September 15, 2022
Q: From the list of services provided in the RFP, it appears that the medical specialties offered include adult and pediatric primary care, behavioral health, Ob/Gyn, dental, and nutrition. Am I correct in concluding that there are no surgeons, radiologists, and other clinical subspecialists?
Q: How many medical coders does Lake County employ?
RESPONSE: Currently 4 with 1 vacancy.
Q: How many encounters-of-care do they provide, either in an average month or per-year?
RESPONSE: Approximately 16,000 encounters per month.
Q: How much has the county budgeted for this program?
Q: What are the current coding quality accuracy rates? What are the top denial reasons applicable to coding?
RESPONSE: E&M – 88.3%; CPT – 100%; ICD-10 CM – 94.5%; Principal Diagnosis – 95.2%. Outside audit determined Medical Decision Making a concern.
Q: Under Scope of Services (pages 5 and 6): Bullet point one, sub-bullet point one: What are the current coder credentials or certifications? What credentials or certifications are required in the job description?
RESPONSE: RHIT or CPC
Q: Under Scope of Services (pages 5 and 6): Bullet point one, sub-bullet point two: Are coders assigned to specific practices/providers? What is the structure? Is five the normal compliment of coders? Are there vacancies? Backlog?
RESPONSE: Coders are assigned by specialty and providers. Two (2) staff cover primary care services/dental/TB, 3 staff (1 currently vacant) cover Mental Health which includes psychiatrists. Staff is currently behind due to vacancy and outside audit findings.
Q: Under Scope of Services (pages 5 and 6): Bullet point one, sub-bullet point three: Please clarify this volume. 25% of 55 providers, 15 encounters each, so 55 x 15 x 0.25 = 206 each quarter
Q: Under Scope of Services (pages 5 and 6): Bullet point one, sub-bullet point four: Who assigns the ICD-10CM code, the provider, or the coder? If the provider assigns, can the coder revise if needed? Does it require provider approval? Would the vendor be auditing both what the provider assigned and the coder updated, or would we be auditing only what went out on the bill?
RESPONSE: Provider assigns ICD-10 CM codes. Currently the coder changes ICD codes if the provider documentation is clear enough that it should be changed, otherwise, they task the provider. Auditing would have to be for both the provider and the coder to determine training opportunities.
Q: Under Scope of Services (pages 5 and 6): Bullet point one, sub-bullet point six: Does a current education program exist and/or what is the process today?
RESPONSE: There is no formal education program. New provider hires meet with the coders initially for an hour or two and then the coders work with them when finding errors.
Q: Under Scope of Services (pages 5 and 6): Bullet point one, sub-bullet point seven: Is the one-hour call with each title or is it a one-hour group call?
RESPONSE: One our group call.
Q: Under Scope of Services (pages 5 and 6): Bullet point one, sub-bullet point eleven: Do all service lines and practices utilize NextGen?
Q: Under Scope of Services (pages 5 and 6): Bullet point two, sub-bullet point three: What is the current process to accomplish this item?
RESPONSE: Coders have limited materials they use for training.
Q: Under Scope of Services (pages 5 and 6): Bullet point two, sub-bullet point four: What is the current process for scheduling (manual/electronic)?
RESPONSE: During COVID training has been remote. There have been requests for in-person training by an individual provider. New hire coding staff will be trained in person to learn the job function.
Q: Under “Position Information”, does this occur routinely today or as needed? If currently in place, how many hours or days are spent with each new team member?
RESPONSE: All new hire providers are trained by a coder. Session could be 1-2 hours. Coders then follow up once the provider starts submitting charges. There is no formal follow-up.
Q: How far in advance notice will Chief of HIM/Director of HIM provide to incumbent when providers need onsite training where applicable?
RESPONSE: The timeframe can be negotiated.
Q: Can vendor propose Schedule B/Pricing Doc for provider training, medical coding training and auditing aside from ICD-10 CM/PCS coding pricing?
Q: Vendor Certification: in what order will precedence proceed i.e. Minority, Woman-Owned Business WOSB, VOSB, small business (SB) concern?
Q: Contract Award: Does vendor have to be registered in the county portal?
Q: How many coders does the Lake County Health Department employee? Is it possible to combine weekly meetings to include several coders in one meeting?
RESPONSE: Currently 4 with 1 vacancy. Individual meetings with each coder are required.
Thursday Sept 8, 2022
No questions have been presented to date.