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Claims DDE Implementation Price



Instructions: Provide prices for all components of the implementation. Vendor can rename, delete, and

add components as needed, but the prices must be fully itemized and address all of its activities and

expenses, including any development needed to satisfy DMAS requirments.







Component Price Comments

Requirements and design

Coding

Customization

Internal testing

Integrated testing

User testing

Provider testing

Vendor-defined-1

Vendor-defined-2

Vendor-defined-3

Vendor-defined-n



Total Implementation $ -

Claims DDE Operations Price



Instructions: Provide a transaction and maintenance price for claims submission as well as a

volume based subscription fee that includes maintenance. The subscription fee will not be

included in the price evaluation. Vendor must provide a base price for each year. Vendor has the

option of providing multiple thresholds and associated prices. The respective thresholds are the

monthly volume levels that the optional price takes effect. Specify as many thresholds as desired.

It is assumed the threshold price is used when the threshold level is met or exceeded (i.e., greater

than or equal to). Operations price will be evaluated based on the Base Price using a monthly

volume of 75,000 claims. Option year prices will not be considered in the price evaluation. Vendor

will be reimbursed retrospectively using actual volumes for the month being paid. Provide any

applicable fixed monthly maintenance fee. Also, Vendor should provide the fees to be used if the

Vendor is asked to bill providers for the fees. This price will not be included in the price

evaluation.









Base Threshold(s) Threshold(s)

Tx/

Subscription

Price Level Tx Price



Operations Year 1

Subscription Fee

Transaction Fee

Maintenance Fee

Transaction Fee with Provider Billing



Operations Year 2

Subscription Fee

Transaction Fee

Maintenance Fee

Transaction Fee with Provider Billing



Option Year 1

Subscription Fee

Transaction Fee

Maintenance Fee

Transaction Fee with Provider Billing



Option Year 2

Subscription Fee

Transaction Fee

Maintenance Fee

Transaction Fee with Provider Billing



Option Year 3

Subscription Fee

Transaction Fee

Maintenance Fee

Transaction Fee with Provider Billing



Option Year 4

Subscription Fee

Transaction Fee

Maintenance Fee

Transaction Fee with Provider Billing

Claims DDE Additional Services Price



Instructions: Provide information and prices for additional services that the Vendor may provide at DMAS' request as part of the contract. Services

identified below are provided solely as examples. Vendor should identify any services it thinks may be needed by DMAS in direct support of the Claims

DDE contract. Price should be specified as an hourly rate. Note that the Implementation Price must address all implementation activities. Provide an

explanation of the service and the circumstances under which it may be needed. These prices will not be considered in the price evaluation.







Operations Operations Option Option Option Option

Service Year 1 Year 2 Year 1 Year 2 Year 3 Year 4 Description

Analysis

Development

Documentation

Consulting

Service-1

Service-2

Service-n



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