Medical and Dental Coding, Auditing, and Data Entry Services for Phoenix Area Indian Health Service (PAIHS) Service Units

Sources Sought Notice

This notice is for market research purposes only to determine compliance with the Buy Indian Act and to assess the feasibility of a set-aside for Indian Small Business Economic Enterprises (ISBEEs). It is not a Request for Quote (RFQ) or a solicitation.

The Indian Health Service (IHS) is seeking information regarding capabilities for Medical and Dental Coding, Auditing, and Data Entry Services for various Service Units within the Phoenix Area Indian Health Service (PAIHS). This service is intended to support compliance with CMS, OIG, Federal and State third-party billing regulations, data integrity standards, and IHS internal controls for outpatient and inpatient encounters.

• NAICS Code: 541611 - Administrative Management and General Management Consulting Services (Medical Coding and Billing Services).
• Response Date: January 30, 2026, 1:00 PM MST/MSD.
• Point of Contact: Dekovan Cook, dekovan.cook@ihs.gov.
• Buy Indian Act Priority: The IHS Contracting Officer will prioritize purchases for ISBEEs.

Firms interested in providing these services should submit the following information in writing:

• Company Name

• Point of Contact (Name, Title, Phone, Email)

• FSS / SEWP Contract Number (if applicable)

• SAM Unique Entity Identifier Number

• Tax ID Number

• Indication of business category (Indian Economic Enterprise - IEE or ISBEE)

• Capability Statement addressing qualifications and ability to meet the requirement.

• Documentation from manufacturer (if applicable) for authorized distributor/reseller status.

• For IEE/ISBEE status: Representation on the designated IHS Indian Economic Enterprise Representation form and identification of the Federally Recognized Indian Tribe or Alaska Native Corporation relied upon for IEE status.

• Responses must demonstrate relevant capabilities to be considered for market research.

• Interested firms must be registered in the System for Award Management (SAM).

• This is the only notice; no other copies will be provided.

Statement of Work (SOW)

This SOW outlines the requirements for providing comprehensive medical and dental coding, auditing, and data entry services for various Service Units within the Phoenix Area Indian Health Service (PAIHS). The goal is to ensure compliance with federal and state laws, regulations, and policies, and to facilitate proper reimbursement and regulatory compliance.

• Medical and Dental Coding: Assigning appropriate ICD diagnosis and procedure codes, ADT, CPT, HCPCS, E/M codes, modifiers, and trans-codes based on Electronic Health and Dental Record (EHR/EDR) information.

• Data Entry: Inputting visit data from EHR/EDR notes or PCC paper forms into the RPMS PCC Package.

• Coding Timelines: Outpatient visits must be coded within 4 business days of service, and inpatient visits within 10 business days of discharge.

• Auditing: Performing coding quality audits on a quarterly basis to identify areas for improvement.

• Service Units: Services may be utilized by multiple PAIHS Service Units including those in Utah, Nevada, Arizona, and California.

• Period of Performance: May 1, 2026 - September 30, 2031 (5-year Blanket Purchase Agreement).

• Place of Performance: Off-site at the Contractor's location.

• Experience: Contractor must have experience with the IHS's Resource and Patient Management System (RPMS), including PCC, ADT, and EHR packages.

• Staff Qualifications: Staff must be qualified, experienced, and credentialed (e.g., AAPC or AHIMA certified). Training for new staff must be supervised.

• Security: Strict adherence to HIPAA, Privacy Act, Homeland Security Presidential Directive-12 (HSPD-12), and other federal security regulations is required. This includes PIV card requirements, annual security training, and data encryption standards (FIPS 140-2 validated).

• Reporting: Monthly volume and status reports are required, along with a data tracking log.

• Incident Response: Immediate response (within 1 hour) to security incidents and breaches is mandatory.

• Contract Clauses: Compliance with various FAR and HHSAR clauses related to privacy, security, and information handling is required.

Form / Attachment / Pricing Sheet

This document is the "Indian Economic Enterprise Representation Form" required by the Indian Health Service under the Buy Indian Act. It serves as a self-certification for offerors to confirm they meet the definition of an "Indian Economic Enterprise" (IEE) as defined by HHSAR 326.601. This form is to be submitted in response to a Sources Sought Notice, Request for Information (RFI), or a Solicitation and resultant contract.

• Eligibility Requirements: The enterprise must meet the IEE definition at the time of offer, contract award, and throughout the contract performance period. Any change in eligibility requires immediate notification to the Contracting Officer.
• Representation: Offerors must indicate whether they do or do not meet the definition of an "Indian Economic Enterprise" with "Indian Ownership" under the Buy Indian Act.
• Required Information: The form requires the Offeror to provide:
  • Name of Federally Recognized Tribal Entity (if applicable)
  • Name of the 51% owner of the IEE Firm
  • Business Name
  • Unique Entity Identifier (UEI) Number
  • Certifying Signature
  • Print Name
• Consequences of False Information: Submitting false or misleading information is a violation of law and punishable under 18 U.S.C. 1001, with false claims subject to penalties under 31 U.S.C. 3729-3731 and 18 U.S.C. 287.

This form is critical for any bidder seeking to participate in opportunities designated for or influenced by the Buy Indian Act. Bidders must accurately complete this self-certification to demonstrate their eligibility. Failure to meet the IEE definition or provide accurate information can lead to disqualification or penalties. Offerors must also be registered with the System of Award Management (SAM).