Field Source Medical Evidence of Record (MER) RFP
- Issue Date:
The Office of Temporary and Disability Assistance (“OTDA”) will receive bids from qualified firms (the “Offerors”), pursuant to the provision of Article XI of New York State Finance Law, with the intent to enter into a contract with one vendor to extract, scan and electronically deliver medical records from specified medical and educational facilities in New York State.
OTDA’s Division of Disability Determinations (DDD) adjudicates claims for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) under an agreement with the Social Security Administration. OTDA, which has Processing Centers in Albany, Buffalo, Endicott and Manhattan, has processed claims filed by New York State residents since the program's inception in 1956.
As part of OTDA's adjudicative process, disability analysts obtain medical evidence from claimants' treating sources. Frequently, the treating source evidence needed is incorporated in the claimants’ medical record from a hospital or clinic. Only a portion of the medical record containing specific information is required to assist OTDA staff in making a determination of disability under federal guidelines.
DDD currently has arrangements with a significant number of medical and educational facilities to have contractor representatives image pertinent medical records and electronically return the information to the disability analyst responsible for the case. These arrangements are necessary to assure the acquisition of proper medical records in a timely fashion so that Social Security Disability claimants are given a thorough and fair review.
OTDA is requesting offers from qualified contractors to abstract and electronically (TIFF 4 format) capture, in an unalterable format, medical records from specified medical and educational facilities throughout New York State. This contracted service will replace a contract that is due to expire. The administrative office of the contractor must be within New York State.
- MER RFP (PDF)
- MER RFP (DOC)
- Appendix A
- Appendix B
- Appendix D
- Appendix F
- Appendix G
- Appendix I
- Appendix J
- Appendix K
- Appendix L
- Appendix M
- Appendix P
- Appendix R
- Appendix U
- Appendix X
- Appendix Y
- Appendix Z
- MacBride Fair Employment Principle
- Non-Collusive Bidding Certification
- Offeror’s ID Form
- Vendor Responsibility Questionnaire
- Offeror Disclosure of Non-Responsibility Determinations
- Offeror’s Certification and Affirmation of Understanding
- Certification of Drug-Free Workplace Requirements
- Security, Nondisclosure, Confidentiality and Press Release Agreement
- Supplier Identification Form
- Consultant Disclosure Reporting Requirements
- Iran Divestment Certification
- ST-220CA Sales and Compensation Use Tax Certification
- ST-220TD Contractor Certification
- OTDA-4934-Proposer’s EEO Staffing Plan
- OTDA-4969-MWBE Waiver Request Form (If applicable)
- OTDA-4970-MWBE EEO Policy Statement
- OTDA-4971-MWBE EEO Workforce Employment Utilization Report
- OTDA-4976-MWBE Certification of Good Faith Efforts
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