Opportunity Detail

Questions and Answers

Ohio Medicaid Enterprise System (OMES), EDI Services RFP
Document #:  0A1285


Question:   Supplement 1 - Scope of Work - Requirement # EDI-020.000.090: Is this requirement stating that vendor solutions should track inbound and outbound billing related transactions? If not please clarify this requirement.

Answer:   Yes.

Date: 4/15/2020

Inquiry: 74558


Question:   We have a few questions related to Supplement Two: Section 3.2 Solution Architecture: 1) Assuming the vendors solutions are agnostic, please confirm if it is recommended that the Offeror implement the solution in the State Private Cloud or the State of Ohio Enterprise Brokered Public Cloud? 2) If so, how is the Offeror required to send ODM the sizing information, and how are they expected to price for the same? 3) Lastly, is the "State of Ohio Enterprise brokered public cloud" a service broker that allows the Offeror to deploy their solution to either AWS or Microsoft Azure and integrate with State of Ohio IT Services?

Answer:   The vendor should bring in a full packaged solution suite (Software as a Service) that is managed and supported by the vendor. If the vendor can utilize State resources without impacting their business and delivery model, they may be required to do so. If the vendor only offers its software in its own cloud-hosted solution as a package, only reference the full package, not the infrastructure components supporting it. The awarded offeror will be expected to leverage some State resources such as the Identity and Access Management platform.

Date: 4/13/2020

Inquiry: 74600


Question:   RFP Document: EDI RFP Base Section: Attachment Three: Requirements for Proposals/Technical Proposal Instructions/Supplement Three – State Information Security, Privacy, and Data Handling Requirements Page Number: page 42 Question: The Technical Proposal Instructions for “Supplement Three – State Information Security, Privacy, and Data Handling Requirements” discuss the redaction process. However, the actual Supplement Three makes no reference to the redaction process. Please confirm: Instructions for submitting redactions are found on page 16 of the EDI RFP Base document The “itemized list of each redaction with the corresponding statutory exemption from disclosure” is a separate document and NOT part of the response to Supplement Three

Answer:   Correct. The reference to the instructions is provided in case, while responding to the questions in Supplement Three, an Offeror will need to include confidential, proprietary, or trade secret information.

Date: 4/9/2020

Inquiry: 74598


Question:   RFP Document: Template C Section: 2.1.1 Mandatory Qualification #1 – Experience Page Number: page 5 Question: The instructions for providing references refers to “the offeror’s (or proposed subcontractor’s) experience.” The first column in Table 3 “Experience” in section 2.1.1 is titled “Offeror/Subcontractor Information.” Please clarify: are offerors required to submit references for the subcontractors?

Answer:   2.1.1 refers to the ""prime contractor"" meaning the Offeror. All of section 2 requires information for the Offeror unless it is stated to provide subcontractor information as in Section 2.4: ""If offeror uses subcontractors, associated companies or consultants that will be involved in any phase of this project, each of these entities must submit this information as part of the response.""

Date: 4/9/2020

Inquiry: 74596


Question:   The term “Key Commercial Software” is used in a couple of different documents (including page 44 of the PDF Base EDI document, and page 20, Section 7 – Terms For Commercial Materials in Template B), but it’s not clearly defined. Please provide the definition of “Key Commercial Software”.

Answer:   The State believes the definition within the RFP documents is accurate and is what will be relied upon regardless of the broad definition provided here in this inquiry response. The broad definition is any commercial software that is explicitly required as part of the Contractor's solution.

Date: 4/9/2020

Inquiry: 74599


Question:   The term “Key Commercial Software” is used in a couple of different documents (including page 44 of the PDF Base EDI document, and page 20, Section 7 – Terms For Commercial Materials in Template B), but it’s not clearly defined. Please provide the definition of “Key Commercial Software”.

Answer:   The State believes the definition within the RFP documents is accurate and is what will be relied upon regardless of the broad definition provided here in this inquiry response. The broad definition is any commercial software that is explicitly required as part of the Contractor's solution.

Date: 4/9/2020

Inquiry: 74580


Question:   A few follow up questions to Inquiry 74403. a. Without history being loaded into new platform, will the prior contractor provide interface for vendor to invoke to get data requested by partners? b. Is the expectation that the vendor just provide Tier 2 Support for the platform, with expectation that Tier 1 Support is handled by ODM? c. If not and the vendor is expected to support Tier 1 support, could you please provide Tier 1 call volume average per day, average per year and peak volumes?

Answer:   a. When TPs request reload of files ODM will provide the files for the EDI vendor to return to the trading partner in the X12 format. b. The vendor is expected to handle Tier 1 and Tier 2 support with Tier 3 support being the responsibility of ODM. c. Yes, the average call volume per month is 600 calls.

Date: 4/9/2020

Inquiry: 74579


Question:   In the event a key reference is unable to list their names due to a policy constraint within the respective State, is ODM open to a blind reference, wherein we can provide those details in a separate communication whenever ODM requires it.

Answer:   In the event a key reference is unable to list their names due to a policy constraint within the respective State, is ODM open to a blind reference, wherein we can provide those details in a separate communication whenever ODM requires it.

Date: 4/9/2020

Inquiry: 74576


Question:   Supplement 1 - Scope of Work - Requirement # EDI-020.000.090: Is this requirement stating that vendor solutions should track inbound and outbound billing related transactions? If not please clarify this requirement.

Answer:   Yes.

Date: 4/9/2020

Inquiry: 74575


Question:   Supplement One - Scope of Work document, Requirement ID #EDI-010.000.150 - please specify the type and number of interfaces along with data formats.

Answer:   ODM will provide the type and list of interfaces to the awarded vendor.

Date: 4/9/2020

Inquiry: 74574


Question:   Follow up question to Inquiry 74474. “The formulas are present in Column D (highlighted green) for each section.” We do not see formulas in Column D. Please validate and confirm if the State will issue an updated version of Template F with formulas in Tab 4 Column D. Thanks

Answer:   An updated cost workbook is being provided on the website in response to this inquiry.

Date: 4/9/2020

Inquiry: 74573


Question:   From a clarification standpoint in Template F - Cost Proposal Workbook. On Tab#5 M&O, Notes section bullet #4 – there is use of the term ‘Installation’ which is expected to be priced for along with purchase, delivery, inspection etc. How does ODM discern Installation from Implementation (Tab#4) in this context? a. Accordingly, what is the guidance for where Vendors should provide implementation costs in terms of resource effort etc., Can we assume that Tab#4 Implementation is for deliverables/artifacts only? b. Is the expectation that M&O which will include environment costs etc., starting from Year 1? Or should we be calling out the DDI effort somewhere else?

Answer:   Tab. 4 reflects deliverables documentation that must be provided at the agreed upon dates for approval by ODM in order to receive payment. The cost associated with any documentation listed in Tab. 4 that must be updated over the course of the contract should be included in Tab 5. M & O, or if the revisions needed are due to an upgrade to the solution, any associated costs should be included in Tab. 7- Upgrades.

Date: 4/9/2020

Inquiry: 74572


Question:   Does the State expect the EDI module to include a Document Management System to fulfill requirements: OMES-120.030.010, OMES-120.030.020, OMES-120.030.030, OMES-120.030.100, OMES-120.030.110. Or, is the expectation that the EDI module will integrate to a Document Management System operated by the State or another module?

Answer:   Yes, the contractor must provide a document management solution and in the future, it needs to be ready to integrate with State provided document management solution.

Date: 4/8/2020

Inquiry: 74567


Question:   Supplement 1 - Scope of Work - Requirement # OMES-140.000.090 “The contractor must provide network connectivity for the state-approved personnel at its offices and facilities during the life of the contract, at the contractors expense. This can be secure guest Wi-Fi or some other state-approved method.” Question - Is this requirement to provide state approved personnel WiFi access when they are at EDI Vendor location or something else?

Answer:   Yes, the contractor is required to provide WiFi access for state approved personnel at their location.

Date: 4/6/2020

Inquiry: 74492


Question:   Supplement 1 - Scope of Work - Requirement # OMES-120.030.020 “The contractor’s solution must provide the capability to confirm delivery and receipt of correspondence by state-identified stakeholders.” Question - What is the expectation of delivery receipt is it for electronic files being “pushed” to the partner mailbox?

Answer:   This is regarding email correspondence informing trading partners of specific Medicaid events relating to their operations on a regular basis.

Date: 4/6/2020

Inquiry: 74490


Question:   Supplement 1 - Scope of Work - Requirement # OMES-120.030.100 “The contractors solution must integrate with the state-supplied printing and mailing services for transmittal of hard copy correspondence.” Question - Is the Offeror expected to connect to mailing/printing services? If yes, please expand and provide an example of material to be printed, and what would the integration be based on?

Answer:   No.

Date: 4/6/2020

Inquiry: 74488


Question:   Supplement 1 - Scope of Work - Requirement # EDI-140.000.060 “The contractors solution must integrate with the OMES Member system of record to access individuals’ information necessary to perform supported business functions.” Question #1) - Will the System Integrator act as a data hub providing directing traffic or is the EDI module Offeror expected to connect directly to the systems, such as OMES Member System directly? Question #2) - What are the formats of integration the systems support, is it regular or RESTful Services?

Answer:   1. The Systems Integrator will act as a data hub. 2. The Systems Integrator supports multiple modes of communication between the modules and infrastructure components. Some examples are web services and batch file transfers.

Date: 4/6/2020

Inquiry: 74491


Question:   Supplement 1 - Scope of Work - Requirement # OMES-120.010.040 "The contractor’s solution must provide the capability to validate that submitted digital documents are legible and reject those which do not meet quality standards." Question - Is the Offeror expected to provide services to scan/digitize documents ex: scan and convert claims?

Answer:   No, there is no expectation that the system provides a scanning/digitizing service. There are some EDI transactions that include attachments and the solution must ensure that the attachments are readable.

Date: 4/6/2020

Inquiry: 74484


Question:   Supplement 1 – SOW: EDI-010.000.100 The contractors solution must provide the capability to receive and send third party liability (TPL) data utilizing state-identified communication mechanisms (e.g., X12 transactions) with trading partners. – page 17 Question: When you say “receive and send TPL”, are you referring to receiving coordination of benefits (COB) on an incoming claim and providing other insurance information in response to eligibility requests or subrogation?

Answer:   This question is referencing a different procurement opportunity, please resubmit under the correct opportunity inquiry section.

Date: 4/6/2020

Inquiry: 74476


Question:   Supplement 1 – SOW: OMES-130.000.030 The contractors solution must transfer appropriate data maintained by the solution to the state-identified data warehouse/business intelligence component(s) on a regular schedule, as determined by the State. – page 30 Question: All raw transactions and metadata will be provided what specific transaction types (837, 835, etc.) need to be transformed for loading to the EDW?

Answer:   All transaction types need to be sent to EDW. The data written to the EDW will not be using X12 format, it will be using web services or batch file transfers.

Date: 4/6/2020

Inquiry: 74475


Question:   Template F - Cost Proposal Workbook - Tab 4 Implementation - It appears that the subtotal and total fields in column D do not contain formulas. Question - Is the State planning to issue an updated version of the price sheet with formulas in Tab 4 Column D or should the Vendor manually calculate the amounts for Column D?

Answer:   The formulas are present in Column D (highlighted green) for each section.

Date: 4/6/2020

Inquiry: 74474


Question:   Follow up to Inquiry: 74428. The response instructed to look for the requested information in Supplement 1 Page 6 Figure1. Upon review of Supplement 1 the upgrade transactions (269,274,275,278 and 838) seem to be missing in the referenced table (Table 1 - Monthly Transaction Volumes). Is this the correct location or is there another location that includes the transaction volume? If not please provide projected monthly volumes.

Answer:   ODM does not currently use the transactions 269,274,275,278 and 838 but desires to accept these transactions in the future. Vendors should be able to make reasonable assumptions based on their industry knowledge and estimate volumes for these transactions based on the numbers provided in table 1 of Supplement One document and formulate a response.

Date: 4/1/2020

Inquiry: 74462


Question:   What is the last day RFP can be submitted and if there is a possibility of extending the timeline on the RFP submission- mainly due to the coronovirus. We have few people who cannot response to the serious nature of the work on the RFP right now, any extension would be helpful.

Answer:   ODM is considering this request, but has not yet made a determination. Regardless of the opening date, the implementation date will not change.

Date: 4/1/2020

Inquiry: 74460


Question:   Response to Inquiry: 74424: “ Yes, ODM must be in compliance with the CAQH CORE rules and be certified.” Follow up question: Since some of the CAQH CORE capabilities are relatively new and not mandated by CMS, is the EDI vendor expected to price in capabilities to support all the phases (I, II, III, IV & V)? Or should IV & V be left for future discussion as long as the solution can be in compliance going forward?

Answer:   The selected vendor will be expected to have the capability to support all CAQH CORE phases, but it is up to each vendor’s discretion how to incorporate this consideration into their cost workbook.

Date: 4/1/2020

Inquiry: 74458


Question:   Response to Inquiry #74400: “Yes, HL7 will be used by ODM in the future. The specific version has not yet been decided.” Follow up question: Since ODM restricts the use of optional features in this RFP, should the EDI vendor look to price this capability for HL7 use in the current bid? Or should that be left for future discussion as long as the solution is capable of handling it in the future?

Answer:   The selected vendor will be expected to provide HL7 capability at some point during the contract period, but it is up to each vendor’s discretion how to incorporate this consideration into their cost workbook.

Date: 4/1/2020

Inquiry: 74457


Question:   Response to Inquiry #74430 : "Yes, ODM plans to implement FHIR/Interoperability rules." Follow up question: Given that the Interoperability ruling is required by Jan 2021, is the EDI vendor expected to price for these FHIR/Interoperability rules in our responses?

Answer:   The selected vendor will be expected to meet the FHIR/Interoperability rules, but it is up to each vendor’s discretion how to incorporate this consideration into their cost workbook.

Date: 4/1/2020

Inquiry: 74456


Question:   As one step to slow the spread of COVID-19 virus, it is highly recommended that employers, including state and federal organizations implement teleworking technologies to the greatest extent possible. Is the State of Ohio open to accept responses (for both the Technical Proposal and Cost Proposal) to this solicitation by electronic mail ONLY?

Answer:   The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 3/30/2020

Inquiry: 74452


Question:   I hope this email finds you well. Given the recent events surrounding COVID-19 and the unprecedented impacts it is having to daily life across the world, we kindly request the opportunity to submit our response via online submission/web portal. Our rationale for this request is detailed below. We are committed to supporting our clients and the greater public good during this challenging time. Per the Governor’s guidance, citizens have been instructed to practice home isolation. Working from home is a solution to mitigate the spread of COVID-19 in Ohio. This aligns with guidance that we have given our practitioners to work from home as much as feasible. Furthermore, CDC guidance around COVID-19 supports social distancing practices and limited exposure to others during this time to prevent spread of the virus. Evaluating the required steps to prepare the OMES EDI RFP response, printing and delivery of the required hard copies necessarily entails contact with others, increasing the risk of virus spread, which could be avoided by submitting our response online.

Answer:   The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 3/30/2020

Inquiry: 74443


Question:   In light of the COVID pandemic, please revise the response requirements to forego hardcopies and USBs and replace them with an electronic delivery format, such as: Email or upload to a site. This would limit staff’s potential exposure given we must work in close proximity to provide such items.

Answer:   The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 3/30/2020

Inquiry: 74423


Question:   3.4 PROPOSAL SUBMITTAL Each Offeror must submit a technical section and a cost section as part of its total Proposal before the opening time on the Proposal due date. The Offeror must submit the technical section as a separate package from the cost section of its Proposal, and each section must be submitted in its own separate, opaque package. The package with the technical section of the Proposal must be sealed and contain one (1) originally signed technical section and ten (10) additional copies of the technical section, and the package with the cost section also must be sealed and contain three (3) complete copies of the cost section of the Proposal. The Offeror must mark the outside of each package with either: “RFP #0A1285 – EDI Services RFP – Technical Proposal” or “RFP ##0A1285 – EDI Services RFP – Cost Proposal,” as appropriate. Included in each sealed package, the Offeror also must provide an electronic “searchable” copy of everything contained within the package on a flash drive (portable storage device) in Microsoft Office (native format), Microsoft Word (native format), Microsoft Project (native format), Microsoft Excel (native format) and Adobe Acrobat format, as appropriate. If there is a discrepancy between the hard copy and the electronic copy of the Proposal, the hard copy will control, and the State will base its evaluation of the Offeror’s Proposal on the hard copy. – RFP Page 15 Question: Given the national health crisis resulting from the Coronavirus, most vendors are in the process of having as many people work from home as possible. The manual effort to print and prepare paper copies of the proposal will require a number of our employees to travel to and work from a company office during the production process. Due to the current crisis, will the State consider eliminating the requirement to submit paper copies of the proposal, and allow the vendors to submit electronic versions only?

Answer:   The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 3/30/2020

Inquiry: 74360


Question:   As one step to slow the spread of COVID-19 virus, it is highly recommended that employers, including state and federal organizations, implement teleworking technologies to the greatest extent possible. Is the State of Ohio open to accept responses (for both the Technical Proposal and Cost Proposal) to this solicitation by electronic mail ONLY?

Answer:   The Department of Administrative Services (DAS), Office of Procurement Services (OPS) has received several inquiries requesting the ability to submit proposal responses electronically as a result of the COVID-19 emergency. OPS is continuing to work with our Office of Information Technology to transition responses to solicitations released by our organization to electronic submission. It is recommended that prospective offerors continue to regularly monitor the State Procurement Website for Q&A postings, announcements and/or solicitation amendments containing instructions or guidance for submission of electronic proposals. Thank you for your patience and support during these uncertain times.

Date: 3/30/2020

Inquiry: 74359


Question:   Is the Systems Integrator permitted to bid for future modules?

Answer:   The System Integrator vendor is not automatically prohibited from bidding on future modules, however, any vendor with inside information related to a procurement that would give that vendor an unfair advantage over other vendors in responding to the RFP, may be disqualified from consideration due to conflicts of interest.

Date: 3/27/2020

Inquiry: 74446


Question:   The State suggests a prohibition of the use of offshore capabilities (from the “Revised Base RFP” PDF page 69) and the need for everything to be done within the United States. However it also suggests on Page 28 the use of a disclosure process expenditure of public funds for offshore services. For purposes of clarity, is the State suggesting there is an option of use of offshore for certain non-production, non-PHI activity as long as it is supported by a legally bound disclosure form? Or do we assume absolutely no offshore capabilities in any capacity?

Answer:   The Governor's Executive Order 2019-12D prohibits the expenditure of public funds for services provided outside of the United States. https://procure.ohio.gov/PDF/EO2019-12D/EO_2019-12D2_Offshore.pdf However, there are certain limited emergency circumstances in which an agency can request a waiver of this requirement.

Date: 3/27/2020

Inquiry: 74445


Question:   The State’s suggests a prohibition of the use of offshore capability (Pg69 Base RFP) and the need for everything to be done within the US, but also noted on Pg28 the use of a disclosure process expenditure of public funds for offshore services. Is the State suggesting theres an option of use of offshore for certain non-production, non-PHI activity as long as it is supported by a legally bound disclosure form? Or do we assume absolutely no offshore capability in any capacity?

Answer:   The Governor's Executive Order 2019-12D prohibits the expenditure of public funds for services provided outside of the United States. https://procure.ohio.gov/PDF/EO2019-12D/EO_2019-12D2_Offshore.pdf However, there are certain limited emergency circumstances in which an agency can request a waiver of this requirement.

Date: 3/27/2020

Inquiry: 74449


Question:   21. Supplement One - Scope of Work document, for sections “Functional Requirements”, “Technical Requirements”, “Implementation Requirements”, and “Maintenance and Operations Requirements” – in addition to providing a response to the “Capability Assessment” column for each requirement, would the State allow vendors to add a column to the right of the “Capability Assessment” column so that we can provide additional explanation/capability description for each specific requirement? This will provide the State detailed description regarding how the proposed approach/solution is going to meet each requirement. Or would the State prefer to add a separate table that includes additional explanation/capability description?

Answer:   A response is required at the end of each category of requirements. Instructions for content are provided as well. Completion is mandatory. See page 18 in Supplement One- Scope of Work at the end of Section 4.1 EDI Standards and Compliance, as an example.

Date: 3/27/2020

Inquiry: 74450


Question:   Question: Supplement 1 – SOW: Figure 1, page 6 Q: For Inbound batch transactions, is the intent that the transactions will 1st be deposited in the EDI solution mailboxes and then flow into the System Integrator (SI)?

Answer:   SI will act as a front door and pass through to EDI. The transaction will then pass back through SI.

Date: 3/27/2020

Inquiry: 74439


Question:   Question: Supplement 1 – SOW: Figure 1, page 6 Q: For Inbound batch transactions, what is the expected output format from the EDI solution (e.g. X12, XML, other)?

Answer:   We expect the transmission to use the an X12 approved schema to provide the input/output to the EDI translator.

Date: 3/27/2020

Inquiry: 74438


Question:   Question: Supplement 1 – SOW: Figure 1, page 6 Q: For Outbound batch transactions, what is the expected input to EDI solution (e.g. X12, XML, other)?

Answer:   We expect the transmission to use the an X12 approved schema to provide the input/output to the EDI translator.

Date: 3/27/2020

Inquiry: 74437


Question:   Question: Reference Point in RFP- supplement 1 EDI objectives. Page 1 Q: Can OMES provide an estimated number of Trading Partners that will access the system from the Sister agencies?

Answer:   There are approximately 1000 trading partners enrolled with the ODM.  This number includes the Sister agencies. 

Date: 3/27/2020

Inquiry: 74436


Question:   We did not see a request for company or corporate references in the RFP docs? Is the State open to receiving corporate references from our past clients? If yes, does the State have a template with a set of questionnaire for vendors to use in obtaining corporate references? or is the State open to any format?

Answer:   See Template C- Bidder Profile which provides instructions for client references.

Date: 3/27/2020

Inquiry: 74432


Question:   Three references for each key role: Does the State have a template with a set of questionnaire for vendors to use in obtaining staff references? or is the State open to any format?

Answer:   See References on page 11 in Supplement One-Scope of Work for requirements for references.

Date: 3/27/2020

Inquiry: 74431


Question:   Is the State seeking to implement FHIR/Interoperability? If yes, would it make sense for vendors to include this capability and pricing information (for example using the “Innovate” Tab in price worksheet)?

Answer:   Yes, ODM plans to implement FHIR/Interoperability rules.

Date: 3/27/2020

Inquiry: 74430


Question:   Supplement One - Scope of Work document, for sections “Functional Requirements”, “Technical Requirements”, “Implementation Requirements”, and “Maintenance and Operations Requirements” – in addition to providing a response to the “Capability Assessment” column for each requirement, would the State allow vendors to add a column to the right of the “Capability Assessment” column so that we can provide additional explanation/capability description for each specific requirement? This will provide the State detailed description regarding how the proposed approach/solution is going to meet each requirement. Or would the State prefer to add a separate table that includes additional explanation/capability description?

Answer:   A response is required at the end of each category of requirements. Instructions for content are provided as well. Completion is mandatory. See page 18 in Supplement One- Scope of Work at the end of Section 4.1 EDI Standards and Compliance, as an example.

Date: 3/27/2020

Inquiry: 74429


Question:   Template F - Cost Proposal Workbook: Please provide anticipated transaction volume for the 5 transactions in the Upgrades tab in the Cost Proposal Workbook.

Answer:   This can be found in Supplement 1- The table provides current Monthly Average Volume, Peak Monthly Volume, and Future Monthly Volume for each Transaction type.

Date: 3/27/2020

Inquiry: 74428


Question:   Please provide the number of trading partners sending/receiving EDI transactions?

Answer:   There are approximately 1,000 trading partners to support.

Date: 3/27/2020

Inquiry: 74427


Question:   Supplement One - Scope of Work document, Requirement ID #EDI-010.000.160 – please clarify the context of “attachments” – are these attachments included in the HIPAA transactions (i.e. claims attachments, prior authorization)?

Answer:   Yes, the ability to capture and maintain data for claim and prior authorization attachments.

Date: 3/27/2020

Inquiry: 74426


Question:   Supplement One - Scope of Work document, Requirement ID #EDI-020.000.050 – Please clarify who are the authorized users and how many users?

Answer:   These are ODM internal users, approximately 10.

Date: 3/27/2020

Inquiry: 74425


Question:   In addition to CAQH CORE Phase I-III, is the State planning to support Phase IV and V rules?

Answer:   Yes, ODM must be in compliance with the CAQH CORE rules and be certified.

Date: 3/27/2020

Inquiry: 74424


Question:   Given the COVID-19 pandemic and the impact across the country, Conduent respectfully requests the state of Ohio extend the due date to July 31, 2020 for the Ohio Medicaid Enterprise System (OMES), EDI proposal response (RFP #0A1285).

Answer:   At this time ODM is not going to change the opening date. If the agency determines at a later date that it will provide additional response time, an RFP amendment will be posted to this website to update the opening date.

Date: 3/27/2020

Inquiry: 74422


Question:   Template B: SLA 15 Real Time Performance Service Level – Page 15 Q: Please clarify if the SLA calculation, “Response time is defined as the time elapsed after transaction receipt until a translated response is delivered” refers to a full round trip transaction (starting when 270 received, ending when 271 is delivered).

Answer:   Yes, round trip of the transactions.

Date: 3/27/2020

Inquiry: 74416


Question:   Template B: SLA 15 Real Time Performance Service Level – Page 15 Q: Can we assume this SLA is applicable to 270/271 Eligibility and 276/277 Claim Status transactions?

Answer:   Yes, this SLA is for both 270/271 and 276/277 to meet CAQH CORE Operating rules.

Date: 3/27/2020

Inquiry: 74415


Question:   Template B: SLA 15 Real Time Performance Service Level – Page 15 Q:Can we assume this SLA is applicable to 270/271 Eligibility and 276/277 Claim Status transactions?

Answer:   Yes, this SLA is for both 270/271 and 276/277 to meet CAQH CORE Operating rules.

Date: 3/27/2020

Inquiry: 74414


Question:   Supplement 1 – OMES-110.010.090 The contractors solution must provide information delivery even in the event that one or more systems or networks may be offline (i.e., Guaranteed Single Message Delivery). Page 52 Q: For synchronous transactions, what is the expected result? For real-time eligibility look up, if the Member system is not available, we would inform the user the information is not available at this time so they see a result. If the eligibility system is down, do we provide an AAA42 response to the trading partner or do we wait for a response from the eligibility system. If the latter, then what response if any besides 271 is expected?

Answer:   The AAA 42 is the expected response if the Member system for Eligibility is not available.

Date: 3/27/2020

Inquiry: 74413


Question:   Supplement 1 – SOW: EDI-140.000.060 The contractors solution must integrate with the OMES Member system of record to access individuals’ information necessary to perform supported business functions. Page 51 Q: Is the intended integration with the Member system expected to be the consumption of web services?

Answer:   EDI must support both batch and webservice transactions.

Date: 3/27/2020

Inquiry: 74412


Question:   Supplement 1 – SOW: EDI-140.000.060 The contractors solution must integrate with the OMES Member system of record to access individuals’ information necessary to perform supported business functions. Page 51 Q: What is the business function supported by this integration? Is this to support the Eligibility transaction?

Answer:   EDI must support 270/271 eligibility transactions

Date: 3/27/2020

Inquiry: 74411


Question:   Supplement 1 – SOW: OMES-130.000.030 The contractors solution must transfer appropriate data maintained by the solution to the state-identified data warehouse/business intelligence component(s) on a regular schedule, as determined by the State. – page 30 Q: Will this data need to be in an OH specified format, or can it be provided as X12 or XML?

Answer:   Data must be provided on a daily basis and in Ohio specified format. Send both the transaction and the metadata around the transaction so that the performance can be measured. The data sent to EDW/business intelligence components should be translated data with the names identical to the table fields used in EDW.

Date: 3/27/2020

Inquiry: 74410


Question:   Supplement 1 – SOW: OMES-130.000.030 The contractors solution must transfer appropriate data maintained by the solution to the state-identified data warehouse/business intelligence component(s) on a regular schedule, as determined by the State. – page 30 Q:Can additional information be provided on the data required by the data warehouse?

Answer:   Send both the transaction and the metadata around the transaction so that the performance can be measured. The data sent to EDW/business intelligence components should be translated data with the names identical to the table fields used in EDW.

Date: 3/27/2020

Inquiry: 74409


Question:   Supplement 1 – SOW: OMES-140.040.010 The contractors solution must integrate with the Single Sign-On (SSO) capability provided by the State, using State standards for login and authentication. - page 41 Q: Does the state envision the EDI solution integrating with the OMES Single Sign On solution for real-time transactions?

Answer:   Yes.

Date: 3/27/2020

Inquiry: 74408


Question:   Supplement 1 – SOW: OMES-140.040.010 The contractors solution must integrate with the Single Sign-On (SSO) capability provided by the State, using State standards for login and authentication. - page 41 Q: Can the State please clarify what users are being authenticated from which systems that single sign on (SSO) needs to be enabled for?

Answer:   Anybody that authenticates into the EDI system must be authenticated through the State's SSO identity platform.

Date: 3/27/2020

Inquiry: 74407


Question:   Is the state interesting is tracking rejected encounters submitted by MCP to measure timeliness in resubmissions?

Answer:   All transactions must be tracked.

Date: 3/27/2020

Inquiry: 74405


Question:   Is the state interested in tracking claims send to MCP as submitted by providers for processing time tracking?

Answer:   In the future OMES all claims will be submitted to the MCP through ODM. Tracking of turnaround time from submission to response from the MCP will be expected and must be met per SLA 15 and SLA 16.

Date: 3/27/2020

Inquiry: 74404


Question:   Is there a need for loading historical data into the new EDI platform? If this is part of the project scope, what is the estimate file size fo the data?

Answer:   No historical data will be loaded to the new platform. However, at the request of the trading partners, the Contractor must be able to deliver EDI transactions generated from the prior contractor.

Date: 3/27/2020

Inquiry: 74403


Question:   Are there any Clearinghouses that would act as trading partners?

Answer:   Yes, ODM has multiple Clearinghouses that act as trading partners.

Date: 3/27/2020

Inquiry: 74402


Question:   Is there a need to track relationship between Provider and MCP?

Answer:   EDI Contractor will not need to track the relationship between Provider and MCP.

Date: 3/27/2020

Inquiry: 74401


Question:   Is there any plan to ingest HL7 Transactions? Are HL7 transactions in scope of the RFP project? If yes, please specify the version(s).

Answer:   Yes, HL7 will be used by ODM in the future. The specific version has not yet been decided.

Date: 3/27/2020

Inquiry: 74400


Question:   In the Supplement 1 - Scope of Work document, we see reference to 824 transaction – is this the Insurance reporting transaction?

Answer:   Yes, this is the Application Reporting for Insurance 005010X186.

Date: 3/27/2020

Inquiry: 74399


Question:   Is there an expectation to have EDI module provide an interface which is accessible through Provider/State facing portals?

Answer:   Yes, the interface will be through the System Integrator.

Date: 3/27/2020

Inquiry: 74398


Question:   Is there any expectation to support 4010 versions of transactions?

Answer:   No.  Version 4010 is no longer used for Healthcare related transactions as mandated by HIPAA.  Version 5010 with Addendas must be supported as well as future versions as requested by ODM OR mandated by CMS/HHS/HIPAA.

Date: 3/27/2020

Inquiry: 74397


Question:   Is the format of data interchange with SI – X12 or XML or JSON or some other format?

Answer:   EDI will receive/send X12. HL7 transactions will also be done in the future and Contractor must be able to support it.

Date: 3/27/2020

Inquiry: 74396


Question:   Will a dedicated connection be needed to System Integrator or the State of OH?

Answer:   No, it will utilize secured internet connectivity.

Date: 3/27/2020

Inquiry: 74395


Question:   Is the System Integrator solution cloud based?

Answer:   Yes, the Deloitte Health Interactive Platform.

Date: 3/27/2020

Inquiry: 74394


Question:   6.1 ATTACHMENT ONE: EVALUATION CRITERIA MINIMUM MANDATORY REQUIREMENTS (PASS/FAIL) 2. The offeror must provide a detailed plan which demonstrates that a minimum of fifteen percent (15%) of the cost of the work each fiscal year under the resulting Contract will be subcontracted through one or more Ohio Certified Minority Business Enterprise (MBE) suppliers. The MBE plan must include, at minimum, the name(s) of the MBE supplier(s), percent of total project cost allocated to each MBE supplier, description of work to be performed by each MBE supplier, letter(s) of intent signed by each identified MBE supplier, and MBE Certification letters for each MBE supplier. If collaborating with more than one MBE supplier, please attach separate forms for each MBE supplier. Question: Since this RFP is primarily for the procurement of a software platform to facilitate EDI transactions and the bulk of the cost will be for the software and not the associated services, will the State consider applying the MBE requirement to the staffing component of the project only?

Answer:   No, the MBE spending requirement is 15% of the overall cost of the contract per state fiscal year.

Date: 3/24/2020

Inquiry: 74358


Question:   Does this project have an incumbent vendor and, if so, which vendor?

Answer:   DXC is the current EDI Contractor.

Date: 3/16/2020

Inquiry: 74317


Question:   5.3 Contract (pages 25-26): What is the anticipated budget for this project?

Answer:   Budget has been allocated for the project, however, the State will not share it at this time.

Date: 3/16/2020

Inquiry: 74316


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Inquiry period ended:  4/10/2020 8:00:00 AM