VA awards $10M contract for outpatient medical billing services to Receivia, Inc

Contract Overview

Contract Amount: $10,094,176 ($10.1M)

Contractor: Receivia, Inc.

Awarding Agency: Department of Veterans Affairs

Start Date: 2025-04-01

End Date: 2026-04-30

Contract Duration: 394 days

Daily Burn Rate: $25.6K/day

Competition Type: FULL AND OPEN COMPETITION AFTER EXCLUSION OF SOURCES

Pricing Type: FIRM FIXED PRICE

Sector: Healthcare

Official Description: 3RD PARTY UOTPATIENT MEDICAL BILLING SERVICES

Place of Performance

Location: COLORADO SPRINGS, EL PASO County, COLORADO, 80920

State: Colorado Government Spending

Plain-Language Summary

Department of Veterans Affairs obligated $10.1 million to RECEIVIA, INC. for work described as: 3RD PARTY UOTPATIENT MEDICAL BILLING SERVICES Key points: 1. Contract value appears reasonable for the scope of outpatient medical billing services. 2. Full and open competition was utilized, suggesting a competitive bidding process. 3. The contract is a delivery order under a larger contract, indicating potential for follow-on work. 4. The fixed-price nature of the contract shifts performance risk to the contractor. 5. The contractor, Receivia, Inc., has a track record with the VA. 6. The North American Industry Classification System (NAICS) code 541219 points to accounting services, which aligns with billing functions.

Value Assessment

Rating: good

The contract value of approximately $10 million for 13 months of outpatient medical billing services seems within a reasonable range for the federal government. Benchmarking against similar contracts for medical billing services would provide a more precise value-for-money assessment. The firm fixed-price structure is generally favorable for the government as it caps costs. However, without specific details on the volume of services or complexity, a definitive value assessment is challenging.

Cost Per Unit: N/A

Competition Analysis

Competition Level: full-and-open

This contract was awarded under 'Full and Open Competition After Exclusion of Sources,' which suggests that while the initial solicitation may have had some restrictions, the final award was made after a broad competitive process. The specific number of bidders is not provided, but the designation implies that multiple responsible sources were considered. This level of competition is generally expected to drive competitive pricing.

Taxpayer Impact: The use of full and open competition is beneficial for taxpayers as it increases the likelihood of obtaining services at the most favorable prices through a robust bidding process.

Public Impact

Veterans will benefit from efficient and accurate outpatient medical billing processes. The contract ensures the continuity of essential administrative services for VA healthcare facilities. The services are likely to be delivered across various VA facilities, potentially nationwide, supporting the VA's mission. The contract supports jobs within the healthcare administrative and billing sector.

Waste & Efficiency Indicators

Waste Risk Score: 50 / 10

Warning Flags

Potential for scope creep if not clearly defined in the base contract.
Reliance on a single contractor for critical billing functions could pose a risk if performance falters.
Ensuring data security and privacy for sensitive patient billing information is paramount.

Positive Signals

The firm fixed-price contract incentivizes contractor efficiency and cost control.
The use of full and open competition suggests a competitive market for these services.
The contract is a delivery order, indicating it's part of a pre-established framework, potentially streamlining execution.

Sector Analysis

The healthcare administrative services sector is a significant component of the broader healthcare industry. This contract falls under the 'Other Accounting Services' NAICS code (541219), which encompasses a range of financial and billing support functions. The federal government is a major consumer of such services to manage its vast healthcare operations, including those for the Department of Veterans Affairs. Comparable spending benchmarks would involve analyzing other large-scale medical billing contracts awarded by federal agencies.

Small Business Impact

The data indicates that this contract was not specifically set aside for small businesses (ss: false, sb: false). Therefore, the primary contractor, Receivia, Inc., is likely a larger entity. There is no explicit information regarding subcontracting plans for small businesses. The absence of a small business set-aside means that opportunities for small business participation may be limited unless voluntarily pursued by the prime contractor.

Oversight & Accountability

Oversight for this contract will likely be managed by the Department of Veterans Affairs contracting officers and program managers. Accountability measures are typically embedded within the contract terms, including performance standards, delivery schedules, and payment clauses. Transparency is facilitated through contract databases like FPDS. Inspector General jurisdiction would apply if any fraud, waste, or abuse is suspected.

Related Government Programs

VA Electronic Health Record (EHR) Modernization
Federal Health IT Services
Medical Claims Processing Services
Government Healthcare Administration Contracts

Risk Flags

Potential for performance issues
Data security and privacy concerns
Limited small business participation

Frequently Asked Questions

What is this federal contract paying for?

Department of Veterans Affairs awarded $10.1 million to RECEIVIA, INC.. 3RD PARTY UOTPATIENT MEDICAL BILLING SERVICES

Who is the contractor on this award?

The obligated recipient is RECEIVIA, INC..

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 $10.1 million.

What is the period of performance?

Start: 2025-04-01. End: 2026-04-30.

What is Receivia, Inc.'s track record with the Department of Veterans Affairs and other federal agencies?

Receivia, Inc. has a history of receiving contracts from the Department of Veterans Affairs. The provided data indicates this is a delivery order, suggesting a pre-existing relationship or contract vehicle. Further investigation into federal procurement databases would reveal the full scope and value of their past awards, including performance history, any past performance issues, and their experience with similar medical billing services. Understanding their prior performance with the VA is crucial for assessing their capability to successfully execute this new contract, particularly concerning timeliness, quality, and adherence to VA regulations.

How does the $10 million contract value compare to similar federal contracts for outpatient medical billing services?

The $10 million contract value for 13 months of outpatient medical billing services needs to be benchmarked against similar federal procurements to assess its value for money. Factors such as the volume of claims processed, the complexity of billing, the specific services included (e.g., coding, claims submission, denial management, patient collections), and the geographic scope of the VA facilities served will influence the cost. A comparison with contracts awarded by other agencies like HHS or DoD for comparable services, considering the period of performance and service level agreements, would provide a clearer picture of whether this pricing is competitive and reflects fair market value.

What are the primary risks associated with this contract, and how are they being mitigated?

Key risks for this contract include potential performance failures by Receivia, Inc., data security breaches of sensitive patient information, and challenges in managing the transition or integration of billing systems. Mitigation strategies likely involve robust performance monitoring by the VA, clearly defined service level agreements (SLAs), stringent data security requirements and audits, and contingency planning. The firm fixed-price nature of the contract also places financial risk on the contractor for cost overruns, incentivizing efficient performance. However, the VA must ensure adequate oversight to catch any performance deficiencies early.

How effective is the 'Full and Open Competition After Exclusion of Sources' method in ensuring competitive pricing for these services?

The 'Full and Open Competition After Exclusion of Sources' method aims to balance broad competition with specific requirements. While it starts with a broad solicitation, excluding certain sources might limit the pool of potential bidders. The effectiveness in ensuring competitive pricing depends on how many qualified bidders ultimately participate. If the exclusion criteria were too narrow or if the market for specialized medical billing services is limited, the competition might not be as robust as true 'full and open' competition. The VA should have justification for any source exclusions to ensure they were necessary and did not unduly restrict competition.

What is the historical spending pattern for outpatient medical billing services by the Department of Veterans Affairs?

Analyzing the VA's historical spending on outpatient medical billing services provides context for the current $10 million award. Understanding trends in contract values, durations, and awarded contractors over the past several years can reveal patterns of reliance on specific vendors, shifts in procurement strategies, or changes in the overall market cost. Significant increases or decreases in spending could indicate evolving needs, changes in healthcare delivery models, or adjustments in budget allocations. This historical data is essential for assessing whether the current contract represents a sustainable investment or a deviation from established spending norms.

What are the implications of this contract being a 'Delivery Order' under a larger contract?

This contract being a 'Delivery Order' (aw: DELIVERY ORDER) signifies that it is a task order issued against a previously awarded indefinite-delivery, indefinite-quantity (IDIQ) or other type of multiple-award contract. This approach allows the government to procure specific services or supplies as needed, often with pre-negotiated terms and pricing. For taxpayers, this can mean faster procurement cycles and potentially better pricing due to pre-competition or established contract vehicles. However, it also means that the overall value and scope are tied to the parent contract, and oversight must ensure that individual delivery orders remain within the original contract's intent and scope.

Industry Classification

NAICS: Professional, Scientific, and Technical Services › Accounting, Tax Preparation, Bookkeeping, and Payroll Services › Other Accounting Services

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

Parent Company: Receivia Inc.

Address: 3145 AVALON RIDGE PL STE 225, PEACHTREE CORNERS, GA, 30071

Business Categories: Category Business, Corporate Entity Not Tax Exempt, Economically Disadvantaged Women Owned Small Business, Self-Certified Small Disadvantaged Business, Small Business, Special Designations, U.S.-Owned Business, Woman Owned Business, Women Owned Small Business

Financial Breakdown

Contract Ceiling: $47,094,167

Exercised Options: $40,094,174

Current Obligation: $10,094,176

Contract Characteristics

Multi-Year Contract: Yes

Commercial Item: COMMERCIAL PRODUCTS/SERVICES

Cost or Pricing Data: NO

Parent Contract

Parent Award PIID: 36C77620D0016

IDV Type: IDC

Timeline