Please note: This is a Sole Source Notification. The Agency hereby provides notice that it intends to enter into a sole source contract per S.C. Code Ann. §11-35-1560 with Vendor for the following supplies, services, information technology, or construction: BHDD-Office of Mental Health is looking to Sole Source to CompuGroup Medical SC, LLC for electronic clearing house to submit claims for OMH inpatient Facilities and Community Mental Health Centers. Electronic Data Interchange (EDI) System provides for the transmission of electronic claims in the ANSI formats for both institutional (UB) and professional (HCFA 1500) claims as dictated by the standards for electronic transactions, 45 C.F.R parts 160 and 162, issued pursuant to the Health Insurance Portability and Accountability Act (HIPPA) of 1996. These claims are sent to CompuGroup via File Transfer Protocol (FTP) from our Inpatient Billing System (Avatar). The client is installed and configured o the computers in the Reimbursement department, and OMH has worked with Compugroup to set up the crosswalks between Avatar and their system for electronic claim submission. The client is proprietary software which CompuGroup either owns or has the right to license, relicense or sublicense, including all updates or error corrections which CompuGroup provides to their customers. CompuGroup will run all claims transactions thru Transactions rule edits and payer specific edits as part of the claims submission process. Once claims have processed though edits, claims are sent to insurance carriers locally or nationwide. CompuGroup also gives the user the ability to access eligibility and claim status inquiries. User can run standard and custom reports. This system is crucial to our everyday submission of claims for the OMH. CompuGroup provides access to proprietary software based services which assist OMH in conducting electroni health care transactions with payers.
