Written Questions and Answers

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Written Questions and Answers Release of Information RFP UK-1820-18 Closing Date: 02/27/18 Today s Date: 02/08/18 No.

1 Written Questions and Answers Release of Information RFP UK Closing Date: 02/27/18 Today s Date: 02/08/18 No Question Does UK know the percentage of 1st requests that were free for being the first request in Kentucky? How many onsite Staff members does UK have today for Release of Information (i.e. UK employees or ROI Vendor employees). Do the volume stats on page 8 include ROI requests from the clinics or were these request volumes only for the Hospitals? Is the ROI process centralized at UK for all requests from the Hospitals and Clinics? Or are the ROI requests at the clinics processed out of each clinic? Does UK know the number of Patient Charts that were requested from the 258 Audits for Calendar Year 2017? Pg. 8 table In regards to the "Pages Copied", would you please provide a breakdown by media (paper, electronic system, fiche & film) for each of the three calendar years? Answer See answer to question 41 please Staff: 14 Managers: 2 The statistics represent all requests, hospital and clinic. The process is centralized, with the exception of the clinics that are off campus. Off campus clinics perform their own release of information for requests they receive. If a request for an off-site location is received on the main campus we will process it on the main campus. Number cannot be determined from STATS kept. As FYI, our current limit for RAC audits is 6 per request. Fiscal Year 2015 (pages only): Paper-653,799 Fiche-19,087 Electronic capture-3,348,735 Fiscal year 2016 (pages only) Paper-814,527 Fiche-21,792 Electronic capture-4,727,200 1

2 Pg a What specific locations within UKHealthCare make up the "enterprise" and fall under the terms of this RFP? Pg a Is 30 days the acceptable turnaround time for all requests without an established or required due date? Pg b Where is the offeror's staff located? Pg. 17 g What specifically does UKHealthCare require with respect to each of these? (Include duration, frequency & types of tests/training) Pg. 18 m What are the locations that offeror may need to "collect" paper records from - aside storage? Where are they located? Pg. 18 m How many charts are ordered from storage? What happens once a paper chart is received? Pg. 18 n What system(s) does UKHealthCare use for their electronic records? What information is in each (if more than one)? Fiscal year 2017 (pages only): Paper-742,947 Fiche-21,647 Electronic capture-6,223,883 UK Hospital (Chandler), UK Good Samaritan and UK Clinic Yes, we follow HIPAA guidelines for turnaround time for any request that does not have a specified turnaround time. Due to space constraints, offeror will have staff located in each facility, Chandler, Good Samaritan and KY Clinic It is the same as new employee orientation, occurs at onboarding. Yearly we complete web-based training on things like fire safety, infection control, etc. In addition, anyone working in any UK facility is required to get an annual flu vaccine. There are also certain immunizations history that must be provided at onboarding. Most records are ordered from offsite. UK staff will assist with collecting paper records. Very few clinics may have paper records being held for physician convenience, or for travel clinics that do not have access to the EMR. Offeror would not be required to go collect paper charts. Charts ordered from storage (hospital only)for FY2015-3,029, FY2016-3,811, FY2017-2,721 Unable to provide STATS on clinic record retrieval from storage as the number contains records called back for patient care. When a paper chart is received it is routed to the requestor, it is processed, UK HIM staff facilitate it s return to it s original location. Allscripts SCM for Inpatient and a few clinics, and Allscripts AEHR for the clinics. There are also 4 decommissioned systems we retrieve information from: SAGE, MEDINOTES, ENCOUNTER PRO, AMAZING CHARTS, AND HAZARD CARDIOLOGY 2

3 Pg. 18 n Does the EMR or each electronic system allow the electronic capture? If not, please provide details. Pg. 18 p Does UKHealthCare provide a microfiche machine? Where located? Does UKHealthCare provide a microfilm machine? Where is it located? Pg. 18 s What are the details in which certified and/or subpoenas are processed, if different than standard requests processing? Pg. 18 t Where does the offeror need to have staff to assist walkins? Pg. 18 v What types of requests are handled and processed via Fax? Pg. 18 y Is the coverage provided (for the stated hours) to answer phones, handle faxes and assist walk-ins? Are there any general HIM responsibilities the offeror will need to perform during these hours/days? Pg. 18 z What is UKHealthCare's approach/policy on the first request for a record & not charging the requestor? Pg. 18 bb Who has the authority to establish timeframes within a request? How is this monitored by UKHealthCare? Pg. 19 hh In regards to the penalties for poor performance related to TAT, accuracy and breaches determined after entering a contract, are these financial? Yes, they allow for electronic capture. Currently the vendor performing ROI provides a microfiche machine. It allows electronic image capture and upload of the image to avoid printing it out. UK has microfiche machines that are read only, they do not capture images. Vendor responsible for copying records for certs/subpoenas. Copied records given to UKHC for actual certification. Records returned to vendor for mailing. Staff will need to be located in 3 areas. Chandler, Good Samaritan and the KY Clinic. STAT requests for patient care, or if indicated on the request, we have to provide according to requestor preference. It is to handle walk-ins, faxes, answer the phone and at Chandler answer the door (the door is locked for security reasons). At Chandler, there is an individual seated at the front desk near the door to assist the walk-ins and therefore answers the door. UK employee badges let staff in, so answering the door is to allow non-uk staff in the department. We follow the KY statute related to free copies. The requestor established the timeframe. We expect the offeror to monitor TAT on requests. When UK gets involved, it is normally due to a complaint by the requestor. At that time, we will pull and review the request for TAT. Depending on the severity and failure to correct, the offeror may be placed on probation and required to prepare a plan of action to correct issue. We provide offeror the opportunity to correct before penalties are carried out or probation is enacted. 3

4 Other? Examples of what UKHealthCare has done and/or will do? Example for ongoing TAT issue: Requests 31days - % of fees paid by UK would be credited Pg. 19 hh What is the typical investigative process used by UKHealthCare to determine when a penalty may be levied? Pg b When the offeror must provide health information for RAC and other audits "in the proper chart order", is there one order for each type of audit? If performing ROI at multiple UKHealthCare location, is the order the same at each? Pg. 26 Attorney s Fees If the offeror prevails, does UKHealthCare pay for the expenses Are we able to have our submitted documents electronically signed or do they have to be signed in ink? Requests days greater % of fees paid by UK could be credited The % would increase as the TAT increased. Request would be pulled and reviewed for timely receipt, entry, chart processing, release etc. Offeror would be asked to review from their perspective to explain situation. UK and Offeror would discuss situation and work on a unified decision to either apply penalty or excuse the issue. We have an established chart order for IP and clinic records. We would provide Offeror with those chart orders to follow. No. The University may not, as a matter of law, agree to pay another party s legal fees. Documents may be submitted with electronic signatures. 27 Is there an expectation by UKHealthCare that the Contractor will provide onsite staff for each hospital or at centralized location? If space is provided by UK, the offeror will have to place staff in the locations we have available. UK will not pay for an off-site location so that the offeror may have all staff in one location. Space is a premium at UK and currently the staff are located in three locations. Offeror must maintain staff in the three locations to assist walk-in customers 28 On page 8 of the RFP: Generally speaking all attorney requests are made as a directive of the patient. 4

5 a. Are patient directive requests counted in the patient request volumes listed or the attorney request volumes? i. If the patient directive requests are counted under the attorney request volumes, what percent of the attorney requests are patient directive requests? b. Are walk-in requests included in the patient request volumes given? c. Are STAT/fax requests included in the physician request volumes given? d. Please provide estimates of STAT/fax requests per day or per month The patient requests are where the patient requested the record go directly to themselves. The stats given are all requests made during the timeframe indicated. Walk-in, mail-in, fax, etc. B. YES Walk-in Stats: , ,437 As an FYI: Opening Door stats: , ,751 (we opened a new walk-in window on the 1 st floor of Chandler and it has decreased the number of patient s coming to the main office) C. Yes D. STAT Faxes: , , Please provide us with call volume totals per day or per month. Calls: , , Please clarify whether Section 3.15, Alternate Proposals, means that if we want to provide information regarding other service models, besides full-service, that we need to submit an entire RFP response for each service model, or if we can provide information about other service models under Section 4.9, Criteria 5 Other Additional Information, and under Section 7.1, Alternate Pricing within the response we are 3.15 Alternate Proposals, each response must be complete (separate) and comply with the instructions within the RFP. Each Alternate Proposal submitted should be clearly marked and comply with section 3.6. Section 4.9, Criteria 5 Is for additional information on the proposal submitted and not a place to provide alternate proposals. 7.1 is alternate pricing for the submitted proposal. 5

6 submitting for our full-service model. 31 In Section 4.6, Criteria 2 Services Defined, we are to respond to each statement with how we will meet each statement. Is UKHealthCare looking for detailed descriptions of how we accomplish each task or confirmation that we will comply with each statement? Looking for confirmation that you will perform these tasks. If there are any tasks you will not perform this should be indicated and it would be nice to understand why you would not perform the task. 32 Please provide a copy of the UKHealthCare Plan B policy mentioned in Section j. See attached. 33 What is UKHealthCare s policy on record retention? The current policy is that we retain all medical records permanently. There has been no destruction of medical records in the history of UK In Section c., will there be dual entry required? a. What is the UKHealthCare tracking system? i. Can data be electronically interfaced into this system? b. What is the hospital EMR and what version is being used? Will the Contractor have access to the HIM department outside of the hours of 8 am to 5 pm Monday through Friday? In Section t, please clarify responsibilities around This would be needed if offeror does not have a tracking system. Hospital EMR is Allscripts SCM version: 16.3 Allscripst AEHR is version: 17.1 Yes, offeror is free to outside the established hours for OT hours, weekends and holidays, but must be staffed during the indicated hours M-F It would be to explain that UK has a patient portal and provide information to the customer regarding 6

7 the patient portal. It would be our standard operating procedure to provide a prepared instruction sheet and brief overview. Is there an additional requirement? Please clarify, by providing a couple of examples, why Section gg. is included in the General ROI list and not as part of Section 4.6.3, RAC and other Audit Requests. For Section 4.6.3, RAC and other Audit Requests, please clarify whether all audits are to be printed and sent to the requestor in paper form or if they can be sent electronically. Regarding Section 6.29, Printing Statutes, is all cost for equipment and supplies, i.e. scanners, paper, toner, and printers, the responsibility of the Contractor or UKHealthCare? We would like to have more detail on the current process. Is current staffing at multiple locations or is there a centralized location? If multiple locations, can we get a breakdown of stats by location and the number of current staff at these locations. If centralized, what is the current staffing to handle the requests? the portal. We have printed materials that can be given out. Also we have portal sign-up sheets that are available to give to the customers. This section applies to any request in which money can be recouped from UK, RAC, Insurance companies etc. The requests must be sent as indicated in the RAC request. Currently we submit the information on CDs. We are open to electronic submission as long as it is listed as an option in the request. Contractor should pay for supplies, paper, envelopes, CDs, etc. UK will supply computers, printers and fax machines. Processing requests can be handled by any location, in other words, just because you physically sit in the KY Clinic does not mean that you only process KY clinic requests. Since we are mostly electronic and we can order and have paper charts delivered to any facility the work can be done in a centralized process per say. Space constraints are the reason staff are located in three locations. Even if we had room for everyone to be in one facility, there would still need to be someone in each facility to handle walk-in customers. Currently there are work areas for: Chandler: 6 Good Samaritan 1 KY Clinic

8 We were provided a breakdown of stats, but is it possible to have these stats broken down by billable vs non-billable as well? Column Billable Requests Copied 23,746 14,626 13,511 Total # billable pages 1,642,124 1,457,615 1,173, Non billable Requests Copied 55,557 59,996 67,113 Total # nonbillable pages 3,705,750 4,701,780 6,152,438 Unable to give you a breakdown by request type 6.0 Contract Term The contract resulting from this RFP shall be effective for one (1) year, and is renewable for up to five (5) additional one-year renewal periods. The total contract period will not exceed six (6) years. Annual renewal shall be contingent upon the University s satisfaction with the services performed. The contract term can be negotiated upon award of a contract. Please see section 3.5 for proposed deviations from the RFP. 42 Due to the heavy investment in new client start-up resource requirements we undertake, we ask for a 3-year term commitment from UKHealthCare (with additional 1 year annual renewals). Would UKHealthCare be open to negotiating a different contract term than the RFP specification stated? Otherwise, can we continue the RFP process if we are 8

9 unable to agree to the stated UKHealthCare Contract Term? 6.0 Termination for Convenience Please see section 3.5 of the RFP and continue with your response. 43 The University of Kentucky, Purchasing Division, reserves the right to terminate the resulting contract without cause with a thirty (30) day written notice. Upon receipt by the contractor of a notice of termination, the contractor shall discontinue all services with respect to the applicable contract. The cost of any agreed upon services provided by the contractor will be calculated at the agreed upon rate prior to a notice of termination and a fixed fee contract will be pro-rated (as appropriate). 44 We cannot accept Termination for Convenience language in our contracts, again due to our significant ongoing investment in resources required in order to provide ROI services on behalf of our clients that meet the mutual needs of both parties. Is UKHealthCare open to discussion regarding this RFP specification, or can we continue the RFP process if we are unable to agree to the stated UKHealthCare Termination for Convenience language in the RFP? Page 22 of the RFP, item (gg). Contractor shall reimburse to the UKHealthCare one hundred percent of any monies recouped by the any third party from the University due, If a auditor requests medical records and the offeror fails to meet the TAT or does not submit the correct information which results in UK payment being recouped due to this, UK would expect the offeror to reimburse UK for the lost revenue of that claim. 9

10 45 46 in whole or in part, to the failure of Contractor to perform Contractor s contracted duties. Can UKHealthCare describe examples/back ground of an event where this would occur, so that we can review and agree? Page 22 of the RFP, item (hh). Upon entering a contract UKHealthCare and Contractor will agree upon penalties to be applied to Contractor due to poor performance related to turnaround time, accuracy, and breach of PHI. Can UKHealthCare provide details of reasonable Service Level Agreements (SLAs), for ROI services that can be discussed? Page 22 of the RPF, RAC and other Audit Requests: a. The entire record shall be copied b. The copies shall be quality checked by Contractor to ensure every page is accounted for and in the proper chart order c. The copies shall be uploaded into the HIM shared folder so that they may be imported into internal tracking system by HIM Operations Manager for ROI d. Paper copies shall be provided to HIM auditors for quality check. e. Copies shall only be released once approval is received from HIM f. Copies shall be provided via paper, CD, DVD, jump This could be a RAC or insurance company requesting records. This would not be an automatic response, there would be detail and investigation before such action would take place. We just want to make sure offeror s are aware of UK s stance on this. I don t see this on page 22. Please see the answer to question number 22 above. We are open to use of electronic submission as long as our RAC will accept electronic submission. Performant is our RAC, and in their initial power point/orientation they stated that we may submit records via esmd, CD/DVD or paper. Before this process is utilized, offeror will have to get clearance from our IT department on its use. We must have reassurances that we can verify receipt of the records by the RAC in whatever method is utilized. 10

11 drive, or any other electronic method as described by ARRA requirements or at the request of the requestor. g. All audit requests, i.e. RAC, or insurance etc. shall be mailed directly from UKHealthCare utilizing a service, such as FedEx, certified mail, etc. that provides electronic tracking of the records with ability to print the signed acknowledgement of receipt. h. The signed acknowledgement of receipt will also be provided to UKHealthCare for inclusion in the internal tracking system. i. Great detail shall be paid to all RAC requests and requests of the same nature. All copies shall be uploaded into the HIM share point site for eventual upload into UK HealthCare s internal tracking system and shall be quality checked not only by the Contractor, but also UK HIM department. No copies of RAC or audit charts shall be mailed prior to approval from UK. We utilize very efficient processes and client-approved sets of protocols regarding how we processes RAC requests and other audits (on behalf of our health system clients), which will be detailed in our RFP response documentation. This includes us utilizing Compliance Hold functionality in our workflow, 11

12 47 allowing the client health system to conduct a final review of documentation (before it is processed and released to the RAC), we deliver requests electronically to the RAC, via the CMS esmd gateway, etc. However, there are multiple aspects of the UKHealthCare specifications listed that are contrary to our standard processes and workflows or that require additional details, so that we can better understand UKHealthCare s expectations/requirements. What additional details concerning UKHealthCare Policy & Procedures and vendor service-delivery expectations can be shared, so that we can better evaluate and determine specification acceptance? Offeror will be required to comply with Health Insurance Portability and Accountability Act of 1996 (HIPAA). University of Kentucky master HIPAA/BAA agreement, Appendix A, and will become an integral part of any agreement. We are unclear if we need to sign the UK Health BAA now or will this be vetted, as part of the vendor selection final process, when a decision by UK Health is made? You can sign it and return it with the RFP response or if there are issues they can be negotiated at the time of a contract award. This is so you are aware you must comply with HIPAA. 12

Written Questions and Answers

Written Questions and Answers Healthcare Consulting Services RFP UK-1857-18 Questions and Answers Issue Date: 05/15/18 RFP Closing Date: 05/30/2018 No. Question Answer 1 We are a solid organ transplant