Third Party Collections Program

Amendment / Modification

This document is Amendment 0001 to the Request for Information (RFI) HT001126RFI0239 concerning the Third Party Collections Program.

• The RFI is for information and planning purposes only and does not constitute a Request for Proposal (RFP) or a promise to issue an RFP.

• The Defense Health Agency (DHA) is not currently seeking quotes or proposals and will not accept unsolicited proposals.

• Costs incurred in response to this RFI will not be reimbursed by the U.S. Government.

• If a solicitation is released, it may be through GSA eBuy for GSA Multiple Award Schedules or OASIS+, or synopsized on the SAM website.

• The DHA is seeking contract support for various medical billing and collection activities in accordance with an attached draft Performance Work Statement (PWS), which is subject to change based on RFI responses.

• The anticipated period of performance is March 2027, not to exceed 5 years.

• The RFI requests information on companies capable of providing similar third-party collections program services, including experience with the Government Billing Solution (GBS) in Medical Treatment Facilities (MTFs), MHS Uniform Business Office (UBO) policies, and training strategies.

• Specific questions are posed regarding experience, understanding of MHS UBO policies, training acquisition and administration, and potential issues with the draft PWS task language.

• Respondents are requested to submit a Capability Statement in two sections: Administrative Information and Requested Information per RFI Section 3.0.

• Capability Statements are due no later than Friday, April 10, 2026, at 4:00 PM EST.

• Responses must be submitted via email to the specified contract specialist and contracting officer, with a specific subject line.

• Proprietary information should be minimized and clearly marked.

• Section 1 of the Capability Statement must include administrative information such as name, mailing address, phone number, and email of the point of contact, recommended contracting strategy, and company information for market research purposes (Company Name, Unique Entity ID, CAGE, NAICS Codes, business size status, applicable GSA SINs, and applicable contract numbers).

• The deadline for submitting Capability Statements is April 10, 2026, at 4:00 PM EST.

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

This Performance Work Statement (PWS) outlines the requirements for a Third Party Collections Program (TPCP) to recover the cost of healthcare services provided by Department of War (DoW) and Defense Health Agency (DHA) military treatment facilities (MTFs) and professional services from third-party payers and non-beneficiaries with Other Health Insurance (OHI).

• Centralize OHI billing and collection activities to standardize and optimize revenue using a government-provided medical billing program (GBS).

• Activities include identification and verification of OHI, updating GBS, direct billing of third-party payers, follow-up on unpaid claims (every 30 days), denials management, payment posting, valid write-offs, and referral of delinquent claims by the 120th day.

• Excludes first-party billing to beneficiaries, interagency billing, billing for Elective Cosmetic Surgery, copying charges, or incidental charges for inpatient stays.

• Requires balance billing for non-beneficiaries only.

• Services will be performed at all MTFs identified in Attachment 1.

• Claims Generation and Submission: 95% of actions accomplished within specified timeframe.

• OHI Verification: 95% of actions accomplished within specified timeframe.

• Payment Posting and Refund Management: 95% of actions accomplished within specified timeframe.

• Follow-Up/Denials Management: 95% of actions accomplished within specified timeframe.

• Unpaid Claims: 95% of actions accomplished within specified timeframe.

• Training Requirement: 95% of actions accomplished within specified timeframe.

• Place of Performance: Determined by the Contractor to carry out services, in coordination with the COR. Travel may be required within CONUS and OCONUS.

• Duty Hours: 7:30 am to 4:30 pm, Monday through Friday (excluding Federal Holidays).

• Contractor personnel must possess Basic Life Support (BLS) certification and complete Privacy Act, HIPAA, and Cyber Awareness training.

• Personnel must undergo a National Agency Check with Inquiries (NACI) investigation.

• Adherence to all applicable U.S. Codes, Federal Regulations, DoW Guidance, CMS guidance, and DHA Policy.

• Compliance with HIPAA and data security requirements.

• Contractor must provide a Quality Control Plan (QCP) and a Human Resource Management Plan.

• Government Furnished Property and Services (GFE) will be provided, including office space, equipment, and administrative support.

Request for Information (RFI)

This RFI is issued by the Defense Health Agency (DHA) for information and planning purposes only. It does not constitute a Request for Proposal (RFP) or a commitment to issue an RFP in the future. The DHA is seeking contract support for various medical billing and collection activities related to the Third-Party Collections Program (TPCP).

The TPCP authorizes the Government to recover costs of healthcare services provided to beneficiaries from third-party payers. This includes billing for services rendered in DHA military treatment facilities (MTFs) and by MTF providers at civilian facilities, as well as care for non-beneficiaries with Other Health Insurance (OHI).

The DHA is seeking information from companies capable of providing similar third-party collections program services. Specific areas of interest include:

• Experience with Government Billing Solution (GBS) in a Medical Treatment Facility (MTF).
• Experience with medical billing, collection activities, denial management, payment posting, and refund services within the Medical Health Services (MHS) environment.
• Understanding of MHS Uniform Business Office (UBO) policies and practices.
• Approach to acquiring and administering training resources for GBS.
• Comments or suggestions to improve the attached draft Performance Work Statement (PWS).

Interested parties are requested to submit a Capability Statement with two sections:

• Section 1: Administrative Information (Name, address, POC, recommended contracting strategy).

• Section 2: Company Information for market research (Company Name, UEI, CAGE, NAICS Codes, Business size, SINs, Contract Numbers).

• Capability Statements are due no later than Friday, 03 April 2026 at 4:00 PM EST.

• Responses must be submitted via email to theophilus.o.agyare.civ@health.mil and jeanna.m.butler.civ@health.mil.

• Email subject line: "HT001126RFI0239 Third Party Collections Program".

• Responses are limited to ten (10) pages.

• Anticipated Period of Performance: Beginning March 2027, not to exceed 5 years.

• The RFI is for market research only and does not commit the Government to a contract. All submissions become Government property.