RCMI & CDM Support Services

What the buyer is asking for

Subject: Revenue Cycle Modernization & Innovation (RCMI) & Charge Description Master (CDM) Support Services to Defense Health Agency (DHA) Resources & Personnel Integration (R&PI), J-8 Financial Operations. THIS IS NOT A REQUEST FOR PROPOSALS (RFP) OR A REQUEST FOR QUOTATIONS (RFQ); IT IS STRICTLY A REQUEST FOR INFORMATION (RFI). NEITHER UNSOLICITED PROPOSALS NOR ANY OTHER KINDS OF OFFERS WILL BE CONSIDERED IN RESPONSE TO THIS RFI. NO CONTRACT WILL BE AWARDED PURSUANT TO THIS ANNOUNCEMENT. 1.0 DISCLAIMER: This RFI is issued solely for information and planning purposes and does not constitute a solicitation. Responses to this notice are not offers and will not be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI. All information received in response to this RFI that is marked Proprietary will be handled accordingly. Responses to the RFI will not be returned. At this time, questions concerning the composition and requirements for a future RFP will not be entertained. 2.0 SUBJECT: The DHA R&PI, J8 Financial Operations is obtaining information for a potential non-personal services contract to provide administrative and technical execution services, as well as technical expertise, for the Revenue Cycle Management (RCM) activities, to include CDM optimization, enhancement, and operations, to support the DHA Electronic Health Record (EHR), Military Health System (MHS) GENESIS, and its itemized billing solution, RevX. 3.0 BACKGROUND: The DHA J-8 recognizes the need to enhance its RCM processes to ensure the efficient and effective management of healthcare finances within the MHS. Using the MHS GENESIS EHR as a catalyst, J-8 seeks to address several critical challenges within its RCM framework: Revenue Leakage and Inefficiencies, Compliance and Regulatory Risks, Data Accuracy and Integration, Patient Experience, Resource Utilization, Financial Transparency, Clean Audit Capability, and Technology and Innovation. In response to these challenges, DHA J-8 aims to launch the RCM Initiative to transform its RCM processes. The goal is to enhance workload capture, financial performance, compliance, patient satisfaction, and resource utilization while ensuring transparency and embracing innovative technologies within the MHS. Industry practice is to document, and bill patient encounters based on an itemized list of charges. To ensure documented care in MHS GENESIS results in an all-inclusive itemized bill within RevX, numerous actions must occur throughout the revenue cycle process (assignment of Patient Identification Process (PIP), provider documentation, medical record coding, and patient billing). Administration staff must ensure the PIP providers completely document and select the proper patient orderable description of care provided. Medical record coders must properly code the care provided. Finally, Uniform Business Office (UBO) staff must properly generate a bill on established separate billing forms for professional charges and institutional charges. The DHA supports and provides medical care for the Department of War, 9.4 million eligible beneficiaries through the $52 billion Defense Health Program (DHP), which includes contracted healthcare networks and Military Treatment Facilities (MTFs). The deployment of MHS GENESIS is complete and currently in a transition phase. While this major technology transformation has provided a significant set of enhanced revenue cycle and business management capabilities for the MHS, they have also brought new requirements to align with industry-leading practices and underscored underlying issues in the legacy environment. For the Government to fully realize the benefits of MHS GENESIS revenue cycle capabilities, these cross-functional challenges require an integrated approach to resolve. The Government will direct the actual implementation and detailed tasks for the RCM Activity as the MHS lacks…

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