OWCP Medical Provider Network – Medical Bill Processing Services

This notice does not constitute a request for proposal or request for quotation nor does it commit the government to contract for these services. The intent of this notice is to provide the pre-solicitation notice as required by FAR 5.2, Synopsis of Proposed Contract Actions in preparation for release of the Request for Proposal (RFP) at a later date.

On or about August 30, 2023, the Department of Labor, Office of the Assistnt Secretary for Administration and Management (OASAM), Office of the Senior Procurement Executive (OSPE), Customer Acquisition Services (CAS), anticipates issuing a Request for Proposal (RFP) to obtain both Medical Provider Network and Medical Bill Processing Services for the Office of Workers' Compensation (OWCP). The solicitation is anticipated to be issued on an unrestricted basis for full and open competition. The NAICS code for this requirement is 524298 with a size standard of $30.5 million. Contractors shall not directly contact the Contracting Officer or Contract Specialist to discuss this requirement. During the solicitation phase, contractors will be provided the opportunity to submit relevant questions.

The government contemplates a single time and material (T&M) type contract with a period of performance consisting of a 12-month base period, four (4) 12-month option periods and the potential for up to two (2) 12-month award term periods.

SERVICE REQUIREMENTS

The U.S. Department of Labor (DOL), Office of Workers' Compensation Programs (OWCP) is responsible for the administration of four (4) occupational injury/illness compensation programs. The services required may involve one or more of the following programs:

1. Federal Employees Program (FECA)
2. Energy Workers Program (ENERGY)
3. Black Lung Program (BLACK LUNG)
4. Longshore Program (LONGSHORE)

Each program seeks to mitigate the impact of work-related injuries and illnesses for specified workers through the provision and management of medical and other benefits.

OWCP has not previously contracted for both Medical Provider Network (MPN) and Medical Bill Processing (MBP) Services. The MPN requirements for the Federal Employees' Compensation, Longshore and Harbor Workers Compensation, Energy Employees Occupational Illness Compensation, and Disabled Coal Mine Workers Compensation programs are new for OWCP have not previously been procured.

The Contractor shall provide a nationwide medical provider network and medical bill processing services to ensure timely and accurate claims adjudication and provision of benefits, minimize service interruptions and delays, and maximize claimant satisfaction. All requirements shall be included in operational pricing, at no additional cost to the Government, unless otherwise specified in solicitation documents.

Specifically, for the Medical Provider Network, the Contractor shall provide access to a medical provider network (MPN) for voluntary use of examinations, treatment, impairment evaluations, reports, and related services by covered workers for accepted injuries and illnesses.

The Contractor must be able to:

Specifically, for the Medical Provider Network:

• Provide access to a medical provider network (MPN) for voluntary use of examinations, treatment, impairment evaluations, reports , and related services by covered workers for accepted injuries and illnesses.

Specifically, for the Medical Bill Processing:

• Interface with OWCP National Office and District Office staff
• Provide a full-service centralized mailroom to receive medical bills, attachments, and other workers' compensation documents such as, but not limited to, claimant and employer correspondence.
• Scan and enter data for bills, attachments and other workers' compensation documents received in the mailroom.
• Process in- and out-of-network medical provider bills to payment or denial and issuing Explanations of Benefits
• Reimburse and pay through electronic funds transfer (EFT) where necessary.
• Process requests for adjustment, authorization of services, suspense resolution, and appeals processing.
• Provide a Call Center to handle inquiries from providers and claimants.
• Provide an interactive voice response (IVR) system to handle automated telephonic inquiries from providers and claimants.
• Provide secure access to images of bills, correspondence, and other documents, and to bill adjudication history and final payment determination.
• Send bill processing detail transactional files (e.g., payment files, bill history files, etc.) based on Government specified formats and timeframes to OWCP.

Full implementation of the contract must occur no later than 180 days after the contract start date.