan on doing any dual coding, and if so, when. No plans at this time. 16. Has a formal GAP Analysis been done, and if so, are you willing to share the results with the chosen vendor? No GAP analysis has been done at this time. 17. Have your Physicians had any form of ICD-10 or CDI training prior to this engagement. Yes, we have an ICD-10 Committee that meets monthly and ICD-10 information and training information has been provided. 18. What preparations have your coders had for ICD-10? Some of the coders have attended Coding Seminars and Conferences focused on ICD-10. 19. Does the University of Tennessee Health Science Center currently have a formal CDI program in place? If so, how many CDI specialists are there? No 20. Will the University of Tennessee Health Science Center please indicate the number of cases reviewed per CDI specialist? 3
21. Will the University of Tennessee Health Science Center please indicate the quality of the cases reviewed? 22. Will the University of Tennessee Health Science Center please indicate the provider query rate? 23. Will the University of Tennessee Health Science Center please indicate the provider query response rate? 24. Will the University of Tennessee Health Science Center please indicate the agree/disagree response rate? 25. Will the University of Tennessee Health Science Center please specify the case mix index? 26. Will the University of Tennessee Health Science Center please indicate the EMR system it is currently utilizing? See Question 12 above 27. Will the University of Tennessee Health Science Center please provide the last 6 months of d/c data with the following Medical Diagnostic Categories for Inpatient records? MDC 1 MDC 4 MDC 5 MDC 6 MDC 8 MDC 9 MDC 10 MDC 18 MDC 20 MDC 21 MDC 23 MDC 24 This training is for clinical use, therefore, there will mainly be outpatient records to review. 28. Will the University of Tennessee Health Science Center please provide the top 10 Outpatient Diagnosis by Specialty? 4
Yes, if vendor is successful, UTHSC will provide this info. 29. Will the University of Tennessee Health Science Center please provide the top 20 Outpatient Diagnosis for the entire practice? Yes, if vendor is successful, UTHSC will provide this info. 30. Will the University of Tennessee Health Science Center please provide the following CDI information? Blended rate for Medicare CMI year to date and last fiscal year Quality measures currently reported 31. Can you provide a distribution of the 57 Providers by Specialty? See Question 2. 32. What is meant by definition of selected providers for education? At least one Providers selected for each specialty from each clinic to attend the on-site training. 33. Can you provide role information for the 50 Staff Members? Are they clinical roles, administrative, front desk, coding, etc.? Can you break out the roles? It will consist of administrative, clinical & billing staff from each clinic. 34. Are the providers that are being trained responsible for assigning ICD codes for their patient charts? Yes 35. Total out-of-pocket expenses, including travel not to exceed one week Is it your intention to conduct all training within 1 week? That is the original plan however, it is negotiable, if necessary 36. Will UTHSC assist with scheduling of training of Providers and Staff? Yes 37. Does UTHSC have an expectation that Provider education is conducted by Physician trainer? No 5
38. If a provider or staff member is not present during the week of onsite training, what provisions will you expect for follow-up? Those in attendance will serve as Super User roles for their clinic. The expectation will be that any person attending the training is able to train the persons that were unable to attend on-site training. However, we would like provisions for on-going training for an ample time frame to address questions to the Consultant once the on-site training completed. 39. What type of access will UTHSC provide for the record review? Please provide a description of the current clinical documentation state, Are the records in scope on the same system? Are they paper-based? Can they be scanned? The majority of the clinics are using an EMR system. But we have 2 which are still paper-based. We will be able to provide access for record review to the Consultant. 40. What EMR systems are in place? If the records are online or scanned, is a remote review and presentation of results acceptable? Will UTHSC provide staff with remote access capabilities? Please refer to Question 12 concerning EMR systems. Yes to the other 2 questions. 41. How did UTHSC determine scope of 5 records per provider? We felt that this was a sufficient number for record review based on the number of Providers that will be reviewed. 42. Please describe the mix of the 57 providers by medical specialty See question 2 above 43. Are all providers on the same E.H.R. System and will that be the system of record for charts or will they be provided by PDF file or other? No we have a decentralized billing system. In most cases, the charts can be provided either remotely or PDF. 44. Shall we assume a mix of inpatient/acute care, professional fee and ambulatory charts to review? If so what might the approximate mix be? No 45. Is UTHSC open to a creative proposal as an option to the current RFP scope that includes analytics? Explanation: We would like to include our approach as a novel time saving method to identify those providers who have the greatest need for training. The analytics will also be useful in determining financial impact of the current documentation and how that documentation can be improved, to what end with respect to revenue cycle management. 6
This would enable, for example a rapid assessment of those 57 providers (and if needed a much wider group) that require the most time, training and effort and those providers who already have strong specificity in their documentation to support ICD-10. Analytics would not be used instead of chart reviews but would be used in conjunction with the chart reviews Access to claims data would be required which we can facilitate in terms of ETL and normalization for analysis. This is negotiable. 46. Normally we provide both remote analysis of charts and on-site training is this the view of the ideal mix of services in the RFP? We would prefer on-site training only. 47. We would like to understand your methodology of selecting 5 charts per provider. Can you please share insights? Vendor uses its proprietary technology to analyze claims, code usage complexity and identify provider at risk of documentation. This would help prioritize audits for specific providers. Would the University of Tennessee Health Science Center want to consider this approach? If yes, are you willing to provide us claims data for analysis? We have observed though our experience that this would reduce effort and provide training in areas of high risk impact. We felt that this was a sufficient number for record review based on the number of Providers that will be reviewed. However, if chosen your approach may be considered. 48. Clinical documentation improvement uses charts for auditing, the length of charts would be an important aspect for us to estimate time and cost. Can you please provide an average length of charts (pages) or average length of stay, for the charts that incumbents need to audit? These are Physician Practices and there is no length of stay except in cases whereas patient is sent from clinic to hospital and those records would be the property of the hospital and not the clinic. 49. We would like to understand the duration of the project, which can help us plan and allocate our coders. Please provide proposed duration for the engagement. No longer than one week. 50. Please clarify the number of copies of the Technical Proposal and Cost Proposal that should be submitted. Pages 3 of RFP document requests one original and 5 copies of the complete Technical Proposal, whereas Page 8 of RFP document requests one original and 3 copies of the complete Technical Proposal. We require an original Technical Proposal and 5 copies of the Technical Proposal. We require an original and 1 copy of the Pricing Proposal. 7
51. Upon review of the RFP, we have a question related to section 3.A. on page 2 of 13. This section referrers to software installation and maintenance. However, the scope throughout the rest of the RFP only referrers to consulting services related to assessments of current clinical documentation, coding, and on-site training. Can you clarify this statement, as I would assume that your current coding/billing software vendor would be handling the updates for ICD-10 and this RFP is more related to training and compliance. That is correct. 52. Consulting services can be performed outside premises/inside the premises. Consulting services to be provided on site at UTHSC. 8