CAHSDOB on 12-Feb-2025 11:22:24 AM CST
Question #1. What is the monthly volume of claims monthly?
Response: 8,000 claims per month
|
|
CureMD on 19-Feb-2025 7:41:18 AM CST
1. What is the estimated annual claim volume and revenue?
|
|
CureMD on 19-Feb-2025 7:41:41 AM CST
2. What is the current payer mix (Medicaid, Medicare, private insurance, self-pay, grants)?
|
|
CureMD on 19-Feb-2025 7:41:55 AM CST
3. What Practice Management or Billing software is being used?
|
|
CureMD on 19-Feb-2025 7:42:13 AM CST
4. Is the department willing to switch to another Practice management system and Clearing house?
|
|
CureMD on 19-Feb-2025 7:42:27 AM CST
5. Does the department require real-time eligibility verification and prior authorization services?
|
|
CureMD on 19-Feb-2025 7:42:40 AM CST
6. Does the department require Coding Services?
|
|
CureMD on 19-Feb-2025 7:42:51 AM CST
7. Does the department require Credentialing Services?
|
|
CureMD on 19-Feb-2025 7:43:07 AM CST
8. What are the top denial reasons currently faced by your department?
|
|
CureMD on 19-Feb-2025 7:43:29 AM CST
9. How many locations do you have.
|
|
CureMD on 19-Feb-2025 7:43:46 AM CST
9. How many Providers with NPI numbers do you have.
|
|
CureMD on 19-Feb-2025 7:43:56 AM CST
10. Are there any specific compliance or state reporting requirements the vendor must adhere to?
|
|
CureMD on 19-Feb-2025 7:44:08 AM CST
11. What level of customer service support is required?
|
|
CAHSDOB on 19-Feb-2025 3:25:44 PM CST
Question #2: What is the current payer mix (Medicaid, Medicare, private insurance, self-pay, grants)?
Response: The payer mix to date is as follows for SFY 2025:
Medicaid 74%
Commercial (including Medicare Advantage Plans) 19%
Medicare 4%
SP 3%
Contract payers will not be included in this RFP.
|
|
CAHSDOB on 19-Feb-2025 3:33:50 PM CST
Question #3: What Practice Management or Billing software is being used?
Response: Qualifacts CareLogic
|
|
CAHSDOB on 19-Feb-2025 3:36:50 PM CST
Question # 4: Is the department willing to switch to another Practice management system and Clearing house?
Response: No, we will remain on Qualifacts Carelogic as our practice management software and Trizetto Gateway EDI as our clearinghouse.
|
|
CAHSDOB on 19-Feb-2025 3:38:41 PM CST
Question #5: Does the department require real-time eligibility verification and prior authorization services?
Response: The current practice management software is not able to complete real time eligibility due to CAHS using a non-embedded clearinghouse. We are currently using Trizetto Gateway EDI and other payer
portals for real time eligibility.
The scope of work did include obtaining prior authorizations for services; however, at this time, CAHS has not decided if the service will be needed with the contract.
|
|
CAHSDOB on 19-Feb-2025 3:40:04 PM CST
Question #6: Does the department require Coding Services?
Response: The department will not require coding services, as the providers code their own service notes. However, an extensive knowledge of behavioral health CPT, HCPCS and ICD-10 coding would be required in
benefit verification, charge master maintenance, processing explanation of benefit denials, and correct any failed claims for submission.
|
|
CAHSDOB on 19-Feb-2025 3:42:22 PM CST
Question #9: How many locations do you have.
Response: CAHSD would have 6 locatons/NPIs that will provide services under the contract.
|
|
CAHSDOB on 19-Feb-2025 3:49:05 PM CST
Question #9: How many Providers with NPI numbers do you have.
Response: CAHS has approximately 99 providers that are either PT or FT that provides services as CAHS.
|
|
CAHSDOB on 19-Feb-2025 3:50:18 PM CST
Question # 10: Are there any specific compliance or state reporting requirements the vendor must adhere to?
Response: The vendor must adhere to the CAHS billing SOP and financial policies, Medicare and Medicaid compliancy , third-party commercial payers and any state or federal regulatory entity’s policies.
|
|
CAHSDOB on 19-Feb-2025 3:52:42 PM CST
Question #11: What level of customer service support is required?
Response: Any client with outstanding self-pay and commercial balances may need to be contacted in order to collect or update payer information.
|
|
Clarification needed: Contract payers will not be included in this RFP
For this BID are you stating you are only requesting for the contract to perform work for out-of-network insurance and self-pay accounts?
If so, what is the average monthly volume?
|
|
CAHSDOB on 20-Feb-2025 9:38:48 AM CST
2/18/25 Question: Our team is working on completing our proposal and needs clarity on the submission method. The links in the RFP direct up to a portal that requires an account and payment ranging from $99-$899. Are
these the correct options for submission? If not, could you provide the submission methods and appropriate link>
Response: See Section 1.7 Proposal Submittal, Page 7 of the RFP for the correct options for submission.
|
|
CAHSDOB on 20-Feb-2025 10:51:03 AM CST
Question #5: Does the department require real-time eligibility verification and prior authorization services?
Response: Yes; the contractor will be required to use the current non-embedded clearinghouse for real time eligibility (Trizetto Gateway EDI) and other payer portals; prior authorization services are included in the RFP.
|
|