JA - Revenue Operations Workflow Payer Compliance - Redacted

LIMITED-SOURCES JUSTIFICATION

1. Contracting Activity:

Department of Veterans Affairs (VA)
Office of Procurement Operations
Technology Acquisition Center

23 Christopher Way

Eatontown, NJ 07724

2. Description of Action: The proposed action is for a sole-source, Firm-Fixed-Price Task Order to be issued under General Services Administration (GSA) Contract GS-00F146DA with Huron Consulting Services, LLC (Huron). This action is required to provide the VA Veterans Health Administration (VHA) Office of Finance (OF) Revenue Operations (RO) with the required support in three critical areas, which include Revenue Operations Workflow Functionality, Claims scoring, reporting, and payment efficacy, and Managerial and Technical Process Optimization. In order to obtain this support, VA requires the Huron Workflow Tool (WFT) software licenses, maintenance, sustainment, and associated technical support for the OF RO. This effort is being conducted under the GSA Multiple Award Schedule (MAS) Program. The proposed effort will be awarded under the GSA MAS contract to Huron Consulting Services, LLC, 550 West Van Buren Street, Chicago, IL 60607, (312)-583-9701.
3. Description of the Supplies or Services: VHA OF RO Program Management Office has a requirement to ensure VA’s RO remain operational. The RO and its seven regionally aligned Consolidated Patient Account Centers rely on the existing workflow management and payer compliance information technology business tools to provide industry modeled automated technologies to sustain and continuously improve revenue cycle activities in support of healthcare revenue collections. This action will provide the OF RO with the support necessary to sustain mission-critical functions across three interdependent areas. The first, RO Workflow Functionality, encompasses the automated work queue management, task routing, denial tracking, and underpayment resolution capabilities that enable RO billing and follow-up staff to prioritize and adjudicate claims across the enterprise, which depend on real-time data feeds from VA-unique systems including Veterans Health Information Systems Architecture (VistA) and the Corporate Data Warehouse (CDW). VistA interoperability with the Huron WFT relies on VA's legacy Health Level 7 (HL7) v2.x-based, non-Fast Healthcare Interoperability Resources (FHIR) messaging architecture; the platform must support custom middleware to bridge this architecture to modern integration standards. The second area, Claims Scoring, Reporting, and Payment Efficacy, requires the Huron