ACADM Phase 1 QA 082626.pdf
Posted: Aug. 26, 2026
• Type: .pdf
• Size: 0.12MB
Overview
Related Opportunity
Related Agency
Summary
This **Q&A document for the Defense Health Agency’s Request for Solutions (RFS) on Autonomous Coding (AC) and Automated Appeals & Denials Management (ADM)** clarifies Government expectations for data rights, intellectual property, system interoperability, performance scope, prototype data, and commercial structure.
The Government will negotiate rights for trained models, tuned parameters, Government-derived datasets, proprietary engines, custom software, and other solution components under resulting agreements; vendors must describe proposed rights in their submissions.
Deliverables generally may not be marked proprietary and must carry Distribution Statement C under the SOO. Vendors with confidentiality concerns must use the RFS Section 4, Addendum 2 procedure.
Commercially available proprietary coding engines are acceptable even if the Government does not receive source code or base-model weights, provided the vendor can integrate, maintain, patch, and retrain the product.
The AC and ADM solutions may be awarded separately, but the Government expects interdependent learning and interoperability through shared outcomes, denial root-cause taxonomies, coded-encounter information, and model-derived insights.
The specific technical design, protections for proprietary technology, and level of direct exchange will be determined after proposals are received.
The projected enterprise throughput is approximately 143,000 encounters per day, or 4.35 million per month, although Milestone 4 validation will initially use a subset of select military treatment facilities before enterprise scaling.
MHS GENESIS is the primary integration system, with potential future inclusion of legacy aged-accounts-receivable systems. The Government will provide de-identified historical accounts-receivable test data and sandbox extracts.
Detailed portfolio information—such as total dollars, claim counts, aging categories, other-health-insurance payer mix, and participating facility counts—will be provided to vendors advancing to later phases and used for Phase 2 cost development.
The Government is requesting vendor-proposed approaches for the production invoicing complexity tiers, post-Milestone 4 encounter volumes, Milestone 2 and Milestone 4 coverage thresholds currently identified as 60% and 80%, and data-retention duration.
The Government also expects vendors to propose a model for consideration rather than assuming fixed parameters.
The Q&A does not establish a definitive “correlation match” methodology for ADM performance or prescribe whether newly developed software must be delivered with source code, Government Purpose Rights, or Unlimited Rights. Instead, these matters remain subject to vendor-proposed rights and subsequent negotiation.
The Government will negotiate rights for trained models, tuned parameters, Government-derived datasets, proprietary engines, custom software, and other solution components under resulting agreements; vendors must describe proposed rights in their submissions.
Deliverables generally may not be marked proprietary and must carry Distribution Statement C under the SOO. Vendors with confidentiality concerns must use the RFS Section 4, Addendum 2 procedure.
Commercially available proprietary coding engines are acceptable even if the Government does not receive source code or base-model weights, provided the vendor can integrate, maintain, patch, and retrain the product.
The AC and ADM solutions may be awarded separately, but the Government expects interdependent learning and interoperability through shared outcomes, denial root-cause taxonomies, coded-encounter information, and model-derived insights.
The specific technical design, protections for proprietary technology, and level of direct exchange will be determined after proposals are received.
The projected enterprise throughput is approximately 143,000 encounters per day, or 4.35 million per month, although Milestone 4 validation will initially use a subset of select military treatment facilities before enterprise scaling.
MHS GENESIS is the primary integration system, with potential future inclusion of legacy aged-accounts-receivable systems. The Government will provide de-identified historical accounts-receivable test data and sandbox extracts.
Detailed portfolio information—such as total dollars, claim counts, aging categories, other-health-insurance payer mix, and participating facility counts—will be provided to vendors advancing to later phases and used for Phase 2 cost development.
The Government is requesting vendor-proposed approaches for the production invoicing complexity tiers, post-Milestone 4 encounter volumes, Milestone 2 and Milestone 4 coverage thresholds currently identified as 60% and 80%, and data-retention duration.
The Government also expects vendors to propose a model for consideration rather than assuming fixed parameters.
The Q&A does not establish a definitive “correlation match” methodology for ADM performance or prescribe whether newly developed software must be delivered with source code, Government Purpose Rights, or Unlimited Rights. Instead, these matters remain subject to vendor-proposed rights and subsequent negotiation.
Note
HigherGov has removed this file due to potential distribution restrictions. To view the document, please visit the Source listed on the Related Opportunity above.
Show All