ISBEE Set Aside - FBSU Claim Management / Revenue Cycle Management (RCM) Service

Form / Attachment / Pricing Sheet

This document is the "Indian Health Service Buy Indian Act Indian Economic Enterprise Representation Form." It requires offerors to self-certify their status as an "Indian Economic Enterprise" (IEE) in accordance with the Buy Indian Act. This certification is a prerequisite for responding to solicitations or receiving contracts under the Buy Indian Act.

• Self-certification statement regarding meeting the definition of an "Indian Economic Enterprise" with "Indian Ownership."
• Requirements for the enterprise to meet the IEE definition at the time of offer, award, and throughout contract performance.
• Notification requirement to the Contracting Officer if the contractor no longer meets eligibility.
• Fields for the Offeror to provide:
  • Name of Federally Recognized Tribal Entity
  • Name of the 51% owner of IEE Firm
  • Business Name
  • Certifying Signature
  • Print Name
  • UEI SAM Number

Bidders must complete and submit this form to demonstrate their eligibility for opportunities set aside or awarded under the Buy Indian Act. Failure to meet or certify IEE status may disqualify an offeror. The form also warns of penalties for false or misleading information and requires registration in the System of Award Management (SAM).

Solicitation / RFP / RFQ

This document is a combined synopsis/solicitation (RFQ) for Claims Management / Revenue Cycle Management (RCM) Services. It is set-aside for 100% Indian Small Business Economic Enterprise (ISBEE) small business concerns. The government intends to award a contract to a responsible party whose offer represents the "Best Value to the Government" based on price and other factors.

• The core requirement is for Claims Management / Revenue Cycle Management (RCM) Service.

• Specific details of the requirements are provided in Attachment: B01 - Statement of Work.

• Offerors must submit a technical proposal (not to exceed 5 pages) demonstrating their capabilities and understanding of the requirements.

• Copies of service-related agreements pertaining to the scope of work must be submitted.

• Offerors must demonstrate a record of successful performance in similar contracts/jobs (Past Performance).

• Offerors must submit a completed price schedule or price proposal.

• The contract will be for a base year and four (4) option years.

• Initial Period of Performance: October 1st, 2026 - September 30th, 2027.

• Option Year 1: 10/01/2027 - 09/30/2028

• Option Year 2: 10/01/2028 - 09/30/2029

• Option Year 3: 10/01/2029 - 09/30/2030

• Option Year 4: 10/01/2030 - 09/30/2031

• The total duration, including options, shall not exceed five (5) years.

• Quotes must be received via email no later than June 26th, 2026, at 1:00 pm MDT.

• Email submission address: Vincent.Hansen@ihs.gov

• Subject line for quotes: 75H70926BAO-031-RFQ [Company Name]

• Quotes must be valid for 90 days from the submission deadline.

• Evaluation factors: Technical, Past Performance, and Price. Technical and Past Performance combined are significantly more important than Price.

• The government intends to award without discussions.

• This acquisition is set-aside for 100% Indian Small Business Economic Enterprise (ISBEE) small business concerns.

• Offerors must be registered and active in the System for Award Management (SAM) at the time of quotation submission.

• Technical questions or concerns must be received via email by June 11th, 2026, at 5:00 pm MDT to Vincent.Hansen@ihs.gov. Subject line for questions: 75H70926BAO-031-RFQ - Questions.

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

• Compliance with Section 508 accessibility standards is required for Electronic and Information Technology.

Form / Attachment / Pricing Sheet

This document is a price schedule template for RFQ # 75H70926BAO-031-RFQ, titled "Claims Management / RCM Service". It is intended for bidders to fill in their pricing information.

• The schedule includes line items for "FBSU Claims Management / Revenue Cycle Management (RCM) Service" and "Setup Fee".
• It provides columns for Quantity (QTY), Unit, Unit Price, and Total Price for a Base Year and four Option Years.
• Bidders are instructed to fill in the blue cells, and the form will auto-calculate totals.
• The template includes fields for "Quoter's Company Name" and "Quoter's SAM UEI".

This is a critical document for bidders to understand the pricing structure required for the "Claims Management / RCM Service" opportunity. Bidders must use this template to submit their pricing proposals, ensuring all required fields are completed accurately. The "TOTAL CONTRACT VALUE" will be determined based on the prices entered by the bidder.

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

To enhance and maximize third-party revenue and collection activities for the Fort Belknap Service Unit by providing an efficient, streamlined process for claims management and insurance eligibility verification.

• Provide technology for online claims management and eligibility verification software.

• Integrate with the Electronic Health Record and third-party eligibility information.

• Verify Medicare and Commercial Payer eligibility in real-time and via batch processing.

• Process all claim types (Emergency, Inpatient, Outpatient, Specialty Clinics).

• Provide daily Medicare AR reports for account management.

• Offer toll-free telephone/technical support during normal business hours (7 AM - 7 PM, Mon-Fri).

• Provide a two (2) hour minimum response time for notifications.

• Claims must be submitted to the appropriate carrier/payer via the contractor-provided clearinghouse by close of the next business day after receipt from IHS.

• Medical insurance must be transmitted electronically.

• Routine editing procedures to detect defects in medical claims information.

• Capability for correcting and resubmitting medical claim errors electronically within 4 hours of batch submission.

• Productivity and submission reports available within 24 hours of batch transmission.

• Period of Performance: October 1, 2026 – September 30, 2031 (Base Year + 4 Option Years).

• Place of Performance: Online insurance verification software access.

• Compliance with HIPAA, IHS OIT mandates, and the Privacy Act.

• Software must not require installation on the Fort Belknap Service Unit or Indian Health Service network.

• Secure internet-based connectivity using SFTP.

• Support for Electronic Data Interchange (EDI) and interactive Telnet.

• Unlimited users and workstation-independent access.

• Adherence to Privacy Act and Confidential Information clauses.