Request for Proposal 18-06-SSP

Request for Proposal 18-06-SSP

Anesthesia Coding Solution

January 30, 2018 Minutes

Attendees:

Moffitt Cancer Center
·  Lori Perks (Purchasing)
·  Desiree Hanson (Supply Diversity)
·  Gloria Davis (Director, HIM)
·  Mary Mayer (Coding Manger, HIM)
·  Karen Fleming (Project Manager, HIM)
·  Dorene Nall (Clinical Systems)
·  Sissy Marler- Schilling (Mgr. Enterprise Imaging)
·  Diane Krouse (Supervisor, Enterprise Imaging) /
·  Lisa Stephens-Haskins (Enterprise Architecture)
·  Myriam Moya
·  Joshua Rivera
·  Susan Seltzer-Green
·  Lapanja James (Project Manager , IT)
·  Martha Rockovich
Vendors:
• AdvantEdge Healthcare Solutions
Michael J. Krivich
Brice Voithofer
Roonda Ash
• (ABC) Anesthesia Business Consultants
Lisa Smith
• Getix Health
Jeffey Schulman
Catherine Smith
• MediRevv
Justin Brame
• Navaro Medical Solutions, Inc. Re: ProSourceMD
Richard Navaro / ·  Pena4, Inc.
Joseph J. Gurrieri
·  RM Health Solutions
Charles Murphy
·  Vinali LLC
Israel Velez
Amy Cobb
Ariel Schwanenfeld
·  World Wide Technology
Matt Matter
Al Slamecka
·  Yves A. Martin Consulting, LLC dba MQUAL
Yves A. Martin
Adele Clarke
Jason Treulich

The H. Lee Moffitt Cancer Center & Research Institute (Moffitt), located in Tampa, Florida. Moffitt Cancer Center is the only National Cancer Institute-designated oncology research institute. Comprised of an inpatient facility, ambulatory outpatient surgery center, ambulatory clinics, a cancer screening facility and research laboratories. Moffitt’s workforce is currently comprised of approximately 5300 employees, 700 medical residents, 600 volunteers, and 1000 students and interns.

Moffitt is in the process of a scheduled implementation of Soarian’s Practice Revenue Management (PRM) that will require a new coding solution. As a result of the need for a new coding solution, a separate coding solution is needed for anesthesia coding.

The purpose of this Request for Proposal is to review, select, and implement a solution for Anesthesia Coding that will meet the following objectives:

• Automate professional practice coding from manual process for Anesthesia coding.

• Improve productivity, quality, accuracy and consistency of provider claims data.

• Streamline workflow process in coding which has a direct impact on the MMG billing process.

• Improved turnaround time from patient registration to bill drop to move from revenue in the MMG professional practices

4.3.1 Anesthesia Coding Requirements

Req # / Description
R1.  / Ability to code for Anesthesia cases including ICD-10 cm, CPT4-codes, and ASA codes.
·  This includes billing for services that are non OR (i.e. radiation, radiology, MRI, bone marrow)
R2.  / Solution must have concurrency rules applicable for anesthesiologists, CRNA’s and students. Include concurrency error reporting.
·  Moffitt’s providers bill patients in 15 minute (1 unit) increments with the exception of one payer that is in 10 minute increments. Application must be able to process billing according to specific payer rules.
R3.  / Ability to have control over the anesthesia coding edits. Edit updates can be frequent and Moffitt needs a process that allows for timely edit enhancements.
R4.  / Solution allows for streamlined and automated process between the anesthesia providers/department and the anesthesia coders to resolve missing information.
R5.  / Ability to bill to all of the insurance payers that PFS currently bills to currently.
R6.  / Ability to send anesthesia billing information to Moffitt’s billing system to be included in electronic and paper statements.
R7.  / Ability to load CMS rules initially.
·  Training on how to maintain the rules going forward is needed as the rules change over time.

4.4  Non- Functional Requirements

Req # / Description
NF1.  / Bidirectional HL7 Interface with Soarian for billing data/insurance information
NF2.  / ADT interface from Cerner Soarian for patient information (i.e. Admissions, Discharge, Transfer Data, Demographics, Insurance Information)
NF3.  / Ability to provide all reports necessary to the anesthesia coding workflow.
·  Specific reports TBD by future state workflow needs of the chosen solution.
NF4.  / Vendor support should provide same day responses within normal 8-5 business hours with maximum 24 hour turnaround time
·  An established escalation process is required for weekday and weekend incidents.
NF5.  / Ability to interface with Soarian (PRM) for insurance information
NF6.  / Ability to interface with Cerner
NF7.  / Ability to connect to 1 EDI Clearinghouse. (currently connecting to Zirmed)
NF8.  / Solution should be a cloud based solution.

4.5  Reporting Requirements

Req # / Description
RR1. / Solution has the ability to provide automated quality measure reporting.
RR2. / Ability to provide all reports necessary to the anesthesia coding workflow.
• Specific reports TBD by future state workflow needs of the chosen solution. (Suspense report, 835 report, etc.)

Question: Quality Measure Reporting: Is Moffitt going to an existing registry and want claim data sent to the registry or do we want a program that tracks and reports to the registry? How is it being currently reporting?

Answer: For billing purposes the charges are going into Soarian then into the Clearinghouse.

Workflow: moduleàSoarian (Moffitt’s billing system)à Clearinghouse (ePremis)

4.6  Technical and Architectural Requirements

If solution is cloud or remote hosted, what is the length of data retention?

·  Is the application and/or database environment single or multi-tenant?

·  If multitenant, what security controls are in place to protect against information breaches?

·  If agreement is discontinued, do we have the ability to download all of our data?

Moffitt will need an architectural diagram that can be presented to the Technology Review Board to make sure that it meets Moffitt requirements.

4.7  Maintenance and Support

1.  Describe the organization and structure of your technical support services.
2.  Describe the support levels/tiers provided by the vendor.
3.  What are the methods for contacting technical support?
4.  What are the standard support hours and Service Level Agreements (SLAs)?

4.9  Implementation and Training

1.  Please provide your general implementation strategy for a health system installation of comparable size and complexity.
2.  What is your recommended implementation model/approach and methodology for Moffitt Cancer Centers? Please include details on the following:
·  Expected implementation length
·  End User resource requirements and count for the implementation
·  IT and functional analyst resource requirements and count for the implementation
·  Project Management resource requirements for the implementation
·  Please provide a list of the vendor personnel roles and count required to implement this project
·  Approach to Analysis
·  Approach to Design
·  Approach to Build
·  Approach to Testing
·  Approach to Go-Live and Go-Live Support and resource requirements
·  Please provide an overview of the installation schedule. Include major tasks and their duration/staffing/major deliverables.
3.  Please describe the documentation and training that will be available to Moffitt users and a training outline. What is the standard model for training the implementation team? What is the standard training model for the end users at time of go-live? What is the standard training durations for each.
4.  Does your company provide staff for the implementation directly or subcontract to partner firms?
·  Please describe and list any proposed subcontractors, if any, and the scope of work they would perform.

4.10 Pricing

What is your licensing/cost structure, types of licenses, length of license term, and license fee structure?
How are changes (additions, reductions) to the numbers of licenses handled? Ex. Are True-ups performed? (i.e. yearly evaluation of end users/licenses to payment tiers)

Questions:

Question: What is the existing Anesthesia Coding Solution that Moffitt utilizes? Are you looking for an off the shelf offering or a customizable solution?

Answer: We currently use the IDX GE Centricity system. GE has managed the rules for concurrency for us. The teaching hospital rules are loaded into the module. We follow the payer carrier for teaching hospitals.

The concurrency according to Medicare

Moffitt is looking for a solution that is customizable and agile to support Moffitt’s workflow, but not a lot of major configuration on the backend. We are not looking for a home-grown system but more of a plug and play system.

Question: Has Moffitt done any assessment of the solutions that will fit best the functional requirements that are needed?

Answer: No.

Question: What is the amount of users that will access the system?

Answer:

·  15 physicians
·  2-3 PRNs / ·  32 CRNAs
·  12 Anesthesia Assistants / ·  2-3 students per month
·  8-10 billers and coders

Question: What is the mandate to subcontract out as far as the finish point, as far as diversity?

Answer: On the subcontracting, Moffitt has a supplier diversity program that encourages the utilization of certified diverse businesses. If you are applying and are not a diverse supplier, state in the RFP how can you help Moffitt achieve their 50% goal (if there are subcontracting opportunities),

Question: When is the software needed?

Answer: Would like the solution to go live in August 2018. We would prefer a vendor that has experience with Soarian Financials.

Proposals are due Thursday, February 15th by 2PM to