VA Awards $88.2M Contract for Healthcare Claims Processing to Signature Choice, LLC

Contract Overview

Contract Amount: $88,196,545 ($88.2M)

Contractor: Signature Choice, LLC

Awarding Agency: Department of Veterans Affairs

Start Date: 2020-09-14

End Date: 2021-09-13

Contract Duration: 364 days

Daily Burn Rate: $242.3K/day

Competition Type: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Pricing Type: FIRM FIXED PRICE

Sector: Healthcare

Official Description: NON-VA COMMUNITY HEALTHCARE CLAIMS PROCESSING&PROVIDER CUSTOMER SERVICE CONTACT CENTER

Place of Performance

Location: WOODBRIDGE, PRINCE WILLIAM County, VIRGINIA, 22193

State: Virginia Government Spending

Plain-Language Summary

Department of Veterans Affairs obligated $88.2 million to SIGNATURE CHOICE, LLC for work described as: NON-VA COMMUNITY HEALTHCARE CLAIMS PROCESSING&PROVIDER CUSTOMER SERVICE CONTACT CENTER Key points: 1. Contract awarded to Signature Choice, LLC for $88.2M. 2. The contract is for non-VA community healthcare claims processing and provider customer service. 3. Competition was full and open after exclusion of sources. 4. The sector is primarily Healthcare services and IT support for claims processing.

Value Assessment

Rating: good

The contract's firm fixed price structure suggests a clear understanding of costs. Benchmarking against similar claims processing contracts would provide further insight into its value.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

The 'full and open competition after exclusion of sources' indicates a competitive bidding process was utilized. This method generally promotes price discovery and ensures fair market value.

Taxpayer Impact: The competitive nature of the award suggests taxpayers are likely receiving a fair price for the services rendered.

Public Impact

Veterans will benefit from efficient processing of their healthcare claims. Improved customer service for providers is expected, potentially leading to better network participation. The contract supports the VA's mission to provide healthcare to veterans.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Positive Signals

Full and open competition utilized.
Firm fixed price contract type.

Sector Analysis

This contract falls within the Healthcare sector, specifically focusing on third-party administration of insurance claims. Spending in this area is substantial across government and private sectors, driven by the complexity of healthcare regulations and billing.

Small Business Impact

The data does not indicate if small businesses were involved in this specific award. Further analysis would be needed to determine the extent of small business participation.

Oversight & Accountability

The Department of Veterans Affairs is responsible for oversight of this contract. Standard procurement regulations and performance monitoring should ensure accountability.

Related Government Programs

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds
Department of Veterans Affairs Contracting
Department of Veterans Affairs Programs

Risk Flags

Contract duration is one year, potentially requiring re-competition soon.
Specific performance metrics and quality assurance details are not provided.
Potential for vendor lock-in if not managed proactively.

Frequently Asked Questions

What is this federal contract paying for?

Department of Veterans Affairs awarded $88.2 million to SIGNATURE CHOICE, LLC. NON-VA COMMUNITY HEALTHCARE CLAIMS PROCESSING&PROVIDER CUSTOMER SERVICE CONTACT CENTER

Who is the contractor on this award?

The obligated recipient is SIGNATURE CHOICE, LLC.

Which agency awarded this contract?

Awarding agency: Department of Veterans Affairs (Department of Veterans Affairs).

What is the total obligated amount?

The obligated amount is $88.2 million.

What is the period of performance?

Start: 2020-09-14. End: 2021-09-13.

What is the benchmark cost for similar healthcare claims processing services?

Benchmarking similar healthcare claims processing services requires access to a broader dataset of contracts. Factors like claim volume, complexity, and specific services offered (e.g., provider support, appeals) significantly influence pricing. Without this comparative data, it's difficult to definitively assess if $88.2 million represents a competitive price point, though the firm fixed price and full and open competition are positive indicators.

What are the key performance indicators (KPIs) for this contract and how is performance being measured?

Key performance indicators for this contract likely include metrics such as claims processing time, accuracy rates, provider satisfaction, and customer service response times. The VA's oversight would involve regular performance reviews against these KPIs. Effective monitoring ensures the contractor meets service level agreements and delivers value, mitigating risks associated with service delivery and operational efficiency.

Are there any potential risks associated with relying on a single vendor for this critical function?

While this award was made under full and open competition, reliance on a single vendor for critical functions like claims processing carries inherent risks. These include potential vendor lock-in, reduced leverage in future negotiations, and the impact of any service disruptions caused by the vendor. The VA should maintain contingency plans and monitor vendor performance closely to mitigate these risks.

Industry Classification

NAICS: Finance and Insurance › Agencies, Brokerages, and Other Insurance Related Activities › Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Product/Service Code: SUPPORT SVCS (PROF, ADMIN, MGMT) › PROFESSIONAL SERVICES

Competition & Pricing

Extent Competed: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Solicitation Procedures: NEGOTIATED PROPOSAL/QUOTE

Pricing Type: FIRM FIXED PRICE (J)

Evaluated Preference: NONE

Contractor Details

Address: 5272 GUNSTON HALL DR, WOODBRIDGE, VA, 22193

Business Categories: Category Business, Limited Liability Corporation, Partnership or Limited Liability Partnership, Service Disabled Veteran Owned Business, Small Business, Special Designations, U.S.-Owned Business, Veteran Owned Business

Financial Breakdown

Contract Ceiling: $88,196,545

Exercised Options: $88,196,545

Current Obligation: $88,196,545

Contract Characteristics

Commercial Item: COMMERCIAL ITEM

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: 36C79119D0007

IDV Type: IDC

Timeline