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Appendix X – Centralized Credentialing Service Level Agreement
Vendor shall achieve the following performance measures by phase:
| ID |
| Implementation Task Performance Requirements |
| Performance Area |
| Damages |
| Applicable RFP Matrix Requirement Citation |
| 1. |
| Vendor shall thoroughly test the Centralized Credentialing Solution and demonstrate proof of successful testing for 100% of the specifications presented in the contract in accordance with testing schedule presented in the DHCFP-approved project management plan. |
| Testing |
| Up to $1,250 per day in damages may be assessed for failure to test as specified. |
Scope of Work Section
| 2. |
| Vendor shall provide training to stakeholders (DHCFP, Managed Care Entities, credentialers, providers, and authorized users) on system functionality and processes prior to go-live and upon request as agreed upon between the Vendor and DHCFP. |
| Training and Outreach |
| Up to $1,250 per day, per occurrence of failure to provide training. |
| Functional Req #17 and #19 |
| 3. |
| Vendor shall submit a Business Continuity/Backup and Recovery Plan for approval within 30 calendar days of contract signing, and update plan at least annually thereafter. |
| Business Continuity |
| Up to $500 per day, per occurrence of failure to provide Plan. |
| System Technical Services |
Req #20
| 4. |
| Implement Centralized Credentialing Solution capabilities and services to comply with American Rescue Plan Act (ARPA) grant funding timeframes. |
| Schedule |
| Amount equal to the reduction in federal ARPA assistance. |
| Scope of Work Section |
| ID |
| Operations and Maintenance Task Performance Requirements |
| Performance Area |
| Damages |
| Applicable RFP Requirement Citation |
| 5. | | |
| The Centralized Credentialing shall retrieve the Nevada Medicaid provider file within two business days of posting. | Comment by Charmaine Yeates: Was it decided that this allowed for applications uploaded on a Friday evening or holiday for instance? | Comment by Cynthia Leech: TBD during negotiations |
| Performance | | |
| $1,250 per day past the two-business day limit. | | |
Functional Req #8
| 6. |
| The Centralized Credentialing shall provide access to credentialing documentation to stakeholders within three business days of completion of credentials verification process. |
| Performance |
| $1,250 per day per incident for failure to provide credentialing documentation. |
| Functional Req #8 |
| 7. |
| The Centralized Credentialing shall perform source verification within a 99% accuracy rate. |
| Performance |
| Up to $5,000 per incident. |
Functional Req #2
| 8. |
| The Centralized Credentialing shall complete the credentials verification process within 60 calendar days of the initial date of receipt of the provider credentialing documentation. |
| Performance |
| $1,250 per day per incident |
| Functional Req #2 and #4 |
| 9. |
| The Centralized Credentialing shall communicate in writing any proposed changes to the credentials verification process thirty (30) calendar days prior to change in process. |
| Communications |
| $1,250 per day per incident |
| Change Management Section |
| 10. |
| Vendor shall create and implement a re-credentialing alignment plan within 12 months of contract begin date to ensure each provider has a single credentialing date. |
| Performance |
| Up to $1,250 per day may be assessed for failure to comply as specified. |
| Functional Req #10 |
| 11. |
| The Centralized Credentialing shall be National Committee for Quality Assurance (NCQA) certified at contract start date and shall maintain NCQA Centralized Credentialing certification based on the most current standards throughout the duration of the contract. |
| Contract Compliance |
| $10,000 in damages may be assessed for failure to maintain certification. |
| Functional Req #1 |
| 12. |
| Vendor shall provide a written report and assessment to DHCFP within one business day following the identification of any security Incident. The report shall detail all actions taken concerning the incident, including the type of incident, the current status, and any potential impact(s), the cause of the incident, and a corrective action plan to prevent future incidents. |
| Security |
| Up to $1,250 per day, per report in damages may be assessed for failure to produce reports. |
| Security Req #20 |
| 13. |
| The Centralized Credentialing Solution shall be available with real time updates to end users 98% of the time, 24 hours a day, 7 days a week, excluding DHCFP approved planned downtime. |
| System Availability |
| Up to $5,000 per day in damages may be assessed for failure to comply with system availability. |
| System Technical Req #13 |
| 14. |
| Scheduled Centralized Credentialing Solution downtime notification reminders shall be communicated to all Centralized Credentialing Solution users 48 hours prior to the scheduled downtime. |
| System Downtime |
| Up to $1,250 per day in damages may be assessed for failure to notify. |
| System Technical_Services Req #12# |
| 15. |
| Notification shall be communicated within one hour to all Centralized Credentialing Solution users when unscheduled system downtime occurs. |
| System Downtime |
| Up to $375 per hour in damages may be assessed for failure to notify. |
| System Technical_Services Req #11 |
| 16. |
| Vendor shall provide technical support by phone and online in accordance with DHCFP’s regular business hours for the duration of the contract. |
| Customer Service |
| Up to $375 per hour may be assessed for failure to provide technical support as specified. |
| Functional Req #15 |
| 17. |
| Staffing levels shall be maintained so that no more than 10% of the calls placed into the queue remain on hold for more than one minute, and to ensure the abandon rate is no greater than 5%. |
| Customer Service |
| Up to $375 per day may be assessed for failure to provide customer care support as specified. |
| Scope of Work |
| 18. |
| Vendor shall respond to all received telephone, email communications, and written correspondence from stakeholders within two business days of receipt of the inquiry. |
| Customer Service |
| Up to $375 per day may be assessed for failure to comply as specified. |
| Functional Req #15 |
| 19. | | |
| Respond to all DHCFP inquiries within one business day. | Comment by Charmaine Yeates: Were details re: escalation process needed? | Comment by Cynthia Leech: Yes but I think I'll add that to the business requirements. |
| Customer Service |
| Up to $375 per day may be assessed for failure to comply as specified. |
| Functional Req #17 |
| 20. |
| Ongoing training and outreach materials shall be reviewed and approved by DHCFP, 5-10 business days prior to a scheduled training or outreach event. |
| Training and Outreach |
| Up to $1,250 per day may be assessed for failure to comply as specified. |
| Functional Req #18 |
| 21. |
| Training shall be provided at least five business days in advance of system upgrades or changes. |
| Training and Outreach |
| Up to $1,250 per day, per occurrence of failure to provide training. |
| Functional Req #18 |
| 22. |
| Vendor shall distribute accurate reports as follows: |
A. Weekly reports shall be made available to DHCFP within two business days following the reporting period.
B. Monthly reports shall be made available to DHCFP within five business days following the reporting period.
C. Requests for ad hoc reports shall be fulfilled and available to DHCFP within three business days of request submission.
D. Reports generated on occurrence (event based) shall be available within 24 hours of the occurrence.
| Reports |
| Up to $500 per day, per report in damages may be assessed for failure to produce reports. |
| Functional Req #14 |
| 23. |
| Centralized Credentialing Solution shall have at least six years (from the end of the calendar year in which the report was finalized) of reporting available online to DHCFP. |
| Report Retention |
| Up to $500 per day in damages may be assessed for failure to comply as specified. |
| Functional Req #15 |