DoD's $19.3M Medical Coding Contract Awarded to Decypher Health Services for Physician Offices
Contract Overview
Contract Amount: $19,364,520 ($19.4M)
Contractor: Decypher Health Services, LLC
Awarding Agency: Department of Defense
Start Date: 2024-09-30
End Date: 2026-09-29
Contract Duration: 729 days
Daily Burn Rate: $26.6K/day
Competition Type: FULL AND OPEN COMPETITION
Number of Offers Received: 7
Pricing Type: FIRM FIXED PRICE
Sector: Healthcare
Official Description: DHA ENTERPRISE-WIDE MEDICAL CODING BACKLOG, WEST REGION.
Place of Performance
Location: SAN ANTONIO, BEXAR County, TEXAS, 78216
State: Texas Government Spending
Plain-Language Summary
Department of Defense obligated $19.4 million to DECYPHER HEALTH SERVICES, LLC for work described as: DHA ENTERPRISE-WIDE MEDICAL CODING BACKLOG, WEST REGION. Key points: 1. The contract addresses a significant medical coding backlog within the Defense Health Agency's West Region. 2. Decypher Health Services, LLC, based in Texas, secured the award. 3. The contract value is $19,364,520.31 with a duration of 729 days. 4. This award falls under the Offices of Physicians (except Mental Health Specialists) NAICS code. 5. The contract was awarded using full and open competition.
Value Assessment
Rating: good
The contract value of $19.3M for a 2-year period appears reasonable for enterprise-wide medical coding services, especially considering the backlog it aims to clear. Benchmarking against similar large-scale coding contracts would provide further validation.
Cost Per Unit: N/A
Competition Analysis
Competition Level: full-and-open
The use of full and open competition suggests a robust process for soliciting bids and ensuring fair pricing. This method typically leads to better price discovery and value for the government.
Taxpayer Impact: The competitive award process is expected to yield a fair price, minimizing unnecessary taxpayer expenditure while addressing a critical healthcare need.
Public Impact
Ensures timely and accurate medical coding, crucial for patient care and billing within the military healthcare system. Supports the operational efficiency of the Defense Health Agency by reducing administrative backlogs. Potentially improves revenue cycle management for military medical facilities. Provides essential services that indirectly impact the health and readiness of service members and their families.
Waste & Efficiency Indicators
Waste Risk Score: 50 / 10
Warning Flags
- Potential for scope creep if the backlog is larger than anticipated.
- Dependence on a single vendor for critical coding services.
- Risk of data security breaches with sensitive patient information.
Positive Signals
- Addresses a clear and stated need for backlog reduction.
- Awarded through full and open competition, indicating a competitive process.
- Firm fixed price contract provides cost certainty.
Sector Analysis
This contract falls within the professional services sector, specifically supporting healthcare administration. Spending benchmarks for similar medical coding and billing services contracts can vary widely based on scope and duration, but this award appears substantial for an enterprise-wide solution.
Small Business Impact
The data indicates that the awardee, Decypher Health Services, LLC, is not a small business (ss: false, sb: false). Therefore, this contract does not appear to directly support small business set-asides or subcontracting goals.
Oversight & Accountability
The contract is managed by the Defense Health Agency, a component of the Department of Defense, which has established oversight mechanisms for its contracts. The firm fixed price structure provides some level of cost control.
Related Government Programs
- Offices of Physicians (except Mental Health Specialists)
- Department of Defense Contracting
- Defense Health Agency Programs
Risk Flags
- Potential for backlog underestimation.
- Vendor lock-in risk due to specialized services.
- Data security and privacy concerns with Protected Health Information (PHI).
- Reliance on vendor's staffing and expertise to meet demand.
Tags
offices-of-physicians-except-mental-heal, department-of-defense, tx, delivery-order, 10m-plus
Frequently Asked Questions
What is this federal contract paying for?
Department of Defense awarded $19.4 million to DECYPHER HEALTH SERVICES, LLC. DHA ENTERPRISE-WIDE MEDICAL CODING BACKLOG, WEST REGION.
Who is the contractor on this award?
The obligated recipient is DECYPHER HEALTH SERVICES, LLC.
Which agency awarded this contract?
Awarding agency: Department of Defense (Defense Health Agency).
What is the total obligated amount?
The obligated amount is $19.4 million.
What is the period of performance?
Start: 2024-09-30. End: 2026-09-29.
What is the historical accuracy rate of medical coding provided by Decypher Health Services, and how will this be monitored?
The historical accuracy rate of Decypher Health Services' medical coding is a critical performance metric. The contract should include specific quality assurance clauses and performance standards, such as a target accuracy rate (e.g., 95% or higher) and a defined process for monitoring, reporting, and addressing any coding errors. Regular audits and reviews by the DHA will be essential to ensure compliance and maintain high-quality coding.
What are the specific risks associated with the 729-day duration and the potential for unforeseen complexities in the medical coding backlog?
A 729-day duration presents risks related to potential changes in healthcare regulations, coding standards (e.g., ICD-10 updates), and evolving technology during the contract period. Unforeseen complexities in the backlog could lead to scope creep, potentially exceeding the contract's budget or timeline if not managed proactively. Robust change management and contingency planning within the contract are crucial to mitigate these risks.
How effectively will this contract contribute to the overall efficiency and financial health of the Defense Health Agency's medical facilities?
This contract's effectiveness hinges on its ability to significantly reduce the medical coding backlog, thereby improving the accuracy and timeliness of claims processing. Successful execution should lead to more efficient revenue cycles, reduced claim denials, and better financial forecasting for DHA facilities. Continuous monitoring of key performance indicators related to backlog reduction and coding accuracy will be vital to assess its overall contribution.
Industry Classification
NAICS: Health Care and Social Assistance › Offices of Physicians › Offices of Physicians (except Mental Health Specialists)
Product/Service Code: MEDICAL SERVICES › GENERAL HEALTH CARE SERVICES
Competition & Pricing
Extent Competed: FULL AND OPEN COMPETITION
Solicitation Procedures: SUBJECT TO MULTIPLE AWARD FAIR OPPORTUNITY
Solicitation ID: HT001523R0004
Offers Received: 7
Pricing Type: FIRM FIXED PRICE (J)
Evaluated Preference: NONE
Contractor Details
Address: 200 CONCORD PLAZA DRIVE, SAN ANTONIO, TX, 78216
Business Categories: Category Business, Corporate Entity Not Tax Exempt, Not Designated a Small Business, Special Designations, U.S.-Owned Business
Financial Breakdown
Contract Ceiling: $19,374,761
Exercised Options: $19,374,761
Current Obligation: $19,364,520
Contract Characteristics
Commercial Item: COMMERCIAL PRODUCTS/SERVICES
Cost or Pricing Data: NO
Parent Contract
Parent Award PIID: HT001524D9001
IDV Type: IDC
Timeline
Start Date: 2024-09-30
Current End Date: 2026-09-29
Potential End Date: 2026-09-29 00:00:00
Last Modified: 2026-01-02
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