Integrated Referral Management and Appointing Center (IRMAC) Services

Solicitation / RFP / RFQ

This is a combined synopsis/solicitation for commercial services, issued as a Request for Proposals (RFP). The Defense Health Agency Contracting Activity (DHACA) intends to award a single contract for the Integrated Referral Management and Appointing Center (IRMAC) requirement. The procurement is an 8(a) set-aside.

• Provide IRMAC services including Centralized Patient Appointing Services (PAS), Referral Management Services (RMS), and Clear and Legible Report accountability Services (CLR).

• Services are for Defense Health Network Indo-Pacific Military Treatment Facilities (MTF) in Hawaii and the Pacific Northwest (Pacific).

• Operational principles, practices, policies, and performance must align with current Defense Health Agency (DHA) directives, guidelines, policies, and standard business rules.

• The contract awardee is responsible for the entire scope of the contract as defined in the Performance Work Statement (PWS).

• Contract Type: Firm-Fixed-Price (FFP)

• Period of Performance:

  • Base Period: 30 September 2026 – 29 December 2026
  • Option Periods 1-5: 30 December 2026 – 29 June 2031

• Place of Performance: To Be Determined, within 25 miles of any Military Treatment Facility within the United States, via phone and electronic communication.

• NAICS Code: 621999 (Size Standard: $20.5 million)

• Service Code: Q701

• Proposals are due by 12:00 pm Pacific Daylight Time on Monday, June 22, 2026.

• Questions are due by 12:00 pm Pacific Daylight Time on Wednesday, June 3, 2026.

• Award will be made using a trade-off source selection process to the responsible Offeror whose proposal is most advantageous (best value) to the Government.

• Evaluation Factors: Technical Capability (Management and Technical Approach, Transition Plan, Staffing Plan), Past Performance, and Price.

• Technical Quality and Past Performance are equally important and significantly more important than Price.

• Offerors must be eligible to receive an 8(a) contract at the time of award.

• 8(a) set-aside. Offerors must be eligible to receive an 8(a) contract at the time of award. Offerors who have graduated from the 8(a) Program are not eligible.

• This solicitation incorporates numerous FAR and DFARS provisions and clauses by reference.

• The full text of provisions and clauses may be accessed electronically at www.acquisition.gov.

Form / Attachment / Pricing Sheet

This document is a "REQUEST FOR PROPOSAL (RFP) CERTIFICATION FORM" that bidders must complete and submit as part of their proposal. It serves to acknowledge the bidder's review and understanding of the solicitation documents and to confirm their commitment to holding prices firm.

• Offeror Information: Requires the Offeror's name, address, telephone number, CAGE Code, DUNS Number, SAM Unique Entity Identifier (UEI), and Point of Contact.
• Attachment Checklist: A section to indicate which attachments are being submitted (Attachment 1– Performance Work Statement (PWS), Attachment 2- Past Performance Questionnaire, Attachment 3– Past Performance Summary Sheet, Attachment 4–Pricing Worksheet, Attachment 5–Incumbent Information & Site Specific Information).
• Proposal Certification: A statement affirming that the contractor has thoroughly reviewed the Combined Synopsis/Solicitation and all accompanying documents, understands and accepts any changes made during the solicitation process, and commits to addressing discrepancies promptly.
• Price Firmness Acknowledgment: A statement confirming willingness to hold prices firm for at least 180 days from the date specified for receipt of offers.

This form is critical for bidders to complete accurately. It confirms their understanding of the solicitation and its amendments, and their commitment to price stability. Failure to complete and submit this form may impact the completeness and acceptability of their proposal. Bidders must also indicate which required attachments they are submitting.

Statement of Work (SOW) / Performance Work Statement (PWS)

This Performance Work Statement (PWS) outlines the requirements for providing centralized Patient Appointing Services (PAS), Referral Management Services (RMS), and Clear and Legible Report (CLR) accountability services for the Defense Health Network Indo-Pacific (DHN-IP) Military Treatment Facilities (MTFs).

• Patient Appointing Services (PAS): Verifying beneficiary eligibility, updating demographic information, scheduling MTF primary or specialty care appointments, and managing cancellations and reschedules. This includes managing inbound and outbound calls and utilizing the MHS GENESIS system.

• Referral Management Services (RMS): Processing specialty care referrals ordered by MTF providers, determining disposition (Appoint to MTF or Defer to Network), and ensuring timely processing in accordance with DHA timeliness standards.

• Clear and Legible Report (CLR) Accountability Services: Ensuring the return of clinical care documentation from network providers to the MTF in accordance with DHA timeliness standards. This includes communication and coordination with civilian network provider offices.

• The contract includes a phase-in period for preparation and successful contract operations.

• Services will be provided from a consolidated location within 25 miles of a military facility.

• Personnel Security: Background investigations, security clearances, and training are required for all personnel.

• Information Security: Compliance with all government privacy and security regulations, including HIPAA, is mandatory.

• Safety: Agents must maintain safety and health standards compliant with OSHA.

• Quality Control: A Quality Control Plan (QCP) must be established and maintained.

• Reporting: Various reports are required, including call volume, disposition, CLR processing, and customer service metrics.

• Contingency Operations: The contractor must have a contingency plan for system outages, inclement weather, and other events.

• Training: The government will provide initial training on MHS GENESIS; the contractor is responsible for sustainment training and ensuring staff familiarity with relevant systems and procedures.

Form / Attachment / Pricing Sheet

This document, "Attachment 1 - PWS Exhibit D - Example Referral Guideline.xlsx", provides detailed guidelines for processing referrals within the Polytrauma/Brain Injury Medicine program, specifically for Traumatic Brain Injury (TBI) and Intrepid Spirit Center (ISC) services. It outlines acceptance criteria, diagnoses, special circumstances, and closure criteria for referrals, serving as a reference for healthcare providers and administrative staff managing patient referrals.

• Acceptance Criteria: Details conditions for accepting referrals based on patient age, diagnosis (TBI definition provided), previous treatment, and service member status (Active Duty/ADSM only for most criteria).
• Referral Processing: Specifies how to handle referrals from within and outside the TBI & ISC clinic, including specific clinics and services like Neuro-Optometry, Vestibular Rehab, and Driving Simulator.
• Diagnoses/Procedures: Lists acceptable diagnoses and conditions related to TBI, including subacute, chronic, and recurrent TBI, and associated symptoms.
• Special Circumstances: Addresses referrals for Service Members residing far from the clinic, those undergoing Medical Evaluation Boards, and specific conditions like Diplopia and convergence disorder.
• Closure Criteria: Outlines reasons and procedures for closing referrals, including when patients have already been seen by both available providers, when non-ADSM patients are referred, or for acute head trauma cases without specific red flags.
• Booking Instructions: Provides contact information and booking procedures for various services offered by the TBI & ISC clinic.
• Provider List: Lists key medical professionals within the TBI & ISC clinic.

While this document is a guideline for internal referral processing, it provides insight into the operational procedures and specific clinical services offered by the TBI & ISC program. Bidders seeking to understand the scope of services, patient population, and clinical pathways related to TBI and polytrauma care within this healthcare system may find this document informative for context, though it does not directly outline procurement requirements.

Form / Attachment / Pricing Sheet

This document, "Attachment 1 - PWS Exhibit B - Example Primary Care Appointing Criteria.xlsx", provides detailed criteria and instructions for scheduling appointments within the Madigan Hearing Program. It serves as an exhibit to a Performance Work Statement (PWS) and outlines specific procedures for different appointment types and beneficiary categories.

• Beneficiary Categories: Specifies eligibility for Active Duty, Reservist/National Guard SMs (AD orders not required), and Noise Exposed DOD/DHA Employees (Civilian). No referral is required for these categories.
• Appointment Types: Differentiates between "Medical Readiness" appointments (HEAR GRP / HEAR GRP 60) and "Diagnostic and Tinnitus Exam" appointments (HEAR SPEC / HEAR SPEC 60). Diagnostic appointments require a prior DD2215/2216 Hearing Exam within 3 months.
• Appointing Process: Details the steps for scheduling, including offering the first available appointment and, if unavailable or refused, submitting a Standby Appointment Request (SAR).
• Patient Instructions: Includes arrival times (15 minutes prior), late arrival policy, COVID/Flu symptom protocols, required identification, and visitor/minor restrictions. It also mentions on-site childcare services and shuttle information for Bremerton patients.
• Provider List: Identifies key personnel within the Hearing Program, including the Chief (MAJ Stacie Harber) and Deputy Chief (1LT Grace Barnhart), and specifies their roles (e.g., SPEC APTS, MEDICAL READINESS ONLY).
• Clinic Information: Provides the Madigan Hearing Program location (Old Madigan/Annex BLDG 9911C), hours of operation, and contact information for appointment requests and cancellations.

This attachment is crucial for understanding the operational details and patient scheduling protocols of the Madigan Hearing Program. Bidders should review these criteria to accurately scope services, staffing needs, and performance expectations if this opportunity involves providing support to this program. It highlights specific appointment slots, eligibility requirements, and patient management procedures that would need to be adhered to.

Form / Attachment / Pricing Sheet

This document, an Excel spreadsheet titled 'Attachment 1- PWS Exhibit C - Example Specialty Care Appt Criteria.xlsx', provides detailed criteria and instructions for scheduling appointments within the Madigan Cardiology clinic. It is intended to guide agents and potentially bidders on the specific requirements for patient appointments.

• Eligibility Guidelines: A referral is required for all appointments, and appointments must be scheduled within 180 days of the referral date.
• Scheduling Instructions: Non-Madigan patients' appointments are scheduled by the clinic. Specific instructions are provided for agents, including what not to book (appointments within 4 hours of the call) and when a new referral is required (if the patient was last seen more than 24 months ago, with an exception for Exercise Treadmill Stress Tests).
• EKG Appointments: These are walk-in only, with specific available hours (M-F 0800-1130 & 1300-1530).
• Appointment Request Process: For 'Procedure Specialty Appointment' (specifically CV Exercise Treadmill Test), agents should schedule the first available appointment. If no appointments are within 28 days, offer outside that window. If still unsuccessful, attempt a warm transfer to the clinic. If that fails or is outside clinic hours, offer to submit a Standby Appointment Request (SAR).
• Patient Instructions: Patients should arrive 15 minutes early, wear gym clothes and running shoes for treadmill tests, and avoid eating for 4 hours prior. Children are not allowed in exam rooms or unsupervised in waiting areas. Valid ID is required for patients 10+, and those 17 and younger must be accompanied by a parent or guardian.
• Provider List: Includes a list of Cardiology Techs for treadmill tests.

This attachment details operational procedures for a specific clinic, which may be relevant for bidders proposing to provide healthcare services or manage appointment scheduling. Understanding these criteria is crucial for accurately estimating resources, staffing, and compliance requirements if the opportunity involves similar patient management or clinical support functions.

Form / Attachment / Pricing Sheet

This document, "Attachment 1 - PWS Exhibit E - Example Performance Report Formats.pptx", provides example formats for performance reports related to the Performance Work Statement (PWS). It is intended to guide bidders on the expected reporting structure and content for performance metrics.

• February Report (PIRMAC): Details inbound telephony performance, including call volume (29,570), average speed of answer (24.30 seconds, standard 60 seconds), and percent abandoned (2.27%). It notes an improvement in WFM optimization and mentions a RevCycle interruption impacting service on February 26th and 27th.
• Appointing, Referral and CLR Error Reporting: Provides data for February 2026.
• Referral Volumes: Presents data on referral volumes.
• Business Days to Case Sent Date: Shows metrics related to case processing times.
• PIRMAC Current Staffing Snapshot (Feb 2026): Lists current staffing levels across various positions (RNS, LPNS, Referral Clerks, CLR Clerks, Appointing Clerks, Administrative, Leads, Supervisors), noting gains and losses.
• PIRMAC Quarterly CLR Processing Status (Feb 2026): Details CLR (Clinical Laboratory Review) processing status for different locations (MAMC, POM, NHB, NHCOH), including volume and adherence to the DHA standard of uploading CLRs within 3 business days.

This attachment is crucial for bidders to understand the performance monitoring and reporting requirements. It outlines the specific metrics, data points, and reporting formats that will be used to evaluate contractor performance under the PWS. Bidders should review these examples to ensure their proposed approach aligns with the government's expectations for performance tracking and reporting.

Form / Attachment / Pricing Sheet

This document is a "Referral & Appointment Center Letter – Specialty Referral Reminder" from the Defense Health Agency. It serves as a notification to a patient regarding an outstanding specialty care referral to Madigan Army Medical Center.

• Recipient Information: Details for the patient receiving the reminder.
• Referral Details: States the purpose is a reminder of a specialty care referral.
• Action Required: Instructs the patient to contact the Pacific Integrated Referral Management and Appointing Center at 1-800-404-4506 to schedule an appointment or to decline the referral.
• Operating Hours: Provides specific hours for the Referral Management Center (Monday-Friday 6 a.m.-8 p.m., Saturday-Sunday 7 a.m.-5 p.m.).
• Referral Validity: Notes that the referral is valid for 120 days from initiation and will be canceled if no action is taken.

This document is a patient-facing notification and does not contain information directly relevant to bidding on an opportunity. It is an example of a communication that might be generated as part of healthcare operations, potentially related to a larger contract for healthcare services or administrative support.

Form / Attachment / Pricing Sheet

This document is a Past Performance Questionnaire designed to gather feedback from references regarding a contractor's performance on a previous contract. This information will assist the Defense Health Agency Contracting Activity in evaluating the past performance of offerors for Solicitation Number HT941026R2001.

• Respondent Information: Details about the contracting activity and point of contact.
• Offeror's Reference Information: Details about the contractor being evaluated.
• Contract Information: Specifics of the contract being referenced, including number, type, performance period, and description of services.
• Market Segment: Identifies the services provided (IRMAC, PAS, RMS, CLR).
• Magnitude: Annual and total contract value.
• Complexity: Number of FTEs, facility type, and contractor's role (Prime, Subcontractor, etc.).
• Performance Assessment: A rating scale (Exceptional, Very Good, Satisfactory, Marginal, Unsatisfactory, Not Applicable) for various performance areas, including:
  • Overall Fill Rate (Quality of Service)
  • On-Time Fill Percentage (Schedule)
  • Turnover Rate (Management)
  • Replenishment Rate (Management)
• Performance Summary: Questions regarding the willingness to award another contract and if the contract was terminated.

Bidders should ensure their references are aware of this questionnaire and are prepared to provide detailed, accurate feedback. The quality of the responses directly impacts the evaluation of past performance, a critical factor in the solicitation process. Bidders should also review the performance assessment definitions to understand how their past performance will be rated.

Form / Attachment / Pricing Sheet

This document is a "Past Performance Summary Sheet" intended to be completed by bidders in response to RFP HT941026R2001. It requires bidders to provide detailed information for each past performance reference they submit.

• Company Information: Company Name and CAGE code.
• Contract Details: Sub or Prime status, Contract Number (or Task Order number for IDIQs), and Period of Performance.
• Point of Contact (POC): Current email addresses and phone numbers for up to two POCs (contracting office and end user/customer).
• Description of Effort: Labor categories, location of services, and number of Full-Time Equivalents (FTEs) performed.
• Contract Award Amount: Base year and each option year amount.
• Project Status: Identification of performance reporting status, years completed, and any terminations or modifications for scope change.

Bidders must use one project summary sheet per project, limited to three pages per project. This form is crucial for documenting and substantiating their past performance, which is a key component of their proposal in response to the referenced RFP.

Form / Attachment / Pricing Sheet

This document is a pricing sheet that outlines the costs associated with various labor categories for the base period and five option years. Bidders should use this sheet to understand the pricing structure and to prepare their proposals.

• CLINs (Contract Line Item Numbers): Specific codes for each service.
• Labor Categories: Includes Patient Appointing Services (PAS), Referral Management Services (RMS), and Clear Legible Reporting Services (CLR), with sub-categories for Pacific and Hawaii.
• Unit of Issue: Specifies the duration for which the unit price applies (e.g., Months).
• Unit Price & Total: Fields for bidders to input their proposed pricing.
• Contract Manpower Reporting: Designated as "NSP" (Not Separately Priced) for all periods.
• Periods of Performance (POP): Details the start and end dates for the base period and each option year, including an extension under FAR 52.217-8 for Option Year 5.

This pricing sheet is critical for bidders to understand the cost structure of the contract. It details the specific services required, the geographical areas (Pacific and Hawaii), and the timeframes for which pricing is needed. Bidders must carefully complete the Unit Price and Total fields for each CLIN to submit a compliant and competitive proposal.

Form / Attachment / Pricing Sheet

This document provides incumbent information for IRMAC (Installation Readiness Medical Affairs Council) services and PHIRMAC (Public Health and Installation Readiness Medical Affairs Council) data, specifically for Military Treatment Facilities (MTFs) in the Puget Sound region and Hawaii. It also includes population and enrollment summaries and call volume projections.

• Incumbent Information: Lists current contractors, contract numbers, services provided (IRMAC, General Clerk III, Medical Clerical and Appointment Clerks, Beneficiary Services Representative), labor segments (PAS, CLR, RMS, CAS), and areas of responsibility (Washington State MTFs, Tripler Army Medical Center, Naval Health Clinic Hawaii).
• Puget Sound Military Health System Population and Enrollment Summary: Provides monthly beneficiary counts (Active Duty, Active Duty Family Member, Other, Retiree) from September 2025 to February 2026, with a Grand Total for each month.
• Puget Sound Call Volume Projections: Details projected annual inbound and outbound call volumes, broken down monthly.

This attachment is crucial for bidders to understand the current landscape of IRMAC services, identify incumbent contractors, and gauge the scale of operations. The population and call volume data provide insights into the potential workload and beneficiary demographics, which are essential for developing accurate proposals and resource planning.