- Country: USA
- Summary: VHA OFFICE OF FINANCE (OF) RECOVERY AUDIT SERVICES
- UST Ref No: 121591660
- Deadline: 07 Jul 2025
- Financier: Self Financed
- Purchaser Ownership: Government
- Tender Value: Refer Document
- Notice Type: Tender
- Document Ref. No.: 36C10X25R0021
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- Description:
- Description
THIS IS NOT A REQUEST FOR COMPETITIVE OFFERS Recovery Audit (RA) Services This is a Pre-Solicitation Notice for The Department of Veterans Affairs (VA), VHA Office of Finance (OF) has a requirement for up to 3 highly skilled contractor(s) to conduct Recovery Audit (RA) activities of healthcare claim payments made for a variety of VHA Community Care programs, as described below. Automated reviews occur at the system level while complex reviews require a qualified individual to review the medical record. Each program has specific payment methodologies as defined by VA regulations. In general, the audit will review various types of paid healthcare claim data with specific dates and criteria included in the description of each auditing scenario.OBJECTIVESKey objectives of the RA contract are to receive access to paid Community Care healthcare claims data; audit that data for potential overpayments to providers based on laws, regulations, policies and industry standard practices (e.g., medical coding) using RAC s technology solutions and validated by qualified individuals employed by RAC; verify overpayments through a defined dispute process by qualified individuals employed by RAC; and report results to VA. The contractor shall also identify FboNotice causes or trends for potential reduction of improper payments. Another key objective of the contract is to manage and perform all provider communications and interactions through the entire lifecycle of each claim s audit and recovery process, which includes announcements of RAs for new audit topics (e.g., claim types, programs) on a provider portal established and operated by the RAC; receiving ml documentation from providers (e.g., via RAC s provider portal); notifying providers of audit findings; communicating findings from the defined dispute process; establishing and operating a Customer Service Center (CSC) for addressing questions from providers.The auditing of various VA Community Care Programs has ... - Documents:
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CLICK HERE TO LOGINVHA OFFICE OF FINANCE (OF) RECOVERY AUDIT SERVICES - USA Tender
The VETERANS AFFAIRS, DEPARTMENT OF, a Government sector organization in USA, has announced a new tender for VHA OFFICE OF FINANCE (OF) RECOVERY AUDIT SERVICES. This tender is published on USARFP under UST Ref No: 121591660 and is categorized as a Tender. Interested and eligible suppliers are invited to participate by reviewing the tender documents and submitting their bids before the deadline on 2025-07-07.
The estimated tender value is Refer Document, and full details, including technical specifications and submission requirements, are provided in the official tender documents. Ensure all submissions meet the criteria outlined to be considered for evaluation.
