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Deliverable Number
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Commodity/Service Type
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Major Deliverable
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Method of Payment
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1
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Economic or financial evaluation of projects
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Phase 1
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Fixed Price - Lump Sum
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| Major Deliverable: Phase 1 |
| Deliverable Price: $25,000.00 |
| Non Price Justification: |
| Performance Metrics: Completed within 90 days or less from the date of contract execution |
| Financial Consequences: Failure to timely and accurately complete the required duties as outlined may result in a rejection of invoice |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 1 |
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10
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Economic or financial evaluation of projects
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Evaluate the CMS claim and perform final reconciliatiion of amounts due to or from CMS under contrac...
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Fixed Fee / Unit Rate
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| Major Deliverable: Evaluate the CMS claim and perform final reconciliatiion of amounts due to or from CMS under contract number H5729 |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Written report every thirty (30) days from the date Phase II is triggered or upon satisfactory completion of work to be performed |
| Financial Consequences: Written report every thirty (30) days from the date Phase II is triggered or upon satisfactory completion of work to be performed |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 10 |
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11
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Economic or financial evaluation of projects
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Report and recommendation regarding the amount of money due to or from CMS
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Fixed Fee / Unit Rate
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| Major Deliverable: Report and recommendation regarding the amount of money due to or from CMS |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Written report every thirty (30) days from the date Phase II is triggered or upon satisfactory completion of work to be performed |
| Financial Consequences: Written report every thirty (30) days from the date Phase II is triggered or upon satisfactory completion of work to be performed |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 11 |
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2
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Economic or financial evaluation of projects
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Review contract between MDMC and CMS
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Fixed Price - Lump Sum
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| Major Deliverable: Review contract between MDMC and CMS |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Completed within 90 days or less from the date of contract execution |
| Financial Consequences: Failure to timely and accurately complete the required duties as outlined may result in a rejection of invoice. |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 2 |
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3
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Economic or financial evaluation of projects
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Review claims submitted by CMS as final reconciliation of contract H5729
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Fixed Price - Lump Sum
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| Major Deliverable: Review claims submitted by CMS as final reconciliation of contract H5729 |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Completed within 90 days or less from the date of contract execution |
| Financial Consequences: Failure to timely and accurately complete the required duties as outlined may result in a rejection of invoice |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 3 |
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4
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Economic or financial evaluation of projects
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Request data/information from CMS, Med3000, MedImpact or other company that may have data to reconci...
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Fixed Price - Lump Sum
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| Major Deliverable: Request data/information from CMS, Med3000, MedImpact or other company that may have data to reconcile amounts from CMS |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Completed within 90 days or less from the date of contract execution |
| Financial Consequences: Failure to timely and accurately complete the required duties as outlined may result in a rejection of invoice. |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 4 |
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5
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Economic or financial evaluation of projects
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Request data/information from CMS, Med3000, MedImpact or other company that may have data to reconci...
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Fixed Price - Lump Sum
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| Major Deliverable: Request data/information from CMS, Med3000, MedImpact or other company that may have data to reconcile amounts from CMS |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Completed within 90 days or less from the date of contract execution |
| Financial Consequences: Failure to timely and accurately complete the required duties as outlined may result in a rejection of invoice . |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 5 |
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6
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Economic or financial evaluation of projects
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Major Deliverable: Review and analyze data/information from other sources
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Fixed Price - Lump Sum
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| Major Deliverable: Major Deliverable: Review and analyze data/information from other sources |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Completed within 90 days or less from the date of contract execution |
| Financial Consequences: Failure to timely and accurately complete the required duties as outlined may result in a rejection of invoice |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 6 |
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7
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Economic or financial evaluation of projects
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Prepare a report and recommendation regarding evaluation and/or settlement options based on availabl...
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Fixed Price - Lump Sum
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| Major Deliverable: Prepare a report and recommendation regarding evaluation and/or settlement options based on available data; |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Completed within 90 days or less from the date of contract execution |
| Financial Consequences: Failure to timely and accurately complete the required duties as outlined may result in a rejection of invoice |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 7 |
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8
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Economic or financial evaluation of projects
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Provide a timeline and cost estimate for the completion of Phase II, if triggered
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Fixed Price - Lump Sum
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| Major Deliverable: Provide a timeline and cost estimate for the completion of Phase II, if triggered |
| Deliverable Price: $0.00 |
| Non Price Justification: Rate Agreement |
| Performance Metrics: Completed within 90 days or less from the date of contract execution |
| Financial Consequences: Failure to timely and accurately complete the required duties as outlined may result in a rejection of invoice |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 8 |
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9
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Economic or financial evaluation of projects
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Phase II: Written report every thirty days from date Phase II is triggered
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Fixed Fee / Unit Rate
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| Major Deliverable: Phase II: Written report every thirty days from date Phase II is triggered |
| Deliverable Price: $50,000.00 |
| Non Price Justification: |
| Performance Metrics: Written report every thirty (30) days from the date Phase II is triggered or upon satisfactory completion of work to be performed |
| Financial Consequences: 15% "Holdback Amount" from the Provider in Phase II for non-performance |
| Source Documentation Page Reference: Pg 3 of 13 |
| Deliverable Number: 9 |
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