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5. PROJECT NO.CODE7. ADMINISTERED BY2. AMENDMENT/MODIFICATION NO.CODE6. ISSUED BY8. NAME AND ADDRESS OF CONTRACTOR4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE9A. AMENDMENT OF SOLICITATION NO.9B. DATEDPAGEOF PAGES10A. MODIFICATION OF CONTRACT/ORDER NO.10B. DATEDBPA NO.1. CONTRACT ID CODEFACILITY CODECODE Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of OffersE. IMPORTANT:is extended, (a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR AC- KNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAYis not extended.12. ACCOUNTING AND APPROPRIATION DATA(REV. 10-83)is required to sign this document and return ___________ copies to the issuing office.is not,A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.15C. DATE SIGNEDB. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGESSET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b). RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:D. OTHERBYContractor16C. DATE SIGNED14. DESCRIPTION OF AMENDMENT/MODIFICATION16B. UNITED STATES OF AMERICAExcept as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.15A. NAME AND TITLE OF SIGNER16A. NAME AND TITLE OF CONTRACTING OFFICER15B. CONTRACTOR/OFFERORSTANDARD FORM 30NSN 7540-01-152-8070PREVIOUS EDITION NOT USABLEPrescribed by GSA - FAR (48 CFR) 53.243(Type or print)(Type or print)(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)(No., street, county, State and ZIP Code)(If other than Item 6)(Specify type of modification and authority)(such as changes in paying office, appropriation date, etc.)(If required)(If applicable)(SEE ITEM 11)(SEE ITEM 13)(X)(X)13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONSAMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT(Signature of person authorized to sign)(Signature of Contracting Officer) 1 7A0000202-27-2015459Department of Veterans AffairsVA Sierra Pacific Network (VISN 21)VA Pacific Islands Health Care System459 Patterson RdHonolulu HI 96819-1522Department of Veterans AffairsVA Sierra Pacific Network (VISN 21)VA Pacific Islands Health Care System459 Patterson RdHonolulu HI 96819-1522To all Offerors/BiddersVA261-15-Q-032402-27-2015Xxxx1Please see the following page for questions and answers. A revised solicitation is attached. Changes are in green.Please sign (boxes 15a-c) and submit this first page with your quote.Nicole DoContracting OfficerQuestions and AnswersIf there are any answers that contradict what was written in Amendment P00001, the answers in Amendment P00002 shall take precedence.I tried to get answers to all of these questions but couldn’t obtain answers for everything. Elsevier does not manufacture their own ICD-10 Simulator. The re-sell the Nuance Clintegrity simulator under their own name, and are only authorized to do so to non-government medical facilities. They are not permitted to re-sell to the VA, or to another company where the simulator will end up in a VA facility (a third-party transaction). In other words, there is no such thing as a “Elsevier ICD-10 Simulator” available to the VA. Thank you. The VA requires the Nuance Clintegrity simulator. Recommend that VISN 21 ask of vendors the number of AHIMA certified trainers with National Accounts with VA VPN access. If no current access, the staff will have to have background checks completed before they are granted VPN access; this can take several months for the background check? depending on the individual. Please see the attached solicitation with revised evaluation factors. Recommend that VISN 21 verify years of experience of personnel in dealing specifically with the VA. We bring this up because there are a few small SDVOSBs that have posted job openings for ICD-10 trainers in recent days.Please see the attached solicitation with revised evaluation factors. Reference the question on partnering and NAICS code:(c) A joint venture may be considered an SDVOSB or VOSB concern if(1) At least one member of the joint venture is an SDVOSB or VOSB concern, and makes the representations in paragraph (b) of this section;(2) Each other concern is small under the size standard corresponding to the NAICS code assigned to the procurement;(3) The joint venture meets the requirements of paragraph 7 of the size standard explanation of affiliates in FAR 19.101; andPoint (2) essentially prevents any SDVOSB from partnering with Nuance, the only makers of the ICD-10 Simulator, and the overwhelming source for ICD-10 Training for the VA. Only the ICD-10 simulator is proprietary to Nuance. Nuance is willing to work with SDVOSB vendors for licensing rights. All other services may be performed by an SDVOSB.May I suggest you change the NAICS code to 541519, Other Computer Related Services?I’m sorry, the NAICS code will not be amended. If there are no technically acceptable SDVOSB vendors, then the VA we re-look at the NAICS and set aside. In section 7.4, ICD-10 Coder Bootcamp Training Sessions, it states that the contractor will "deliver full day sessions for up to 20 coder trainees".?Do coders attend a single 8 hour session or are they expected to attend all 4 days of onsite training??Coders will attend all 4 days of onsite training. Please see revised PWS for a sample itinerary that is based off of Elsevier’s ICD-10 e-learning modules. Because the Government is asking for a specific product,?to assist in purchasing licenses,?how many coders?will be trained?and how many healthcare providers?will be trained for this contract??The end user believes that up to 20 coders at each site will be trained. Some sites contract out medical coding services so may have less coders. The contractor shall be on-site for provider training for three days at each site (except Manila). The end user also believes that there may be low turnout of healthcare providers to training, which is why we would also like online module trainings available for specialty areas. Can the simulator software be managed as Software-as-a-Service (SaaS) vs. being installed at each site?We need to be able to access the simulator. It does not need to be installed on our network. Nuance is willing to work with SDVOSB vendors for the simulator. You may want to work with them for guidance on this issue.Can the ICD-10 training software be managed as?Software-as-a-Service (SaaS) vs. being installed at each site?See above. Nuance is willing to work with SDVOSB vendors for the simulator. You may want to work with them for guidance on this issue.Question: Reference Elsevier ICD-10 simulator: Which ones of the following are the contractor responsible: installing, setting up, training and maintaining this software application? The contractor is responsible for all aspects.Question: Reference Elsevier ICD-10 simulator: Is the contractor responsible for insuring the interoperability between two proprietary platforms?Yes.Question: Reference Elsevier ICD-10 simulator: Is it the government’s intent to host the software within their domain or to access the software through the internet?Access through the internet is acceptable. You may want to contact Nuance for guidance. They have worked with the VA before on similar services.Question: Reference Elsevier ICD-10 simulator: Will the government need this software beyond the training?We will not need this simulator past 9/30/15. Question: Are you expecting a Provider to teach other Providers, or is the use of an ICD-10 Approved Trainer sufficient to meet this requirement?The ICD-10 trainer must hold an AHIMA trainer certificate. An ICD-10 AHIMA approved trainer is sufficient. Question: If providers are required to teach providers, then do these providers need the same ICD-10 certifications as the coders/auditors?See above. Question: Will all types of training (boot camp and provider) be done sequentially or concurrently across VISN 21? Specifically, will no two locations be in training at the same time?This may be done sequentially or concurrently. Question: Would the schedule be set to enable the vendor to decrease its travel costs (certain days may impact overtime rates and cost), or would the site set this?Yes, this is encouraged. Question: If the site cannot complete the days of training for reasons outside the contractor’s control, would the site pay the training costs if our company incurred costs?I cannot answer this question, it would depend on the facts of the situation. Question: Would the contractor be expected to host the webcast or would the contractor use the VA’s webcasting service?Contractor provided webcast. Question: Are the VISN 21 Encounter Forms currently in use the same version and content, which would enable the contractor to estimate the associated work effort?The encounter forms are located in our VISTA system and not pdfs. See revised PWS. The forms are pushed to each clinic by VA National. Most clinics will use the national form but some clinics may choose to customize their forms. Contractor shall understand and be able to update these forms in the VISTA system. Question: When would the interview of key staff of impacted areas be conducted? Can this be conducted remotely? (in reference to PWS 4.1.2)This is up to the contractor and may be done remotely. Question: In reference to the back-end of the revenue improvement scope of work, will the government provide more specifics available about the expectations for provider awareness sessions?I did not receive an answer to this question. Question: How many non-standard forms require conversion?All ICD-9 encounter forms will need to be converted to ICD-10 for each site. The majority will be standards forms provided by national. About 20% of forms will be non-standard so customization will be required to meet the needs of the specialty. Depending on the site, there are approximately 100-500 forms total. Question: 8.4 Data Analytics: The vendor has a specific file configuration layout to assure proper mapping of data from ICD-9 to 10 with the associated DRG impact. Can this requirement be met by VA’s “in-house” process/configuration?We cannot answer this question. Question: 8.4.4: An internal reference to facilitate re-identification will be necessary to select cases for the gap analysis to assure a deeper dive on cases where potential coding and documentation risks are identified. Can the contractor make reasonable adjustments for PHI redaction?Yes Question: 8.5.2: In reference to SOW 8/4, are the inpatient audit of 200 records the same records reviewed in 8.5.1?NoQuestion: We believe “JB” means Job; is this interpretation correct?Yes, JB means “job”Question: What are the parameters of a typical Job in the context of the pricing section of the RFQ?Price needs to be all inclusive and this is a fixed-price amount. Therefore the price quoted needs to include ALL costs associated with this job.Nuance will be supporting this through10/1/15?only.? Elsevier no longer has a partnership with Nuance associated with this product.See #1 above. Please contact Nuance. They are willing to work with SDVOSBs for the simulator. Under CLIN 0009, 0010, & 0011 in the Units column, what does the term "JB" stand for? (Item 0010 changed in Amendment 0001)JB = JOB Is there a definition or description of The Vendor’s Resource Management?? It appears to be a deliverable under 5.1.4, but there are no specifics.Disregard. This will be addressed in responses to RFQ. We have some trainers that meet the VA requirements today, but need to train more staff to get the correct certifications.? AHIMA no longer offers the ICD-10-CM/PCS Trainer or ICD-10-CM Trainer Certificate.? Can we substitute AIHC Training Certificates until AHIMA reoffers the trainer certification?An AHIMA Academy ICD-10-CM/PCS Certificate or an AHIMA-Approved ICD-10-CM/PCS Trainer/AHIMA-Approved ICD-10-CM Trainer Certificate is mandatory. The Provider Sessions-You are asking for two consultants for these sessions.? Will each Consultant be hosting their own separate sessions? Will both consultants each have 6 sessions/day?Provider training for specialty areas may be provided back to back with the Boot Camp training to reduce travel costs.? If a certain site has low demand for provider training or if the Boot Camp training utilizes all travel time, specific specialty training may be provided via online training module. Do we need to provide students with copies of ICD-9 and ICD-10 coding books?No Do both Consultants need to be onsite at the same time or are they basically a backup for each other?Both should be on site.Can a certified trainer be assigned to represent more than one site/location?YesDo you consider the trainers as Consultants or are they a separate entity?Consultants are trainers, auditors and project managers.Are there other times that the Consultants will need to be at the facilities or is the onsite presence for the Boot Camp/Provider training sessions only?This is up to the contractor to decide. They must be on site for the training sessions but may choose to be on site for the audit and project management duties. For the two Consultants that are assigned to each location:What are the Consultant’s main responsibilities?See PWS. Consultants are trainers, auditors, and project managersCan the same Consultant(s) be assigned to more than one location? (See question 6)? YesWe infer from the PWS that each site gets unique Consultants dedicated to that site – is this correct?No, you may use the same consultants for each site but you must adhere to the timeline of the PWS.Would it be permissible to have an additional 2-3 Consultants assigned to each site to be used as back-up Consultants as needed?YesIs it possible to utilize the extra Consultants (the additional people that will be named as back up Consultants) to support all 7 locations?YesDoes the Technical Proposal page limit include Resumes?? Can the Resumes be provided as an attachment to Volume 1 Instead?Yes that is fine. May be submitted as an attachment.Our research tells us that NUANCE software is available to commercial organizations at a price 25% higher than the price charged to the Government.? Further, it appears the distributor (Alvarez & Associates, an SDVOSB) is the only federal supplier.? In order to level the competitive playing field, given the government requirement for the Nuance software, would the Government consider providing the software to the successful contractor or unbundle the service delivery from the software acquisition??Nuance is willing to work with other SDVOSB vendors. Please contact them for details. Because of the NUANCE Software issues, our team had elected to post-pone our response development until this issue is resolved.? Once the government resolves the issue, will the government extend the deadline for past performance surveys and contractor proposal submissions?The deadline will not be extended. ??See attached document: VA261-15-Q-0324 ICD-10 CONSULTING TRAINING VISN21. ................
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