Beckley VA Medical Center .gov

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FedBizOppsSources Sought Notice*******CLASSIFICATION CODESUBJECTCONTRACTING OFFICE'S ZIP-CODESOLICITATION NUMBERRESPONSE DATE (MM-DD-YYYY)ARCHIVE DAYS AFTER THE RESPONSE DATERECOVERY ACT FUNDSSET-ASIDENAICS CODECONTRACTING OFFICE ADDRESSPOINT OF CONTACT(POC Information Automatically Filled from User Profile Unless Entered)DESCRIPTIONSee AttachmentAGENCY'S URLURL DESCRIPTIONAGENCY CONTACT'S EMAIL ADDRESSEMAIL DESCRIPTION ADDRESSPOSTAL CODECOUNTRYADDITIONAL INFORMATIONGENERAL INFORMATIONPLACE OF PERFORMANCE* = Required FieldFedBizOpps Sources Sought NoticeRev. March 2010QMedical Transcription Services517-20-1-5056-0001 (VA-19-00059418)2580136C24519Q034105-30-201960N14561410Department of Veterans AffairsNetwork Contracting Office 5 (NCO 5) 90CNCO 5510 Butler AvenueMartinsburg WV 25405Phillip.Duba@Beckley VA Medical Center200 Veterans AvenueBeckley, WV25801Phillip.Duba@Beckley VA Medical CenterTranscription ServicesDESCRIPTION/SPECIFICATIONS/WORK STATEMENT1.Scope: The Contractor shall provide off-site medical transcription services for digital dictation, traditional medical transcription and correction editing services for The Department of Veterans Affairs, Mid-Atlantic Health Care Network, Beckley VA Medical Center, Beckley, WV 25801 (hereafter referred to as VA, VAMC or the Government) 24 hours a day, seven days a week, 365 days a year, including Holidays, within prescribed turnaround times (TAT), using vendor-supplied dictation/transcription equipment and meeting the prescribed turnaround times discussed herein. This requirement will be for Beckley VA Medical Centers in VISN 5. Due to security and privacy concerns associated with the sensitive data that is the subject of this contract, all transcription, verification and uploading of reports shall be physically performed in the United States of America and there will be no subcontracting of this requirement. The Beckley VA Medical Center address and phone number is below:Beckley VA Medical Center200 Veterans AvenueBeckley, WV 25801304-255-2121Contractor shall transcribe reports utilizing appropriate formats including headers and footers. Contractor shall also transmit and/or upload completed reports to VA using transmission and batch protocols provided by VA. The dictated material includes highly technical medical terminology, and requires an in-depth, (minimum of three years’ experience), knowledge of specialized vocabularies. Specialized vocabularies shall encompass a variety of subjects in the fields of Medicine and Surgery to include: ambulatory care, anesthesiology, cardiology, dermatology, dentistry, drug and alcohol treatment, endocrinology, general medicine, gastroenterology, general surgery, geriatrics, gynecology, hematology, immunology, internal medicine, neurology, neurosurgery, nuclear medicine, oncology, ophthalmology, oral surgery, orthopedics, otolaryngology, otorhinolaryngology, vascular, pathology, psychiatry, psychology, plastic surgery, pulmonary, renal, radiology, rheumatology, spinal cord injury, thoracic surgery, transplant and urology. Material is dictated by a variety of clinical staff and requires adaptation to variations in accents, speech, tone, voice volume, delivery, pronunciation, enunciation and may require corrections to grammar. The types of reports dictated will vary from facility to facility but may include any and/or all of the following: Discharge (including interfacility transfer, interward transfer and nursing home placement) summaries, procedure reports/notes (including, but not limited to: cardiac catheterization, endoscopy, dermatology, etc.), history and physical examination reports, annual physical examination reports (for outpatients and nursing home residents), radiology reports, emergency department notes, compensation and pension examination reports, outpatient and inpatient progress notes, cardiology reports (Holter monitors, echocardiograms, stress treadmills), neurology reports (Sleep study reports, EEG, EMG, Dopplers), surgical pathology reports, cytology reports, autopsy reports, mental status examinations, Persian Gulf and Agent Orange examination reports, consultations, and other miscellaneous medical reports as required.Radiology:Contractor shall furnish the necessary labor, supplies and equipment to provide off-site medical transcription services for the Radiology Service, as a back-up to the current system if needed, to cover routine and emergency services.Coverage shall be seven days a week 24 hours per day within prescribed turnaround times (TAT)Radiology reports require a 24-hour turnaround time. Contractor shall transcribe reports utilizing headers and footer and appropriate formats for radiology reports. Contractor shall also transmit and/or upload completed reports to VA using transmission and batch protocols provided by VA. The dictated material includes highly technical medical terminology and requires a comprehensive knowledge of radiology terminology. Material is dictated by a variety of radiologists and requires adaptation to variations in accents, speech, tone, voice volume, delivery, pronunciation and enunciation. Radiology reports are transcribed directly into VISTA.Pathology:Contractor shall furnish the necessary labor, supplies and equipment to provide off-site medical transcription services for the Pathology Service, as a back-up to the current system if needed, to cover routine and emergency services.Coverage shall be seven days a week 24 hours per day within prescribed turnaround times (TAT)Pathology reports require a 24-hour turnaround time. Contractor shall transcribe reports utilizing headers and footer and appropriate formats for radiology reports. Contractor shall also transmit and/or upload completed reports to VA using transmission and batch protocols provided by VA. The dictated material includes highly technical medical terminology and requires a comprehensive knowledge of pathology terminology. Material is dictated by a variety of radiologists and requires adaptation to variations in accents, speech, tone, voice volume, delivery, pronunciation and enunciation. 2.System: The VA Medical Centers do not have dictation equipment. The transcribed documents are either typed directly into the VAMC Veterans Health Information Systems and Technology Architecture (VISTA) system or are typed and uploaded into the VISTA system. Remote access to VA systems that contain sensitive information must be done through the One-VA VPN. After contract award and prior to VA granting VPN access, the contractor shall be required to complete all privacy and security requirements. Contractor must be able to connect via One VA/VPN (Virtual Private Network) into the system, transmit transcribed documents, monitor jobs in the dictation system database and produce management reports from the database. Equipment necessary to comply with the terms of this contract is the responsibility of the contractor. Contractor must utilize the VPN software supplied by the VAMC. Contractor shall connect to the VAMC system utilizing a secure Virtual Private Network (VPN). The VA shall provide the license for the VPN. Currently, there is no cost to the Contractor for a VPN license, but this may be subject to change. Contractor shall pay all for connect/toll changes for dialing any and all VA-provided telephone numbers. Contractor shall be responsible for all costs associated with connection to the VPN. VA will be transitioning to the Remote Enterprise Security Compliance Update Environment (RESCUE) for upload purposes at some point in the future, and Contractor will be required to be able to connect through this system, once it is brought on-line. Adequate power and connections will be maintained by the Contractor to provide uninterrupted service. Contractor shall notify the specific VAMC Contracting Officer’s Representative (COR) immediately of any equipment or connections that are not functioning properly and could adversely affect dictation and/or transcription.Contractor shall assign a job number to each transcription job that will be used to track that job throughout the process. The Contractor shall send the digital dictation system’s dictation activity log, complete with the job numbers, covering midnight to midnight of the previous day’s dictation (Friday through Sunday on weekends) showing dictated date and time, transcription date and time, report type, author identification, patient identification (name, Social Security Number) and line length. This shall be transmitted daily electronically or to a specified printer or fax by 7:00 a.m. EST each business day or immediately upon request by VA personnel and will be validated by a designated Medical Center employee. The Contractor shall send electronically the digital dictation system’s dictation activity log for previous months upon request.3. Set-up/Support: The Contractor shall spend as much time as necessary at each facility to ensure that the implementation of services is smooth and seamless to users at each facility. The Contractor shall ensure that STAT and H&P Reports will reprioritize when entering the Contractor’s transcription system. The Contractor shall continue to provide assistance as needed to those facilities that request it, and shall continue to provide daily communication by e-mail, telephone or fax for jobs not transcribed or pulled. The Contractor shall ensure that all requested jobs are returned to their respective facilities by 3:30 p.m. EST each day.4.Term: Services are required for a base and four (4) years for each facility.5.Prices All Inclusive: Any equipment, material, or services required in the performance of this contract (i.e., dialing toll charges, site visit(s) to the VAMC for training the Contractor, background investigations, etc.) shall be included in the price of the line items.6.Orientation and Training:Given the complex nature of this contract, the Contractor shall be required to undergo training as follows: Contractor and certain members of Contractor’s personnel shall be required to come to the VAMC for on-site orientation and training if needed. The number of technical staff to need to be trained will be determined by the VA. The length of training should be a minimum of two (2) days, longer if necessary. Training shall focus on all aspects of the requirement to ensure all personnel are adequately trained and ensure as few problems as possible arise in uploading and other areas. As technical questions arise, VA staff shall assess for content and provide direction.b. Government regulations mandate that any individuals given access to a Federal System, or a system being operated on behalf of the Federal Government, must complete annual security awareness training that conforms to the requirements of the Department of Veterans Affairs Office of Cyber and Information Security Training. Contractor is required to ensure that all their employees with such access receive this training as part of their orientation, as well as, repeating this training annually. These individuals are required to complete the intranet-VA Information Security Awareness Course which is provided to meet this requirement, complete the course test, and obtain the on-line certificate to that effect. A copy of the certificate must be provided to each specific VAMC COR.c. Per VHA Handbook 160 5.1, contractor and business associates are required to complete annual VHA Privacy Training. Contractor is to ensure that their personnel receive privacy training that conforms to the requirements of Veterans Health Administration during their initial orientation as well as annually.d. Contractor shall be required to ensure that all transcriptionists being assigned to work on this account go through a probationary period, during which time; every report transcribed must be proofread and checked for errors by a member of the Contractor’s QA/supervisory/editing staff. The length of time required for this process of editing/training/proofreading shall be determined by the Contractor’s QA/supervisory/editing staff based on the transcriptionists’ ability to transcribe the VAMC reports correctly, including formatting and text content. However, the VAMC reserves the right to require the Contractor to put any transcriptionist back into a probationary status, if the COR determines there is a need for such action based on the quality of work being received by the VA.e. The VHA requires contractors performing services directly or indirectly affecting the VHA Revenue Cycle complete Compliance training. This training will be accomplished using one of the following two options:The contractor may use VISN 5’s Course Content Outline for New Employee Orientation. The contractor’s own Compliance training course will suffice if it is supplemented by the information that is contained in VA’s course content. The contractor will provide a copy of the training certificate to the Contracting Officer’s Representative (COR). A copy of the training certificate will also be maintained in the Contractor’s contract file.7.Contingency Services: Contractor shall maintain the resources necessary to ensure that transcription services for the Beckley VA Medical Center are uninterrupted, regardless of contingency or circumstance. Immediately upon implementation of any contingency services by Contractor, the Contractor’s account manager shall notify the COR or designee at the specific VAMC. A detailed explanation of the problem shall be provided to VA and any deviations from current practice shall be outlined to the specific VAMC COR or designee annotating how TAT shall continue to be met. Offerors shall submit with their proposal, documentation detailing an adequate contingency plan in the event of a Contractor system failure. The contingency plan will be reviewed and either accepted or rejected by the Contracting Officer.8.VA Records: In accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Contractor shall have the plant security and ADP security necessary to safeguard VA records. The Contractor shall also maintain backup media (voice recording) of dictated material for a period of no less than 90 days from the date of dictation, as well as backup media (copies all transcribed documents) for a period of no less than 12 months from the date of dictation, with the ability to be verified by the ISO and OI&T. If, at any time, VA is in need of backup reports, Contractor shall provide to VA within 24 hours at no additional cost. 9. Physical Plant Security: Contractor shall make every effort to provide a secure physical plant wherever the transcription is being performed. This could be accomplished in many different ways, such as but not limited to: locked buildings, locked offices with limited access, security camera’s, card reader access, security codes, locked server rooms, etc. Contractor should always be mindful and aware of security concerns, as transcription is a type of service that can be prone to security breaches. *****If the Contractor is using remote transcriptionists, at no time are these remote transcriptionists to save any VA information onto their hard drives. Contractor should read this contract thoroughly and ensure their company is able to fully comply with VAAR Clause 852.273-75 Security Requirements for Unclassified Information Technology Resources (October 2008) contained herein. Noncompliance with this clause, any security requirements contained herein, and any associated information listed or inferred by this contract, could be grounds for immediate termination. VA reserves the right to perform on-site inspection(s) of any facility where work is being performed on this contract in order to ensure the contractor is in compliance with all Security, Cyber Security, Privacy and Protected Health Information requirements.? Inspection(s) may be performed by VA’s COR, ISO, and/or CO.SPECIAL TERMS & CONDITIONSDEFINITIONS:(a)Visible Black Character: A Visible Black Character is defined as strike-able and visible characters and includes any printed letter, number, symbol, and/or punctuation mark excluding any or all formatting (e.g., bold, underline, italics, table structure, formatting codes). All visible black characters can be seen with the naked eye as a mark, regardless of whether viewed electronically or on a printed page.(b)Visual Black Character (VBC) Line or ASCII no Spaces Line: A VBC Line is defined as the total number of characters you can see with the naked eye, divided by 65. It includes any character contained within (between) a header or footer. Spaces, carriage returns, and hidden format instructions, such as bold, underline, text boxes, printer configurations, spell check, etc., are not counted in the total character count. A VBC Line is calculated by counting all visual characters and simply dividing the total number of characters by 65 to arrive at the number of defined lines. Font will be Courier New 11 point. No charges are assessed for blank lines (a line containing no text). There will be no bolding or underlining of words in transcribed reports due to incompatibility with VISTA. Transcription shall be completed in Microsoft Word. Site must be configured with the following line counting options enabled, unless otherwise specified in the contract or elsewhere in this section:(1)Include Headers and Footers;(2)Include Template;For billing purposes, lines are calculated by adding the number of characters in a report and dividing by 65. Not all characters in a report are countable for line counting and billing purposes. Only those characters in a report following the upload header up to and including the footer are countable for line counting and billing purposes. The upload header includes all text/characters including and between $HDR and $TXT. The COR will provide a sample report that illustrates what is considered countable and non-countable for line counting and billing purposes. The Contractor shall not bill the VA for any other typed documents – this includes but is not limited to logs, TAT reports, e-mails or correspondence to the VA, and any typing required to upload patient reports into the patient’s electronic medical record. The VA will be responsible for payment of lines received rather than lines transmitted which will be determined upon upload to the correct patient’s electronic record in VISTA/CPRS by the VA’s VISTA system.(c) TAT (Turn-around-time): The Contractor’s system shall allow the Contractor to immediately access jobs through a pool assignment as soon as they are dictated. TAT is the difference between the time the author hangs up at the conclusion of dictating into the system, and the time the Contractor’s correctly transcribed report is uploaded (regardless of upload methodology) into the appropriate patient’s electronic record in VISTA/CPRS. When the author begins to dictate a job number will be assigned for tracking purposes. When the author hangs up at the completion of a dictation, that same job number is repeated. The dictation system shall then record the date and time that the dictation was completed/closed. The system shall also record the date and time the transcription of that report was completed. However, it must clearly be understood that the date and time the transcription is completed has absolutely no bearing on the overall TAT. Overall TAT can only be determined by the VAMC’s COR or designee once the correctly transcribed report has been uploaded into the appropriate patient’s electronic record.NOTE: Turnaround Time is calculated on a 24-hour basis (including weekends and holidays). Overall turn-around-time (TAT) requirement varies between report types, as described below:TURNAROUND TIMEREPORT TITLEREQUIRED TATSTAT dictation (any report dictated and designated to be transcribed STATTwo (2) hoursTransfer Discharge SummariesTwo (2) hoursEmergency Room NotesFour (4) hoursHistory and PhysicalsFour (4) hoursLTC (Long-Term-Care) Placement SummariesFour (4) hoursInterim SummariesFour (4) hoursDischarge SummariesTwenty-Four (24) hoursAddendum to any ReportTwenty-Four (24) hoursOperation ReportsTwenty-Four (24) hoursNon-OR Procedure ReportsTwenty-Four (24) hoursConsultation ReportsTwenty-Four (24) hoursAnnual Physical Exam ReportsTwenty-Four (24) hoursPersian Gulf/Agent Orange Exam ReportsTwenty-Four (24) hoursCompensation & Pension Exam ReportsTwenty-Four (24) hoursRadiology ReportsTwenty-Four (24) hoursPathology ReportsTwenty-Four (24) hoursEmergency Room NotesTwenty-Four (24) hoursProgress notesTwenty-Four (24) hoursOther non-STAT dictationTwenty-Four (24) hours(d)VISTA: VA electronic health care architecture based on software modules developed with “M” (“MUMPS”).(e)STAT: Report needs to be transcribed within the turnaround time indicated or sooner as designated by the report work type, author of the report and/or the COR or HIMS designee.(f)COR: Contracting Officer’s Representative (g)VPN: One VA VPN is the connection method Contractor shall use. 2.PREPARATION & FORMAT OF REPORTS:(a)General Format: The length of each report shall vary according to the type of medical report required. The reports shall be created and saved as ASCII text – only printable characters, single spaces, and <CR><LF>. The lines of the text are to be single-spaced with double-spacing between paragraphs. No report shall include any text other than what was dictated (except for formatting and grammar correction, as instructed by the VA COR). Comments and/or questions must be sent as separate correspondence referencing the dictation system job number. Typed comments and/or questions are not counted except in cases of extreme emergency. Typed header information is not countable as billable. Carriage returns, blank lines and tabs outside the body of the report, as well as margin settings and other word processing commands are excluded from line and/or character count and shall not be billed.(b)Header and Footer Format: Contractor shall ensure all header and footer information complies with the sample header and footer.(c)Header Information: Header text contains information required for uploading and must be exact (including spacing) complying with samples and instructions provided by the VA for each type of report. Each document shall include the specified header conforming to the standard provided by VA for that type of document. The header includes the document type, patient name, patient Social Security Number, date of encounter (date of visit, surgery and/or admission), the document’s author, the cosigner (when required depending on title of author), the attending physician, when indicated (attending physician is not required for Compensation and Pension exams), dictation date (and time, when indicated), and the transcriptionist identifier. Errors in Upload Header information are considered formatting errors; regarding performance requirements (see Performance Requirements Summary Matrix attached)(d)Footer information: Footer information shall be typed on one line two spaces below the end of the body of the transcribed report and shall include the dictation job number; the initials of the author; the date and time of the dictation, the date and time of transcription, the Contractor’s name and transcriptionist’s initials. At the direction of the VA, the Contractor shall insert additional information, such as signature blocks, on certain types of reports.3.TRANSMISSION OF DOCUMENTS TO VA:(a)Destination of transcribed documents: Contractor shall upload transcribed documents directly into the electronic patient record by batch transmission through the VA VISTA system.(b)Frequency of Transmission: Transcribed documents shall be transmitted to VA at least every two hours from 7:00 am – 8:00 pm (EST) or more frequently at Contractor’s discretion. Additional transmissions of transcribed documents shall be transmitted to VAMC as frequently as is necessary to assure the vendor meets contract Turn-around-time.(c)Format & Protocol of Transmission: The Contractor shall be responsible for transmitting properly formatted documents over digital networks. Contractor must provide his/her own communications software, which shall enable them to upload the transcribed data into the electronic patient record. As discussed in the Orientation and Training Section, VA shall provide on-site orientation and training to the Contractor’s upload staff for this complex process during the initial period of this contract. The VA shall provide additional technical support to the Contractor throughout the term of this contract. Compensation & Pension (C&P) reports: Contractor shall upload reports into the patient record as they are transcribed. Because VISTA menu structures may be modified prior to and/or following the phase-in period of commencement of this contract, the step-by-step protocol may be slightly modified. In this event, VA shall provide the Contractor with an updated protocol. Medical Reports (Non-C&P): Contractor shall upload reports into the patient record as they are transcribed. Because VISTA menu structures may be modified prior to and/or following the phase in period or commencement of this contract the step-by-step protocol may be slightly modified. In this event, VA shall provide the Contractor with an updated protocol. Selection of the correct report title, as dictated by the author, and/or as instructed by COR is critical during the upload process. VA will update vendor with new note titles periodically. Other Medical Reports: At the discretion of the VA, the contractor shall upload other classes/types of reports that may not have been addressed in Section 1 and 2 above. Any such reports may require a separate upload protocol. In the event additional protocol(s) are required, the VA shall provide the Contractor with the appropriate protocol(s) for immediate implementation.STAT reports are required to be uploaded under this contract; however, if an emergency arises, VA may request a STAT report from the Contractor telephonically/electronically, along with any instructions to the Contractor regarding a special delivery location (such as a departmental fax machine number or a VA host PC). Requests for Re-Uploads: In instances where an upload fails, the VA shall contact the Contractor and request a re-upload of that report. The Contractor shall re-upload the requested report within one hour of the time of the request. All re-uploads will be provided at no cost to VA. 4. QUALITY ASSURANCE: All transcription performed by the Contractor shall be proofread for spelling, punctuation, grammar and qualitatively reviewed by the Contractor, prior to upload, to ensure the reports are error free and of the highest professional quality. A contractor quality control certification shall accompany every transcription performed. Each transcribed report shall contain no more than 3 total errors per every 65 lines (65-characters each) in the report. Definitions for errors include, but are not limited to, the following: punctuation, grammar errors, incorrect job number transcribed in footer of report, non-medical spelling errors, inappropriate abbreviations, inserting paragraph headings and subheadings when not dictated and if not instructed to do so by the COR, medical spelling errors, missing or incorrect patient identification in header, transcribing abbreviations in the “diagnoses”, “procedures”, and/or “assessment/impression” sections of all reports, context errors, not transcribing information clearly dictated; typing three @ signs (@@@) representing a blank (when the dictation is audible upon review by the COR); formatting in ways other than instructed through VA-provided samples, etc. All problems should be identified and resolved within the TAT.The contractor shall be required to have a quality control plan in place at the time performance begins, and a written statement of the quality control plan shall be submitted with the Contractor’s proposal. Periodic quality assurance checks will be performed by representative for Health Information Management Section (HIMS). This review will include comparison of the actual (audio) dictation to the typed report. If a report must be redone due to an incorrectly formatted and/or carelessly typed document, the Contractor shall correct/type the report within four (4) hours of notification by telephone by HIMS personnel at no further charge to the Government. Corrected reports shall be flagged as corrected when returned to the VA. STAT Reports shall be corrected and retransmitted within one (1) hour following notification by telephone by HIMS personnel. In the event a report requires correction or retyping due to an error by Government personnel, the service will be billed in accordance with the Schedule of Items. The Contractor shall have a system in place which will enable the transcriptionist(s) to type three @ signs (@@@) representing a blank line, if they cannot understand the dictator and/or if they have a question about the dictation, and the report will automatically be routed through a supervisor/editor, prior to upload. At this point, the supervisor/editor is to review the entire report (including the header and footer), listening to the dictation, filling in the blanks (if possible), and making any other corrections to the format and content (including grammar, punctuation and spelling), prior to upload. The Contractor shall perform QA, checking for complete and accurate information in the header of all reports, prior to upload, to ensure all reports are uploaded into the correct patient’s electronic record and associated with the correct visit/event/admission/surgery date. Ninety-nine percent (99%) of the reports transcribed and uploaded shall be uploaded into the correct patient’s electronic record. If a problem is identified upon receipt by the VA (i.e., incorrect job number, error in body of text, uploaded into the wrong patient’s electronic record, etc.), the VA COR will take whatever steps necessary including, but not limited to, contacting the Contractor to have the discrepancy researched and the problem resolved by their staff. The Contracting Officer has the right to terminate a transcriptionist from transcribing dictation for the VAMC, when quality assurance monitors reflect consistent problems with performance. The Contractor must correct all unsatisfactory work unless excused by the COR. Consistent failure (two consecutive months, or greater than three months within a six-month period) to meet any of the quality standards below, will be considered unacceptable and will be referred to the Contracting Officer for administration.(a)Quality Standards:The Contractor shall meet the following timeliness and accuracy rates: (1)On average, no more than one error per 20 reports which changes the meaning of the report will be acceptable. These errors include but are not limited to:incorrect or omitted medical terminology that is clearly dictatedpunctuation or spelling which changes the meaning of the sentenceentering material that is not dictated (except when necessary for the purpose of correcting diction and/or grammar)entering material that is not part of the report such as dictators' directions to transcriptionistsmisspelled words that have been caught by a spell-check programthree @ signs (@@@) representing a blank line for dictation that is clearly understandableunauthorized abbreviations (NOTE: abbreviations shall not be used in “diagnoses” and “procedure performed” and/or "assessment/ impression” section of any of the reports. Abbreviations used in the text are to be limited to those commonly used in laboratory testing, as listed in Stedman’s Abbreviations, Acronyms and Symbols, most recent edition, and those abbreviations on the VA approved abbreviation list, which shall be distributed to the Contractor at the time of contract award.) (2)Each report which contains one or more errors that change the meaning of the report shall be at no cost to the Government. (3)Four or more errors per 20 reports shall be at no cost to the Government. (The number of errors here is becoming significant regardless of whether they change the meaning of the report). (b) Quality Monitors: The VA COR shall monitor reports randomly throughout the month for Quality Assurance by comparing the transcribed report with the dictation. Monthly Quality Assurance reports shall be submitted by the Contractor to the COR at the VAMC by the fifth day of each month for the previous month’s activities. These reports shall include by Job number for each report reviewed, the transcriptionist identifier, the number of lines of transcription, report type, number of errors, types of errors (as listed in 4(b) quality standards above), and actions taken to decrease errors. (c) Quality Standards Price Deduction-Disincentive (See Performance Requirements Summary Matrix): In addition to the items listed under number 4, Quality Standards, items (2) and (3), detailing instances in which the reports will be provided at no cost to the Government, at least 95% of all reports must meet the quality standard requirements during each billing cycle, or a 10% deduction will be applied to the entire month’s invoice. If less than 90% of all reports meet quality standard requirements, a 15% deduction will be applied to the entire month’s invoice. Consistent failure to meet the 95% standard is considered unacceptable and will be referred to the Contracting Officer for administration.NOTE: During the initial 90-day startup of this contract, no penalties will be imposed for failure to meet quality monitors and TAT, provided that the Contractor is making satisfactory progress. (d)Upload Standards: Contractor shall upload and correct upload errors under this contract. A sampling of errors that must be corrected by HIMS personnel will be recorded as format errors by the COR in the monthly QA monitoring report. These errors include but are not limited to: errors in the note titles assigned during upload, uploading to incorrect patient name, SSN, visit, event, admission or procedure date, deviations from patient/clinic/ward location listed in VISTA/VPN for each patient care episode, and errors in the name of author, attending, and/or cosigning physician. Upload errors caused by errors or omission on the part of the VA author or VAMC staff do not count against the Contractor’s TAT performance. If there is no specific clinic appointment, surgery or procedure slot open for a transcribed report, the Contractor shall transmit the report to the VA within the required TAT, and the VA COR will have a slot created and will upload the report. This would be considered an upload error caused on the part of the VA and, therefore, would not be assessed against the Contractor in the QA reporting process. (e)TAT Report:Contractor shall provide the VA COR with a daily TAT report. Contractor must have MS Outlook or compatible software that is capable of sending and receiving attachments. Each day, the Contractor shall send an electronic mail message with an attached spreadsheet (created in MS Excel or compatible software). The spreadsheet shall provide specific details about all the jobs transcribed during the previous day and should also allow VA to search for a specific job and or provider individually. Required fields (columns) in the spreadsheet shall include patient name, patient SSN, Job ID number, author, date and time of dictation, date and time of transcription, (if report completed when submitting this report); date and time of upload. The spreadsheet (and all its fields) shall be populated with details of all jobs that were transcribed during the previous day – the job numbers are to be pulled from the transcribed reports. The report of a previous day’s transcription is due no later than 8:30 am EST the following day. The Contractor shall supply the VA with the necessary secure mechanism (secure server) to enable the VA to have real-time access to the information recorded by the Contractor’s dictation equipment, with regards to dictation, transcription, date and time, as well as all other information mentioned above. The VA reserves the right, to provide the Contractor with a more sophisticated TAT reporting mechanism, should it become available. The Contractor shall comply with the VA’s line-counting software by implementing the VA’s reporting mechanism for billing and payment purposes. This report contains sensitive data that shall be transmitted via a secure mechanism (secure server, etc.). Contractor shall have the capability to encrypt e-mail in the event it becomes necessary to copy portions of reports to create a visual representation of the errors that are occurring. (f)TAT Report Standards:(1)There shall be no more than two instances per month where the TAT report is late.(2)There shall be no instances when a TAT report is greater than two days late.(3)Reports shall have an accuracy rate of 99% for all fields and entries.(h)TAT Price Deduction-Disincentive (See Performance Requirements Summary Matrix):At least 95% of all reports must meet TAT requirements during each billing cycle, or a 10% deduction shall be applied to the entire month’s invoice. If less than 90% of all reports meet TAT requirements, a 15% deduction shall be applied to the entire month’s invoice. Consistent failure (two consecutive months or greater than three months within a six-month period) to meet the 95% standard is unacceptable and will be referred to the Contracting Officer for administration.(i)Proofreading: Contractor shall proofread all reports for compliance with established format for each work type and any necessary corrections are to be made at that time and prior to transmission. For any words or phrases that cannot be transcribed due to difficulties in hearing the dictators voice, the transcriptionist shall type three @ signs (@@@) representing a blank, to send the report through a supervisor/editor for further QA (as described under paragraph 4, Quality Assurance).(j)Spell check:Contractor shall use a medical spell checker on each document and perform corrections for spelling, punctuation and grammar.(k)Corrections: Any report(s) returned to the Contractor for correction for reasons stated herein shall be returned to the VAMC within the following timeframes at no additional expense to the VA: Routine reports (normal 24-hour TAT requirement) are to be corrected and returned within four hours of receipt by the Contractor; special reports (normal 4- hour TAT requirement) are to be corrected and returned within two hours of receipt by the Contractor; and any STAT reports (normal 2-hour TAT requirement) are to be corrected and returned within one hour of receipt by the Contractor.(l)Skipped Jobs: All reports shall be transcribed using the TAT priority requested. Contractor shall ensure STAT reports are continually re-sequenced so that they are always the first priority for transcription. Consistent skipping of jobs to avoid a certain report type or author is not allowed. (m)Partial or Incomplete Dictation:Dictation may be interrupted if there is an equipment malfunction or if the dictator terminates the dictation, prior to the end of the report. In cases where the dictation is continued or completed in another job number on the same day, Contractor shall be responsible for combining all segments of the dictation into one complete report prior to the final upload. When dictation is incomplete and not continued or completed on the same day, the transcriptionist will return twice after the last word dictated and type “Dictation Ended At This Point.” In rare instances, the dictation might be cut off at the beginning of a report. In this instance the transcriptionist is to return once after the header, and prior to transcribing the report, and type “Dictation Started At This Point.” These are the only instances when the transcriptionist is allowed to type any kind of comment in any report, except other than those comments that could be dictated by the author regarding dictation or continuation of a prior report. (n)Missing Reports: Contractor shall ensure that VA COR’s and HIMS Personnel are aware of any minimum time frames in which VA providers must be on the line before recording actually begins to eliminate “0” line reports. Missing reports are defined as reports dictated by the physicians, verified and transcribed, but not delivered to the VA. The Contractor shall be accountable for any missing reports. Any transcription redone due to a missing report shall be transcribed and returned at no charge to the VA within four hours after receipt of notice from VA COR or designated HIMS personnel. Any more than two occurrences of missing reports per month is considered unacceptable, and consistent occurrences (two consecutive months or greater than three months within a six-month period) of two missing reports each month will be referred to the Contracting Officer for administration. 5.SPECIAL GOVERNMENT RESPONSIBILITIES:(a)Electronic access:VA shall provide electronic access to VA computer systems. Government regulations mandate that any individuals given access to a Federal System, or a system being operated on behalf of the Federal Government, must receive information security awareness training as part of their orientation training and must be provided with refresher security awareness training at least annually. The intranet VA Information Security Awareness Course shall be provided to meet this requirement. Individuals are required to complete the course, pass the test and retrieve an on-line certificate. A copy of the certificate must be provided to the COR who will provide it to the Information Security Officer.(b)Training of Contractor Staff: Training of the Contractor’s upload staff shall occur during a 30-day phase-in period between contract award and the commencement of live production. The Contractor staff shall be on-site for this training at each VAMC for as long as deemed necessary by VA COR and Contractor Staff, in order to ensure proper training has been accomplished to go live. Contractor staff receiving this training must be the “hands-on” staff who shall be working on uploading the work for the VA account. In accordance with VAMC Memorandum, Automated Information Systems Security Policy Consultation with designated Government Information Support staff shall also be available as needed,(c)List of staff:VA will provide a list of staff, as well as rotation schedules when applicable.(d)Templates: VA will provide reports and/or header & footer formats and an approved List of Abbreviations.(e)Workflow Fluctuations: VA will provide advance notification whenever possible regarding workflow fluctuations or other changes that impact Contractor performance.(f)Regular meetings:Meetings between the VA Transcription Staff and those of the Contractor shall be held monthly for the base year of the contract and then quarterly throughout the remainder of the option years, unless problems arise that require more intense discussion and frequency of meetings. 6.SPECIAL CONTRACTOR RESPONSIBILITIES:(a)Primary and Alternate Point of Contact: Contractor shall provide the name and phone number of the person who shall function as the contractor’s designated liaison and that of the person who will act in the absence of the designated liaison, who will resolve issues at the operations level. These individuals shall work with the VA COR on day-to-day operations and shall be available from 7:00 am – 11:00 p.m. EST seven days a week. Telephone or e-mail inquiries to the Contractor shall be responded to within two (2) hours. A telephone answering service or machine utilized by the Contractor during normal working hours shall be checked frequently, so as to obtain any messages left by the VA. (b)Company Representative: Contractor shall provide the name of a company representative who is authorized to act on behalf of the company to resolve ongoing problems that have not been resolved at the operations level.(c)Computer System: The Contractor shall have computers and software able to support the requirement. If not already owned or in use by Contractor, Contractor shall purchase, lease, etc., necessary software, equipment and/or services required to adhere to the contract specifications found herein, including the equipment necessary to enable the VA to have real-time access to view dictation/transcription data as it is recorded by the Contractor’s dictation/transcription console. (d)Privacy & Security: Contractor shall ensure that all personnel with access to Government computer systems and/or records comply with the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and the VA Medical Center’s Automated Information Systems (AIS) Security Policy and that each has completed the VA System Access Agreements. Violations may be cause for termination of the contract. The Contractor is required to provide adequate on-site security of all facilities, equipment and software where patient information is stored, utilized, or accessed, to ensure protection from hazard, theft, and unauthorized access. The Contractor shall ensure the confidentiality of all patient information and will be held liable in the event of breach of confidentiality. The Contractor shall comply with the provisions of the Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), and Federal Privacy Act of 1974 (Public Law 93-579), as well as other statutes regarding confidentiality of patient information. The Contractor shall be required to sign a Privacy Act Confidentiality Statement and a Rules of Behavior Statement. In connection with the provision of the services provided, the VAMC will disclose to the Contractor Protected Health Information (PHI) and Electronic Protected Health Information (EPHI) that is subject to privacy protection, as mandated by HIPAA. The Contractor, as a recipient of PHI and EPHI from the VAMC, shall be required to sign a Business Associate Agreement (BAA). Through the BAA, the Contractor will agree in writing to certain mandatory provisions regarding the use and disclosure of PHI and EPHI. (See Attachment 5). Any breach of confidentiality and/or unauthorized release of information is subject to a penalty of $5000 to $10,000 for each offense. Any individual making unauthorized disclosure may be criminally liable for violations of the Act.(e)Records Storage:Upon request, the Contractor shall provide re-uploads of transcribed reports as far as back as one (1) year from the date of upload into VISTA. At the conclusion of the first year, Contractor shall properly dispose of all media containing VA reports that are older than 12 months. To ensure proper disposal of any paper record containing PII or sensitive information, National Archives and Records Administration (NARA) rules and the National Institute of Standards and Technology (NIST) 800-88 Guidelines for Media Sanitization will be followed. NARA’s rules are not shredder specific, but the rules are nevertheless applicable, in particular, where paper records are to be disposed. NIST 800-88 guidelines are shredder specific. If the records contain PII or other sensitive information, they must be destroyed by burning, pulping, shredding, macerating, or other suitable means. National Security Agency (NSA) specifications for High Security Crosscut Paper Shredders (NSA/CSS 02-01) and High Security Disintegrators (NSA/CSS 02-02) would be applicable. When disposing of paper records containing PII or sensitive information, the chosen shredder device must have a crosscutting capability which produces particles that are 1 X 5 millimeters in size or that will pulverize/disintegrate paper material using disintegrator devices with a 3/32-inch security screen. (Reference NSA Disintegrator Evaluated Products List). No PII or sensitive information should ever be placed into a dumpster or similar device that has not been shredded, pulped, or macerated. Temporary records that are collected for destruction must be kept in a secure, nonpublic area of the facility, until the destruction is completed. In addition, Contractor shall ensure all VA media data is disposed of by erasing all computer disks and files containing VA information. This should be accomplished using an industry standard data eraser or purging program. Contractor shall provide to the VA the name of the software used and demonstrate its capabilities for complete erasure of files from computer hard drives. At each disposal of information, Contractor shall certify in writing to the VA, that all VA data has in fact been destroyed(f)Information Technology:Contractor shall ensure that all information technology used in performance of this contract is compatible with VA systems and virus-free.(g)Staffing Requirements: Contractor shall provide sufficient transcriptionists to meet the contract requirements and a plan to address periodic fluctuations in VA workload. All transcription services will be performed in the United States or its territories by citizens of the United States of America.(h)Qualified Staff: Contractor shall provide qualified transcriptionist with a minimum of three years’ experience to meet the quality standards of this contract. (i)Phasing Plan: Contractor shall have a phasing plan for the transition period between contract award and live production. This phasing plan shall be submitted with proposal.(j)Contractor Personnel Security Requirements: All Contractor employees who require access to the Department of Veterans Affairs’ computer systems shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access. The required investigation(s) shall be initiated prior to contract performance. If the investigation has not been completed prior to the start date of the contract, the Contractor shall be responsible for the actions of those individuals they provide to perform work for VA.(1)Position Sensitivity: The position sensitivity has been designated as Low Risk.(2)Background Investigation: The level of background investigation commensurate with the required level of access is performed by the VA Law Enforcement Center in Little Rock, Arkansas. (3)Contractor Responsibilities: The Contractor shall bear the expense of obtaining background investigations. If the investigation is conducted by the Office of Personnel Management (OPM), the Contractor shall reimburse VA within 30 days. The estimated cost for a low risk level background check is $250.00 each. The Contractor shall prescreen all transcription personnel and all personnel requiring access to the computer systems to ensure they are U.S. citizens and that they maintain a U.S. citizenship and are able to read, write, speak and understand the English language. The Contractor shall submit or have their employees submit the following required forms to the VA Office of Security and Law Enforcement within 30 days of receipt:Standard Form 85P, Questionnaire for Public Trust PositionsStandard Form 85P-S, Supplemental Questionnaire for Selected Positions.FD 258, U.S. Department of Justice Fingerprint Applicant Chart.VA Form 0710, Authority for Release of Information Form.Optional Form 306, Declaration of Federal Employment.Optional Form 612, Optional Application for Federal Employment. The Contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract. Failure to comply with the Contractor personnel security requirements may result in termination of the contract for default.(4)Government Responsibilities:The VA Office of Security and Law Enforcement shall provide the necessary forms to the Contractor or to the Contractor’s employees after receiving a list of names and addresses.Upon receipt, the VA Office of Security and Law Enforcement shall review the completed forms for accuracy and forward the forms to OPM to conduct the background investigation.The VA facility shall pay for investigations conducted by the Office of Personnel Management (OPM) in advance. In these instances, the Contractor will reimburse the VA facility within 30 days.The VA Office of Security and Law Enforcement shall notify the Contracting Officer and Contractor after adjudicating the results of the background investigations received from OPM.The Contracting Officer will ensure that the Contractor provides evidence that investigations have been completed or are in the process of being requested.The Contractor may utilize a private investigating agency if such agency possesses an OPM and Defense Security Service certification. A Cage Code number must be provided to the VA Office of Security and Law Enforcement, which shall verify the information and advise the Contracting Officer whether Contractor’s access to the computer systems can be authorized.7.CONTRACTOR QUALIFICATIONS:Financially Responsible Business: Offers will be considered only from those firms who are regularly established in the business of transcription and are, in the judgment of the Contracting Officer, financially responsible and able to show evidence of resources, experience and qualifications necessary to render services in accordance with the contract requirements.Experienced Staff: Contractor transcription staff shall be a Certified Medical Transcriptionist or have three (3) years of recent work experience transcribing physician dictated inpatient medical record reports including but not limited to: History and Physicals, Operative Reports, Consultation Reports, Discharge Summaries, Procedure Reports, and Diagnostic Imaging Reports. Prior VA transcription experience is desired. Prior VA transcription experience in the Computerized Patient Record System (CPRS) environment is preferred. The VA reserves the right to review the resumes of transcriptionists typing VA work. In addition, the Contractor shall be required to ensure that all transcriptionists being assigned to work on this account go through a period of editing/training, as described in the Description/Specifications/Work Statement, Subparagraph 5, Orientation and Training.Stable Workforce: Contractor shall have a stable workforce, with experienced administrators, technicians, and credentialed staff necessary to comply with the contract requirements and holding at least one of the following:RHIT – Registered Health Information Technician;RHIA – Registered Health Information Administrator; orAAMT – Association of American Medical TranscriptionistsTraining and Quality Assurance Plan: Contractor shall maintain an ongoing Training Plan and Quality Assurance Plan. VA reserves the right to periodically review training records for Contractor’s staff assigned to this contract, receive written documentation of any on-going quality improvement training provided to staff, and receive and review copies of quality monitors performed on VA reports on a monthly basis.Equipment, Hardware & Software Experience: Contractor shall have extensive knowledge and experience with computer systems, specifically Microsoft Word and VA’s internal software, VISTA/CPRS. 8.CONTRACT ADMINISTRATION:Communication Points: Normal day-to-day issues and problems shall be resolved by communication between the VA and the Contractor at the lowest level possible. Issues and problems that cannot be resolved at this level shall trigger communication between the VA COR and the Contractor’s primary or alternate operations manager. Problems unresolved at this level shall be referred to the VA Contracting Officer and the Contractor’s designated Corporate Official.Price All Inclusive: Contractor shall be able to set any schedule of work hours for its employees under this contract providing the VA’s TAT requirements shall be met; however, the contract price stated in Prices/Costs is considered payment in full for all services rendered under this contract. The Government will not be liable for any overtime pay/holiday differential.(d)Contracting Officer Can Reject Contractors Personnel: The Contracting Officer reserves the right to reject any of the Contractor’s personnel and refuse them permission to perform work under the contract.(e) Access to ADP Files: In the performance of official duties, the Contractor’s employees have regular access to printed and electronic files containing sensitive data which must be protected under the provisions of the Privacy Act of 1974 (5 USC 552a) and other applicable laws, federal regulations, VA statutes and policies. The Contractor’s employees are responsible for: * Protecting the data from unauthorized release or from loss, alteration, or unauthorized deletion. * Following applicable regulations and instructions regarding access to computerized files, release of access codes, etc., as set out in a computer access agreement that the Contractor’s employees sign. (f) Contracting with Parties Listed on the OIG List of Excluded individuals/Entities: In accordance with the Health Insurance Portability and Accountability Act (HIPAA) and the Balanced Budget Act (BBA) of 1977, the Office of Inspector General has established a list of parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs. Therefore, all offerors shall review the OIG List of Excluded Individuals/Entities on the OIG web site at HYPERLINK "" oig to ensure that the proposed candidate(s) and/or firm(s) are not listed. Offerors should note that any excluded individual or entity that submits a claim for reimbursement to the Federal Health Care Program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) of $10,000 for each item or service furnished during a period that the person or entity was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMPs may also be imposed against health care providers and entities that employ or enter into contracts with excluded individuals or entities to provide items or services to Federal program beneficiaries. By signing the offer/bid, the Contractor certifies that he/she has reviewed the OIG List of Excluded Individuals/Entities and that the proposed candidate(s) and/or firm is not listed as of the date the offer/bid was signed.(g) Contract Administration Data: The Contracting Officer is the only person authorized to approve changes or modify any of the requirements of this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue changes that shall affect price, quantity or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer without authority, no adjustment shall be made in the contract price to cover an increase in costs incurred as a result thereof.After award of contract, all administrative functions, inquiries and correspondence relative to the administration of the contract shall be addressed to the Contracting Officer.PERFORMANCE REQUIREMENTS SUMMARY MATRIXPerformancePerformance StandardAcceptable QualityMonitoringDisincentiveObjectiveLevel (AQL)Methods/PerformanceAssessmentFormatMust be completed in95%COTR will10% deduction accordance with thereview finished from monthly prescribed formats;documents invoice for failureonly approvedfor format to meet AQLabbreviations are used.All transcription will be accomplished in consistenttype font with the document.TimelinessRoutinely received #1 – Level – 95% COTR will10% deduction electronically, transcribed #2 – Level – 90% will review from monthly and returned within 24 hours 30% finished invoice forSTAT reports (including transfer documents forSummaries) within 2 hours, andfailure to AQLH&Ps, LTC placement summaries#1. 15% deduction from and interim summariesmonthlyinvoice forwithin 4 hoursfailure to meet AQL #1.deduction from monthly invoice for failure tomeet AQL #2.AccuracySubmit accurate transcription#1 – Level - 95% COTR will 10% deductionto include correct medical #2 – Level – 90%randomlyfrom monthlyterminology that is clearlyreview finishedinvoice fordictated; correct punctuationreports forto meet AQL.and spelling; no unauthorizedaccuracy.15% deductionabbreviations; three @ signs (@@@)from monthlyrepresenting blank line for dictationinvoice forthat is clearly intelligible failure to meetAQL#2.Refer to Quality Standards listing ................
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