Alternative Resource (Insurance) Verification Services for Quentin N Burdick Memorial Health Care Facility in Belcourt, ND

Sources Sought: Alternative Resource (Insurance) Verification Services for Quentin N Burdick Memorial Health Care Facility

Sources Sought Notice Number: IHS-SS-25-1516624

This Sources Sought Notice is for informational and planning purposes only and shall not be construed as a solicitation, an obligation or commitment by the Indian Health Service.

This notice is intended strictly for market research to determine the availability of Indian Economic Enterprises (IEE).

Your responses to the information requested will assist the Government in determining the appropriate acquisition method, including whether a set-aside is possible. The anticipated applicable NAICS code for this acquisition is 524298, All Other Insurance Related Activities- other relevant NAICS codes will be considered based on responses received (such as conference centers, etc.)

1. BACKGROUND

The IHS is an agency within the Department of Health & Human Services and is responsible for providing federal health services to American Indians and Alaska Natives. The Indian Health Service provides a comprehensive health service delivery system for approximately 1.9 million American Indians and Alaska Natives who belong to 567 federally recognized tribes, in 35 states. The Indian Health Service Headquarters is located in Rockville, MD and then divided into twelve (12) physical areas: Alaska, Albuquerque, Bemidji, Billings, California, Great Plains, Nashville, Navajo, Oklahoma, Phoenix, Portland, and Tucson.

The Great Plains Area Office (GPAO) works in conjunction with 19 Indian Health Service Units and Tribal Managed Service Units to provide health care to approximately 130,000 Native American located in North Dakota, South Dakota, Nebraska, and Iowa.

QNBMHCF falls under the GPAO and provides medical care to approximately 14,550 tribal members living on the Turtle Mountain Indian Reservation. The Service Unit was built in 1967 with renovation and clinic expansion completed in 1992, to provide an expanded level of outpatient health care services specifically designed to meet the needs of our population. Services include: 24 Hour Emergency Services, Laboratory, Radiology (CAT Scan & Mobile MRI) and 24-Hour Pharmacy Services, Optometry, Dental, Clinic, Emergency, Podiatry, Same Day Clinic, and Behavioral Health.

1. OBJECTIVE

The primary objective of this project is to provide a wide-range of alternate resource verification services for the Health Information Management and Patient Registration Departments for the Quentin N Burdick Memorial Health Care Facility for direct patient care.

1. SCOPE

The Contractor is responsible for having electronic verification software (and license agreements) for eligibility verification with Medicare, Medicaid, Blue Cross Blue Shield of ND, Mail handlers, Champus, GEHA and any other applicable alternate resources.

The Contractor utility will provide an automated system which will assist patient registration and admissions in verifying patient alternate resource eligibility. Real-time EDI transactions, including patient eligibility verification, claim status, address verification, and others, can be interfaced with the existing RPMS, so that inquiry and response data are electronically transferred between the registration computer system and clearinghouse.

Each PC user attached to the network will have the ability to either manually or automatically initiate an eligibility inquiry during the patient registration and/or admission process. The automatic trigger can be based on the rules established (i.e. patient name, social security number, financial class, insurance carrier code, etc.).

It is not necessary to re-key the needed search information in order to initiate the eligibility request. Information in real-time simplifies patient registration and admissions through automation of patient eligibility and benefits verification tasks.

The Contractor will confirm alternate resource coverage, effective dates, deductibles, co-insurances and allow pre-registration personnel to resolve issues prior to patient visits; correctly identifies Medicare, Medicaid and Private Insurance coverage information for patients classified as self-pay; eliminates the need to re-key data from IHS into a standalone system; eliminates the time-consuming, error-prone process of manually posting eligibility responses; identifies coverage and patient data discrepancies before claims are submitted incorrectly; reduces data errors from automation, resulting in cleaner claims and a decrease in A/R days; eliminates the need to call payers to verify coverage; correctly identifies primary and secondary payers for coordination of benefits; searches efficiently with auto-triggered searches based on the criteria you define and maintains a historical database of all real-time EDI transactions.

The Contractor is responsible for maintaining patient confidentiality and adhering to the IT rules of behavior, Privacy Act of 1974, the Health Insurance Portability & Accountability Act (HIPAA) of 1996 and the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009.

Contractor performance shall be according to the requirement contained in this statement of work. The government reserves the right to accept or reject services at any time during the contract period of performance if the level of performance is unsatisfactory to IHS.

1. CONTRACT REQUIREMENTS/ AND PERSONNEL QUALIFICATIONS

The Contractor shall have extensive knowledge in providing an alternate resource verification services;

In accordance with Federal Acquisition Regulation (FAR) of Part 9, under Contractor Qualifications a responsible Contractor must,

1. Have adequate financial resources available to meet the terms of performance as stated in this contract, or the ability to obtain them (see 9.104-3 (a));
2. Be able to comply with the required or proposed delivery or performance schedule, taking into consideration all existing commercial and government business commitments;
3. Have a satisfactory performance record (see 9.104-3 (b) and Subpart 42.15). A prospective contractor shall not be determined responsible or non-responsible solely on the basis of a lack of relevant performance history, except as provided in 9.104-2;
4. Have a satisfactory record of integrity and business ethics;
5. Have the necessary organization, experience, accounting and operational controls, and technical skills, or the ability to obtain them (including as appropriate, such elements as production control procedures, property control systems, quality assurance measures, and safety programs applicable to materials to be produced or services to be performed by the prospective contractor or subcontractors). See 9.104-3(a).
6. Have the necessary production, construction and technical equipment and facilities, or the ability to obtain them (see 9.104-3(a)); and
7. Be otherwise qualified and eligible to receive an award under applicable laws and regulations.

1. TYPE OF ORDER

This is a firm fixed price purchase order.

1. ANTICIPATED PERIOD OF PERFORMANCE

The anticipated period of performance will consist of a base year of twelve (12) months, followed by four (4) twelve-month option periods, for a potential total period of performance of five (5) years, contingent upon continued need, contractor performance, and availability of funds.

1. PLACE OF PERFORMANCE

Quentin N Burdick Memorial Health Care Facility

1300 Hospital Loop

Belcourt, ND 58316

1. REPORT(S)/DELIVERABLES AND DELIVERY SCHEDULE

N/A

1. PAYMENT

Payment will be rendered once all supplies are shipped and accounted for and invoice is uploaded into IPP to be paid.  

10.0     Capability Statement/Information:

Interested parties are expected to review this notice to familiarize itself with the requirements of this project. Failure to do so will be at your firm’s own risk. The following information shall be included in the capability statement:

1. A general overview of the respondent’s opinions about the difficulty and/or feasibility of the potential requirement, and any information regarding innovative ideas or concepts.

2. Information in sufficient detail of the respondent’s (a) current capability and capacity to perform the work; (b) prior completed events of similar nature/size; (c) organizational experience and management capability; and (d) examples of prior completed Government contracts and other related information.

3. The respondents’ UEI number, organization name, address, point of contact, and size and type of business (e.g., 8(a), HUBZone, etc.) Pursuant to the North American Industry Classification System (NAICS) code: 524298, All Other Insurance Related Activities, or comparable NAICS

4. Any other information that may be helpful in developing or finalizing the requirements of the potential acquisition.

5. The capability statement shall not exceed 10 single-sided pages (including all attachments, resumes, charts, etc.) presented in single-space and using a 12-point font size minimum, in either Microsoft Word or Adobe Portable Document Format (PDF), with 8-1/2 by 11-inch paper size, and 1 inch top, bottom, left and right margins.

6. All proprietary information should be marked as such. Statements should also include an indication of current certified small business status; this indication should be clearly marked on the first page of your capability statement (preferably placed under the eligible small business concern’s name and address). Responses will be reviewed only by IHS personnel and will be held in a confidential manner.

11.0   Closing Statement

Point of Contact: Farrah Azure, Purchasing Agent, at Farrah.Azure@ihs.gov  

Submission Instructions:

Interested parties shall submit capability via email to Farrah Azure, at Farrah.Azure@ihs.gov . Must include Sources Sought Number IHS1516624 in the Subject line. The due date for receipt of statements is August 26, 2025, 12:00 p.m. Central Time.

All responses must be received by the specified due date and time in order to be considered.

This notice is for information and planning purposes only and shall not be construed as a solicitation or as an obligation on the part of IHS.

IHS does not intend to award a contract on the basis of responses nor otherwise pay for the preparation of any information submitted. As a result of this notice, IHS may issue a Request for Quote (RFQ).

THERE IS NO SOLICITATION AVAILABLE AT THIS TIME. However, should such a requirement materialize, no basis for claims against IHS shall arise as a result of a response to this notice or IHS’s use of such information as either part of our evaluation process or in developing specifications for any subsequent requirement.

Disclaimer and Important Notes. This notice does not obligate the Government to award a contract or otherwise pay for the information provided in response. The Government reserves the right to use information provided by respondents for any purpose deemed necessary and legally appropriate. Any organization responding to this notice should ensure that its response is complete and sufficiently detailed to allow the Government to determine the organization’s qualifications to perform the work. Respondents are advised that the Government is under no obligation to acknowledge receipt of the information received or provide feedback to respondents with respect to any information submitted. After a review of the responses received, a pre-solicitation synopsis and solicitation may be published in SAM.gov. However, responses to this notice will not be considered adequate responses to a solicitation.

Confidentiality. No proprietary, classified, confidential, or sensitive information should be included in your response.