Attachment E Quality Assurance Surveillance Plan.pdf

ATTACHMENT E QUALITY ASSURANCE PLAN

Quality Assurance Surveillance Plan For: Electronic Data Interchange (EDI) and Paper-Based Health Claims and Associated

Medical Documentation (P2E) Services

Contract/Order Number: TBD

The Contractor shall provide all resources necessary to accomplish the requirements described in the Performance Work Statement (PWS). The Contractor shall also follow all applicable privacy laws, including but not limited to the Health Insurance Portability and Accountability Act of 1996 (HIPAA; Pub.L. 104–191, 110 Stat. 1936, enacted August 21, 1996), in the performance of this requirement.

Contractor’s Name: TBD

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to monitor Contractor performance. This QASP describes:

What will be monitored?

How monitoring will take place?

Who will conduct the monitoring?

How monitoring efforts and results will be documented?

Copies of the original QASP and revisions shall be provided to the Contractor and Government officials responsible for surveillance activities. The Government can change the method of surveillance at any time.

1.1 PERFORMANCE MANAGEMENT APPROACH

The PWS sets forth “what” service is required as well as the performance standards associated with that task, as opposed to “how” the Contractor should perform the work (i.e., results, not compliance). This QASP will define the performance management approach taken by the Office of Office of Integrated Veteran Care or Office of Finance? to monitor the Contractor’s performance to ensure the expected outcomes or performance standards communicated in the PWS are achieved. Performance management rests on developing a capability to review and analyze information generated through performance assessment. The ability to make decisions based on the analysis of performance data is the cornerstone of performance management; this analysis yields information that indicates to what extent the expected outcomes for the project are being achieved by the Contractor.

Performance management represents a significant shift from the more traditional quality assurance (QA) concepts in several ways. Performance management focuses on assessing whether outcomes are being achieved and to what extent. This approach migrates away from scrutiny of compliance with the processes and practices used to achieve the outcome. A performance-based approach enables the Contractor to play a large role in how the work is performed, as long as the proposed processes are within the stated constraints. Required processes are those required by law (federal, state, and local) and compelling business situations, such as safety and health. A “results” focus by the Government provides the Contractor flexibility to continuously improve and innovate over the course of the contract/order as long as the critical outcomes expected are being achieved and/or the desired performance levels are being met.

1.2 PERFORMANCE MANAGEMENT STRATEGY

The Contractor is responsible for the quality of all work performed. The Contractor measures that quality through the Contractor’s own quality control (QC) program. QC is work output, not workers, and therefore includes all work performed under this contract/order regardless of whether the work is performed by Contractor employees or by Subcontractors. The Contractor’s QC Program (QCP) will set forth the procedures for self-inspecting the quality, timeliness, responsiveness, customer satisfaction, and other performance requirements in the PWS. The Contractor will implement a performance management system with processes to assess and report its performance to the designated government representative.

The government representative(s) will monitor performance by the Contractor to determine how the Contractor is performing against performance standards. The Contractor will be responsible for making required changes in processes and practices to ensure performance is managed effectively. The Contractor will be monitored and assessed throughout the period of performance of the contract/order as to either meeting or not meeting the performance thresholds stated in the Performance Metrics Section of the PWS. The Contracting Officer’s Representative (COR) will perform monthly assessments. The Performance Based Service Assessment Survey, or other method, may be used to document this assessment. A sample Performance Based Service Assessment Survey is provided at the end of this document. When a Contractor performance issue occurs, the COR will notify the Program Manager and Contracting Officer (CO). The COR/CO will engage the Contractor PM to resolve the discrepancy.

1.2.1 PERFORMANCE FEEDBACK:

At the end of each assessment period, the assessment will be reviewed by the Program Manager and CO. The COR/CO will notify the Contractor of the results no later than 15 working days after the end of the assessment period.

2. Government Roles and Responsibilities

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract/order terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the Contractor receives impartial, fair, and equitable treatment under this contract/order. The CO is ultimately responsible for the final determination of the adequacy of the Contractor’s performance.

Assigned CO: Terri Duenas, Contracting Officer Organization: Department of Veterans Affairs, Office of Procurement, Acquisition and Logistics, Strategic Acquisition Center (SAC-V)

Assigned CS: Justin Sink, Contract Specialist Organization: Department of Veterans Affairs, Office of Procurement, Acquisition and Logistics, Strategic Acquisition Center (SAC-V)

b. Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract/order and shall assure proper Government surveillance of the Contractor’s performance. The COR shall keep a quality assurance file. This file shall contain all quality assessment reports. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf.

Assigned COR: TBD

c. Other Key Government Personnel – None

3. Contractor Representatives

Program Manager –TBD

b. Other Contractor Personnel – TBD

4. Performance Standards

The Performance Metrics for Deliverables and Performance Standards are outlined in the Performance Work Statement (PWS). The schedule of deliverables is outlined in Section 5 of the PWS. The table is listed below.

Performance Standards define required performance for specific tasks. The Government performs surveillance to determine if the Contractor exceeds, meets or does not meet these standards (see table of Objectives).

The Government may utilize the Performance Based Service Assessment Survey, provided at the end of this document, or other method to compare Contractor performance to the Acceptable Levels of Performance (ALPs).

5. Methods of QA Surveillance

The Government will evaluate contractor performance and deliverables against the following criteria to determine interim and final acceptance of the services provided:

Task ID Indicator Standard Accepta ble

Quality

Level

Method of

Surveillance

Incentive

5.1.1 Kick-Off Meeting Bilaterally

acceptable date (but not later than

(NLT) 10

business days of award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.1.2 Kick-Off Meeting

Agenda

NLT two (2) business days prior to the

Kick-Off

Meeting

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.1.3 Kick-Off Meeting

Minutes

NLT three

(3) business days after conclusion of the Kick-Off

Meeting

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.1 Specifications for

Hosted

Transactions

(270/271, , 276/277, 278)

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and

5.2.2

Specifications for

Direct

Transactions

(270/271, 277CA,

278, 837, 837COB, 275,

835)

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.3 Business Rules for

Payer Specific

Edits (278, 837, 837COB)

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and

5.2.4 Specification for

Paper to EDI

(P2E)

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.1 The Contractor

shall receive paper claims

(CMS-1500, UB-

04, and American

Dental

Association

(ADA) Dental

Forms), and documentation supporting claims from VA community providers and all

VFMP claims at a single mailing address

NLT 180

days after contract award

100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.2 The contractor

shall store original paper documentation for six calendar weeks after receipt. After six calendar weeks the contractor shall submit a shred request approval to the

COR.

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and

5.2.4.3 The contractor

shall receive paper claims and supporting documentation scan paper claims and supporting documentation and convert all scanned documentation into the industry standard EDI transactions format and shall charge the VA a per page rate.

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.4 The contractor

shall convert ninety-eight percent (98%) of all clean paper-based claims and supporting documentation to

HIPAA compliant

EDI transactions within two (2) business day of receipt and one hundred percent

(100%) of all paper-based forms within five

(5) business days.

contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.5 The Contractor

shall return one hundred percent

(100%) of deficient claims and/or supporting documentation to the provider with a clear explanation of deficiencies within ten (10) business days of original receipt. Copies of

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and rejected claims and letters shall be accessible to

VA personnel.

5.2.4.6 The Contractor

shall confirm the actual date of receipt is entered into the Internal

Control Number

(ICN) and all required claims aging, and inventory controls are applied for all claims. The

Contractor shall count the actual date of receipt as day one.

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.7 The Contractor

shall provide within Claims

Attachments transactions identifiers and means to match to the existing claim.

contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.8 The contractor

shall provide all services necessary to return to sender the

“inappropriate paper” and paper forms that are illegible that may be received, i.e., claims that are not contained on designated claims forms or valid medical documentation.

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and

5.2.4.9 The EDI 275

transaction file shall include a unique Trace

Number (TRN) segment that contains the

Provider

Attachment

Control Number.

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.10 The EDI 837

transaction file shall include a

Paperwork

(PWK) segment that contains the

Attachment

Control Number to include the matching unique

TRN.

contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.11 When additional

accompanying

EDI Standard

Transactions are adopted and mandated by

CMS for use at a future date, the

Contractor shall comply with those

EDI Standard

Transactions by the compliance dates as specified by the

Department of

Health and

Human Services

(HHS).

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.12 The Contractor

shall meet a data quality performance metric of >99.5% for overall data quality inclusive of Optical

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Exercise of

Character

Recognition

(OCR) and keyed data (including handwritten forms).

Analysis of contractor's progress reports.

option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.13 If the VA

discovers a scanning error after submission from the contractor, the contractor will assist the VA with resolution of the error so the claim may be processed.

contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.14 If the VA

discovers a scanning error after submission from the contractor, the contractor will assist the VA with resolution of the error so the claim may be processed.

contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.4.15 The contractor

shall provide for electronic document retention of received paper claims or paper medical documentation for a minimum of six years from the date received. The stored electronic documents retained in the contractor system shall be accessible and viewable to

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and

VA employees per

Section 508 of the

Rehabilitation Act

(29 U.S.C. § 794d) as outlined in

PWS Section 16. .

The VA shall be able to establish the folder taxonomy within the contractor’s system.

5.2.5 Implementation

Work Breakdown

Structure and

Schedule with

Durations, Predecessors, and

Responsible

Parties

NLT 30 days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.6 Implementation

Development and

Reports

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.7 Implementation

Testing and

Report

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.8 Implementation

Deployment and

Report

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation

Analysis of contractor's progress reports.

option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.9 Weekly

Implementation

Meetings and

Status Reports

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.10 Create and

Manage Payer

Identifiers

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.11.1 Communication

Plan

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.11.2 Provider

Communication

System

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and

5.2.11.3 Secure Email

System

NLT 180

days after contract award

Per PWS 100%

100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.2.11.4 Emergency Call-

Back Service

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.3.1 EDI Enrollment

Process

NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.3.2 Transactions NLT 180

days after contract award

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.1 Daily Claim (837)

Transaction

Counts Report by

Payer ID, Claim

Type and

Provider

Daily Per PWS 100% 100%

Inspection or

Direct

Observation or

Exercise of option period and past performance and/or other incentives proposed and progress reports.

5.4.2 Monthly

Summary Claim

(837) Transaction

Counts by Payer

ID, Claim Type and Provider

Report

NLT the 4th business day of each month

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.3 Daily 835 Health

Care

Payment/Advice

Transactions

Picked up by

Provider Report

Daily Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.4 Monthly

Summary 835

Health Care

Payment/Advice

Transactions

Picked Up by

Provider Report

NLT the 4th business day of each month

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.5 Daily Real-Time

Transaction

Volume (270/271, 276/277/277CA,

278) Report

Daily Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.6 Monthly

Summary of Real-

Time Transaction

Volume (270/271, 276/277/277CA,

278) Report

NLT the 4th business day of each month

Per PWS 100% 100%

Inspection or

Direct

Observation progress reports.

option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.7 Daily

Attachments (275)

Transaction

Counts Report

Daily Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.8 Monthly

Summary

Attachments (275)

Transaction

Counts Report

NLT the 4th business day of each month

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.9 Daily P2E

Reports

Daily Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.10 Monthly

Summary P2E

Reports

NLT the 4th business day of each month

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and

5.4.11 Ad Hoc Reports NLT five (5)

business days after request

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.12 Monthly Status

Meeting

NLT than the seventh (7th) day of each month

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.12.1 Monthly Status

Meeting Agenda

& Other

Supporting

Documentation

NLT two (2) business days prior to the meeting

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.4.12.2 Monthly Status

Meeting Minutes

NLT three

(3) business days after the meeting

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and accepted by

VHA

5.5 Transition

Support A.

Transition Plan B.

Certification of

Transition

Completion

(Optional)

Bilateral agreement

TBD

Per PWS 100% 100%

Inspection or

Direct

Observation or

Analysis of contractor's progress reports.

Exercise of option period and past performance and/or other incentives proposed and

6. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP.

a. DIRECT OBSERVATION. (Can be performed periodically or through 100% surveillance.)

b. PERIODIC INSPECTION. (Evaluates outcomes on a periodic basis. Inspections may be scheduled [Daily, Weekly, Monthly, Quarterly, or annually] or unscheduled, as required.)

c. USER SURVEY. (Combines elements of validated user complaints and random sampling.

Random survey is conducted to solicit user satisfaction. May also generate inspections and sampling.)

d. VALIDATED USER/CUSTOMER COMPLAINTS. (Relies on the patient to identify deficiencies. Complaints are then investigated and validated.)

e. 100% INSPECTION. (Evaluates all outcomes.)

f. PERIODIC SAMPLING. (Variation of random sampling. However, sample is only taken when a problem/deficiency is suspected. Sample results are applicable only for the specific work inspected. Since sample is not entirely random, it cannot be applied to total activity performance.)

g. RANDOM SAMPLING. (Designed to evaluate performance by randomly selecting and inspecting a sample of cases.

h. Progress or status meetings.

i. Analysis of contractor's progress reports. (Evaluate cost, schedule, etc.)

Each month, the COR shall review the Contractor’s performance/generated documentation corresponding to a validated customer complaint or validated inability to perform in accordance with the ALP in a specific area and document your results accordingly. This assessment shall be placed in the COR’s QA file.

7. ACCEPTABLE LEVELS OF PERFORMANCE (ALP)

Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and ALP.

The ALPs are included in the Performance Metrics Section of the PWS for Contractor performance and are structured to allow the Contractor to manage how the work is performed, while providing negative incentives for performance shortfalls.

8. Incentives

The Government shall consider the Contractor’s performance when deciding to exercise any options.

9. Documenting Performance

a. Acceptable Performance

The Government shall document acceptable performance accordingly. Any report may become a part of the supporting documentation for any contractual action.

b. Unacceptable performance

When unacceptable performance occurs, the COR shall inform the CO. This will always be in writing although when circumstances necessitate immediate verbal communication, that communication will be followed in writing. The COR shall document the discussion and place it in the COR file.

When the CO determines formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR) and present it to the Contractor's program manager.

The Contractor shall acknowledge receipt of the CDR in writing to the CO. The CDR will state how long after receipt the Contractor has to take corrective action. The CDR will also specify if the Contractor is required to prepare a corrective action plan to document how the Contractor shall correct the unacceptable performance and avoid a recurrence. The CO shall review the Contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

10. Frequency of Measurement

a. Frequency of Measurement.

During contract/order performance, the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed, and at a minimum shall be twice a year.

b. Frequency of Performance Assessment Meetings.

The COR shall meet with the Contractor monthly to assess performance and shall provide a written assessment to the CO.

Quality of submission should also be considered. See examples below. Error rates or resubmits for content flaws would be the measures associated with these standards.

Accuracy - Work Products shall be accurate in presentation, technical content, and adhere to accepted elements of style.

Clarity - Work Products shall be clear and concise. Any/All diagrams shall be easy to understand and be relevant to the supporting narrative.

Consistency to Requirements - All work products must satisfy the requirements of this PWS.

File Editing - All text and diagrammatic files shall be editable by the VA in Windows-based or Adobe environments/platforms.

Format - Follow specified VA Directives or Manuals and/or best business practices.

Presentations - Presentations shall be clear, concise, executive-focused, and written in plain, clear English with minimal jargon, understandable by lay persons. The quality of deliverables directly contributes to organizational communications.

Project Plan - Project Plan shall be comprehensive; recognize and address authority, perceptions, and concerns of stakeholders; incorporate scope of requisite requirements across the organization and/or agency.

Reports - There shall be no omissions in the reports, documents or functional requirements.

Publications and other documents - Deliverables shall be in formats appropriate to target audiences; user friendly, clear, thorough and comprehensive.

Meeting support - Pre-meeting preparations and logistics; smooth meeting operations;

comprehensive post-meeting summaries to include but not limited to: Minutes, Action Items, Attendees, Program Objectives and Milestones and major decision points.

Analyses and Assessments - Analyses and assessments are performed with accuracy, completeness and adherence to industry best practices.

Obtain stakeholder input - Deliverables shall consist of the timely implementation of input mechanisms and shall consist of an accurate and comprehensive synthesis of results and recommendations. Integration of relevant stakeholder input documented for deliverable.

The following rating definitions can be used as a guide when completing the Performance Based Service Assessment:

Performance Rating

Criteria

Exceptional Performance meets all contractual requirements and exceeds most to the government’s benefit. The contractual performance of the element or sub-element being assessed was accomplished with almost no minor problems for which corrective actions were taken by the contractor, and the corrective actions were highly effective.

Very Good Performance meets all contractual requirements and exceeds some to the government’s benefit. The contractual performance element or sub-element being assessed was accomplished with very few minor problems for which corrective actions taken by the contractor were highly effective.

Satisfactory Performance meets contractual requirements. The contractual performance of the element or sub-element contains some minor problems for which corrective actions taken by the contractor appear or were satisfactory.

Below Satisfactory

Performance does not meet some contractual requirements. The contractual performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor’s proposed actions appear only marginally effective or were not fully implemented.

Poor Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance of the element or sub-element contains serious problem(s) for which the contractor’s corrective actions appear or were ineffective.

PERFORMANCE BASED SERVICE ASSESSMENT

CONTRACTOR: GOVERNMENT REQUIRING ACTIVITY

CONTRACT/ORDER NUMBER/ TITLE:

PERIOD COVERED:

Place an X in the appropriate response

Performance Standards for Assessment VERY ***BELOW ***

EXCELL

ENT

GOO

D

SATISFACT

ORY

SATISFACT

ORY POOR

VALUE 5 4 3 2 1

A. MEETING TECHNICAL NEEDS:

1. What level of understanding does the contractor have of my technical needs and my mission requirements?

2. What level of efficiency and effectiveness does the contractor demonstrate in meeting my requirements?

3. Overall, how well does the contractor meet my technical needs and mission requirements?

B. PROJECT MILESTONES AND SCHEDULE:

1. How well does the contractor meet my established milestones and project dates?

2. How timely are products, reports, and invoices completed, reviewed, and delivered?

3. How would you assess the reasonableness of cost of the services being provided and the accuracy of submitted invoice?

4. How well does the contractor notify me in advance about potential milestones and scheduling problems so that I have enough time to correct them?

C. PROJECT STAFFING:

1. How current is the expertise of those contractors performing requested tasks?

2. Do contractor personnel possess the necessary knowledge, skills and ability to accomplish assigned tasks?

3. Are the staffing levels assigned by contractor appropriate for accomplishing the mission?

D. PERFORMANCE MEASURES:

1. Overall, how well does the contractor meet my established target rates for each claims processing section?

2. How accurately are claims entered into the VA- FSC computer systems?

3. How well does the contractor adhere the VA ICARE values?

4. What overall rating would you give to the contractor's performance?

** Ratings for a Performance Standard are calculated by adding the individual scores under a Performance Standard and dividing it by the number of sub-standards under that Performance Standard.

***Poor and Below Satisfactory ratings must be explained in Section II (Narrative Clarification) below. Must be supportive and objective

II NARRATIVE

CLARIFICATION

(USE ADDITIONAL SPACE

AS REQUIRED)

Typed Name And Title of Government Project Lead/ Date