The Contractor shall: Provide both Medicare Part B and Part B Railroad NSV and real-time Insurance Verification Must be on the most current Part B Palmetto Network Service Vendors approved list (attached). Must be able to service the 31 Heath Districts in need of these services within VDH, which includes approximately 120 local health department locations. Each local health department has its own NPI, but is under a single VDH Tax ID number. Each district has different Medicare Part B Submitter ID and generates their own 837P claim files. A few districts also have Medicare Part B Railroad Submitter IDs and generate small and infrequent claim files Must be able to handle an estimated annual total claim volume of 10,000-12,000 claims across the districts per year. Claim volume is very cyclical, with most claims generated October-January due to influenza vaccination activities. Claim volume also varies significantly from district to district, with some districts having a 0-claim volume for several months out of the year. Requirements for NSV Function: Must be a web-based solution that does not require VDH to have/obtain additional software. Must have the ability to upload Medicare Part B and Part B Railroad claims using provider-developed 837P claim files to our Medicare contractor (currently Palmetto GBA).
