DA10--Healthcare Provider Credentialing and Privileging Software-as-a-Service (SaaS) and Credentialing-as-a-Service (CaaS) (VA-26-00054853)

Amendment / Modification

This amendment is issued to address a transmittal issue with the initial posting of the Request for Information (RFI). The issue prevented the RFI Description from being easily readable.

• The RFI Description was not readable in the initial posting.

• Potential respondents are directed to review the two documents attached to this notice for clarity on the Government's intent and information requests.

• All other terms and conditions of the RFI remain unchanged.

• This amendment does not alter proposal deadlines or submission requirements beyond directing respondents to the attached documents for the RFI's core content.

Form / Attachment / Pricing Sheet

This document, titled 'DRAFT- Credentialing and Privileging_RTM.xlsx', appears to be a Business Requirements Package (BRP) for a Credentialing and Privileging System Modernization (NSR 20251210). It details the functional and non-functional requirements for a system designed to manage practitioner credentialing and privileging processes within the Department of Veterans Affairs (VA).

• Business Requirements: Outlines specific needs for managing practitioner credentialing and privileging, including generating electronic applications, performing duplicate practitioner checks, searching for existing records, and creating new practitioner files.
• Acceptance Criteria: Defines the conditions that must be met for each business requirement to be considered fulfilled.
• Business Rules: Provides detailed explanations and logic behind the requirements, ensuring clarity on system behavior.
• Non-Functional Requirements: Addresses aspects like system performance, accessibility, and security.
• Process Mapping: Maps requirements to existing process models.
• Supporting Documentation: References VA Directives, Policies, and Laws.

This document is crucial for potential bidders as it outlines the detailed functional and non-functional requirements for a new or modernized Credentialing and Privileging (C&P) system. It specifies the expected capabilities of the system, including but not limited to:

• Automated workflows: For application generation, duplicate checking, and routing.
• Data management: Handling practitioner data, document uploads, and verification processes.
• User interfaces: Requirements for C&P Specialists and practitioners interacting with the system.
• Compliance: Adherence to VA directives, policies, and laws.
• System performance and security: Non-functional requirements that will impact the solution's architecture and implementation.

Bidders should analyze these requirements to understand the scope and complexity of the system to be developed or implemented, informing their technical approach, resource allocation, and pricing strategies.

Request for Information (RFI)

This RFI seeks industry feedback on two potential strategies for the Department of Veterans Affairs (VA) regarding healthcare provider credentialing and privileging. The goal is to inform future acquisition strategies to improve provider onboarding, ensure continuous credential monitoring, and maintain compliance with VA, federal, and accreditation standards. Responses may influence set-aside determinations.

• Objective: To gather information on a potential enterprise-wide, fully electronic SaaS platform for all aspects of the credentialing and privileging lifecycle. The VA seeks a commercially available SaaS system with minimal customization, integrating technology, automation, and compliance workflows.

• Scope: The solution must be a turnkey implementation, supporting end-to-end credentialing, verification, continuous monitoring, privileging, and committee workflows. It must integrate with VistA and the Federal Health Record, meet FedRAMP security requirements, and support VA workflows.

• Key Requirements: Secure electronic system, automated display of credentials, timely processing (5 days for new, 120 days prior to expiration for existing), 100% Joint Commission compliance, 99% verification accuracy, continuous monitoring, data migration, role-based access, reporting, and compliance with VHA Directives 1100.20 and 1100.21.

• Required Information: Solution description (people, processes, technology), RTM mapping, past performance, current deployable capabilities (e.g., Credentialing Lifecycle Management, PSV, SSV, Privileging Management), Authority to Operate (ATO)/FedRAMP status, integration details, and Rough Order of Magnitude (ROM).

• Objective: To gather feedback on a strategy to partner with a credentialing service organization for full-spectrum credentialing operations. The aim is to streamline workflows and accelerate provider onboarding.

• Scope: The service organization must provide a comprehensive, fully electronic credentialing solution supported by qualified personnel. This includes obtaining, verifying, and assessing provider qualifications.

• Key Requirements: Secure electronic system, automated credential display, timely processing (5 days for new, 120 days prior to expiration for existing), 100% Joint Commission and VHA policy compliance, 99% verification accuracy, continuous monitoring for all provider types (over 250,000 providers), data migration, role-based access, reporting, and compliance with VHA Directives 1100.20 and 1100.21.

• Required Information: Description of the service organization's capabilities (technology, staffing, verification, compliance), implementation plans for unmet requirements, evidence of reduced credentialing timelines, IT/security compliance confirmation, integration of technology with personnel, software/operational capacity, ability to start by October 30, 2026, commercial licensing, and proposed innovations.

• Respond to Part 1 and/or Part 2 in a single file, clearly identifying which part(s) are addressed.

• Page limit: 15 pages per part, 30 pages cumulative.

• Include company name, address, POC, business size, SAM Unique Entity ID, DUNS number, and references.

• Submissions are due by April 3, 2026, 12:00 PM ET.

• Questions are due by March 25, 2026.

• This is an RFI only; it is not a solicitation or RFQ.

• No funds have been authorized for this effort.

• No marketing materials are allowed.

• The VA is not obligated to acquire any products or services described.