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Proposal Certification (RFP 4.2.4)




BIDDERS – SIGN AND SUBMIT CERTIFICATION WITH PROPOSAL.
I certify that I have the authority to bind the bidder indicated below to the specific terms, conditions and technical specifications required in the Department’s Request for Proposals (RFP) and offered in the bidder’s proposal. I understand that by submitting this bid proposal, the bidder indicated below agrees to provide Medicaid Management Information System (MMIS) and Fiscal Agent Procurement Support services which meet or exceed the requirements of the Department’s RFP unless noted in the bid proposal and at the prices quoted by the bidder.
I certify that the contents of the bid proposal are true and accurate and that the bidder has not made any knowingly false statements in the bid proposal.


January 6, 2006

Signature Date



Desh Ahuja Executive Vice President

Name Title



FOX Systems, Inc.

Name of Bidder Organization



This page intentionally left blank.

Organizational Information and Past Performance (RFP 4.2.5)


In this Section we describe the organizational structure and history of FOX. We have included descriptions of previous projects with similar work requirements and have provided appropriate references.

Legal Structure (RFP 4.2.5.1)


Disclose the legal structure of your organization and the state in which the organization is registered.
FOX is an S-corporation that was incorporated in California in March, 1987.

Organizational History (RFP 4.2.5.2)


Describe the history of your organization.
FOX is a recognized leader in management consulting, data analysis and reporting, business process improvement, and strategic systems planning. FOX is one of the nation’s premier HIPAA consultants, offering the expertise, vision, leadership, and compliance support to help organizations comply with Federal requirements and improve their business operations. Using proven methodologies, we are able help them automate business solutions, increase organizational efficiency and effectiveness, achieve significant competitive advantages, and increase their bottom line. We understand the healthcare business, and provide practical solutions to real-life business problems.
Incorporated in 1987 by Dr. Susan J. Fox, we are a woman and minority-owned firm, established specifically to serve the public sector. We maintain our corporate headquarters in Scottsdale, Arizona and project offices in Los Angeles, California; Baltimore, Maryland; Santa Fe, New Mexico; Salem, Oregon; Nashville, Tennessee; Anchorage, Alaska; Jackson, Mississippi; Concord, New Hampshire; and Tallahassee, Florida. In addition, FOX operates a national call center in Fargo, North Dakota to provide services as the NPI Enumerator contractor for CMS.
FOX has worked with a wide range of public and private sector clients, from large government agencies to small private sector health care providers. Our consultants come from every area of the health care industry offering a full range of specialized knowledge and skills: HIPAA, managed care, business analysis, systems design, training and documentation, operations research, and clinical. We offer the following core competencies:


  • Knowledge and experience with HIPAA requirements

  • Proven HIPAA assessment methodologies and supporting tools

  • HIPAA remediation support and project management

  • Legacy of Medicaid and managed care knowledge and experience

  • Business process re-engineering

  • Feasibility studies and development and evaluation of alternative strategies and processes

  • Cost-benefit analysis based on industry trends and relevant technology

  • Experience in such areas as claims processing, prior authorization, eligibility verification and information management

  • System procurement support to large county and state agencies

Specifically, our consulting services are focused in these areas:


HIPAA Compliance Solutions

  • Awareness education and training

  • Gap analysis and strategy development

  • Compliance execution and monitoring

  • Post-compliance assurance


Strategic Systems Planning

  • Information system strategies

  • Analysis of system requirements and specifications

  • Facilitation of Joint Application Design (JAD) sessions

  • Systems procurement support – RFP development, proposal evaluation

  • Independent verification and validation (IV&V)


Management Consulting and Strategic Planning

  • Strategic systems planning

  • Program development and evaluation

  • Facilitation

  • Feasibility studies

  • Cost-benefit analysis


Business Process Improvement

  • Operational assessment and review

  • Operational improvement and process redesign

Organizational Structure (RFP 4.2.5.3)


Provide a table of the structure of your organization, including the names and credentials of the owners and executives.


Date Established

March 1987

Incorporated in California



Primary Customers


Public Sector

State Medicaid agencies, public health departments, and other federal, state, and local health and social service agencies


Private Sector

Health plans, physicians groups, hospitals, health care purchasers, and other Managed Care Organizations (MCOs)



Business Locations

Corporate Headquarters

6263 N. Scottsdale Rd., Suite 200

Scottsdale, Arizona 85250

480-423-8184 (voice)

480-423-8108 (fax)
NPI Enumerator Call Center

Fargo, North Dakota



Project Office Locations

Anchorage, Alaska; Los Angeles, California; Baltimore, Maryland; Santa Fe, New Mexico; Salem, Oregon; Nashville, Tennessee; Jackson, Mississippi; Concord, New Hampshire; Tallahassee, Florida

Ownership

Privately Held

Staff Size

Over 100 full time staff and consultants. FOX also employs additional associate consultants as required for extended contracts.

Computer Resources

Novell 5.0 LAN in Scottsdale based on Compaq Proliant 1600 servers operating under Windows NT. We host our own Web site at www.foxsys.com.

Names and Credentials of Owners and Executives


Susan Fox

Susan Fox is the founder and Chair of the Board of FOX. She has over 25 years of experience assisting public and private health care programs, and is a nationally known Medicaid expert who has worked with over 30 states. She currently supports the CMS Medicaid Information Technology Architecture project and FOX projects in several states. Her expertise includes business process re-engineering, upgrading information systems, expanding and integrating programs, and development of products for utilization management and information reporting. In addition, Dr. Fox has strong qualifications in the design of Medicaid Management Information Systems (MMIS), cost containment strategies, reimbursement models, managed care alternatives, and the use of technology in the health care industry. Dr. Fox has provided oversight and technical assistance to FOX HIPAA assessment project teams in many states. Dr. Fox is a frequent speaker at national health care administration conferences, has authored and edited numerous white papers on health care technology, and is a member of the Private Sector Technology Group, advisory to CMS. She has participated in the installation of MMIS Systems in over 20 states as well as in commercial health care settings. Dr. Fox has served as Client Executive on FOX’ IV&V projects, and has participated in many Joint Application Designs (JAD) sessions to define MMIS, decision support, and managed care reporting requirements. Dr. Fox earned a B.A., M.A., and Ph.D. from the University of California, Berkeley, and has completed coursework towards an MPA in Health Care Administration from the University of Southern California.


Mark Shishida

Mark Shishida is the Chief Executive Officer of FOX and has 28 years of healthcare operations and consulting experience. He has led many systems design, development, and implementation projects for FOX, and has extensive operational experience and knowledge of managed care, Medicaid, Medicare, third-party billing, welfare, and social service programs. Mr. Shishida has provided consultation to state agencies for the acquisition of Medicaid Management Information Systems (MMIS) and Fiscal Agent operations contracts, has developed APDs and MMIS Fiscal Agent RFPs, and has led proposal evaluation and contract negotiation efforts. Furthermore, he has performed IV&V services for the development of a new MMIS, provided consultation in the review of MMIS/FA requirements and needs, and developed an APD and RFP for either replacement MMIS or a takeover of current systems with significant enhancements. He is the former Assistant Chief of Program Integrity for the Illinois Department of Public Aid. He has a BA from the University of Illinois–Chicago, and is a member of the American Public Human Services Association (APHSA) and the, National Association of SURS Officials (NASO).



Desh Ahuja

Desh Ahuja is the Executive Vice President of FOX, and has over 25 years of operations and project management experience in designing, developing, implementing, managing and operating large-scale management information systems in health care and public welfare organizations. Mr. Ahuja has helped 12 public and private sector health care organizations to develop IS and IT strategies, procure and install system solutions, and manage and operate their programs. He is the former Director of Information Systems for the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid Program, where he led the development, implementation, and operation of the Prepaid Medicaid Management Information System (PMMIS) and the Arizona Long Term Care System (ALTCS). He was responsible for building the MMIS department from the start of the program and also for maintaining and enhancing the MMIS and all EDP operations. As System Development Director for McAuto Systems Group, Inc., Mr. Ahuja headed the Systems Development Group of the Management Information System for the McAuto Medicaid fiscal agent contract in Arizona. For National Benefit Life Insurance Company, he served as the Project Manager and conducted a complete design review of the new Group Claims Processing System. Mr. Ahuja also served as Project Manager for Bradford National Corporation, where he managed the Part B Medicare Claims Processing and Payment System for multiple National Carriers such as Aetna and Blue Cross Blue Shield of Minnesota. Mr. Ahuja has a B.S. in Mathematics and Chemical Engineering from Punjab University in India, and has completed graduate work towards an MBA from the Graduate School of Business Administration at New York University.


William F. Larkin, Jr.

William (Bill) Larkin is the Vice President of Business Development. He has over 27 years of extensive senior operations and project management experience in the design, development, and implementation of large Medicaid Management Information System and other healthcare information systems. He is currently the Vice President of Business Development for FOX, and as a member of the FOX team, has managed successful MMIS, HIPAA, and requirements analysis projects for the states of Oregon and Tennessee. As the former President of the HealthNet Data Link (HDL), a healthcare information technology company, he managed the Electronic Data Interchange, Managed Care Information Systems and Services, and Resource Data Information lines of business, and established principal business strategies that doubled HDL’s revenue. He also organized business marketing and sales initiatives to support large IT and QA contracts in government and large healthcare payer organizations. Mr. Larkin implemented a key healthcare eCommerce strategy with Internet directory services for the Blue Cross Blue Shield Association and achieved NCQA accreditation for HDL. Furthermore, Mr. Larkin held the position of Claims Operation and Provider Relations Manager for System Development Corporation (now Unisys) and he was the Operations Manager for the State of Florida where he was responsible for the testing, installation, and operation of a large claims processing system. He also served as the Project Manager to implement Medicare Part B systems, and was heavily involved in the requirements definition, development, and operations phases of this project. He is a graduate of The Ohio State University in Columbus, Ohio, where he earned a BA in History. He is a member of the American Association of Health Plans, the Medicaid Private Sector Technical Advisory Group, and the IPA Association of America.


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