Attachment 003 - Quality Assurance Surveillance Plan (QASP).docx

QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

ASPE – Accident and Sickness Program for Exchanges

SBU - CONTRACTING AND ACQUISITIONS

iSBU - CONTRACTING AND ACQUISITIONS

TABLE OF CONTENTS

SBU - CONTRACTING AND ACQUISITIONS

QUALITY ASSURANCE SURVEILLANCE PLAN

(QASP)

INTRODUCTION

This Quality Assurance Surveillance Plan (QASP) is pursuant to the requirements listed in the Office of Education and Cultural Affairs (ECA), Accident and Sickness Program for Emergencies (ASPE) Statement of Work (SOW). This plan sets forth the procedures and guidelines ECA will use in ensuring the required performance standards or services levels are achieved by the contractor.

Purpose The purpose of QASP is to describe the systematic methods used to monitor performance and to identify the required documentation and the resources to be employed. The QASP provides a means for evaluating whether the contractor is meeting the performance standards/quality levels identified in the SOW and the contractor’s quality control plan (QCP), and to ensure that the government pays only for the level of services received at the appropriate level of quality.

This QASP defines the roles and responsibilities of all members of the Integrated Project Team (IPT), identifies the performance objectives, defines the methodologies used to monitor and evaluate the contractor’s performance, describes quality assurance documentation requirements, and describes the analysis of quality assurance monitoring results.

Performance Management Approach The SOW structures the acquisition around “what” service or quality level is required, 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 ECA to monitor and manage the contractor’s performance to ensure the expected outcomes or performance objectives communicated in the SOW are achieved. Performance management rests on developing a capability to review and analyze information generated through reporting and tracking generated as part of the contract implementation process that can be used for performance assessment of the services provided. The ability to make decisions based on the analysis of performance data is the cornerstone of performance management; this analysis yields information that indicates whether 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. The only exceptions to process reviews are those required by law (federal, state, and local) and compelling business situations, such as safety and health. A “results” focus provides the contractor flexibility to continuously improve and innovate over the course of the contract provided that the critical outcomes expected are being achieved and/or the desired performance levels are being met.

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 regardless of whether the work is performed by contractor employees or by subcontractors. The contractor’s QCP will set forth the staffing and procedures for self-inspecting the quality, timeliness, responsiveness, customer satisfaction, and other performance requirements in the SOW/PWS. The contractor will develop and implement a performance management system with processes to assess and report its performance to the designated government representative. The contractor’s QCP will set forth the staffing and procedures for self-inspecting the quality, timeliness, responsiveness, customer satisfaction, and other performance requirements in the SOW/PWS. This QASP enables the government to take advantage of the contractor’s QC program and will be provided to the government representative upon implementation of the contract vehicle and will be reviewed and modified in coordination with the government representative at least annually. Written reports generated from the QASP will be provided to the government representative semi-annually.

1.3.2 The government representative(s) will monitor performance and review performance reports furnished by the contractor to determine how the contractor is performing against communicated performance objectives. The government will make determinations regarding incentives based on performance measurement metric data and notify the contractor of those decisions. The contractor will be responsible for making required changes in processes and practices to ensure performance is managed effectively.

ROLES AND RESPONSIBILITIES

The Contracting Officer The Contracting Officer (CO) is responsible for monitoring contract compliance, contract administration, and cost control and for resolving any differences between the observations documented by the ECA "Contracting Officer's Representative (COR)" and the contractor. The CO will designate one full-time COR as the government authority for performance management. The number of additional representatives serving as technical inspectors depends on the complexity of the services measured, as well as the contractor’s performance, and must be identified and designated by the CO if determined to be needed.

Government Surveillance Government surveillance may occur under the inspection of services clause for any service relating to the contract.

IDENTIFICATION OF REQUIRED PERFORMANCE STANDARDS/QUALITY LEVELS

The required performance standards and/or quality levels are included in the SOW and in Attachment 1, “Performance Requirements Summary.

METHODOLOGIES TO MONITOR PERFORMANCE

Surveillance Techniques In an effort to minimize the performance management burden, simplified surveillance methods shall be used by the government to evaluate contractor performance when appropriate. The primary methods of surveillance are to include those that apply:

· Random monitoring, which shall be performed by the COR designated inspector.

· 100% Inspection – Each month, the COR, shall review the generated documentation and enter summary results into the Surveillance Activity Checklist as needed.

· Periodic Inspection – COR typically performs the periodic inspection on a monthly basis or as part of daily/weekly feedback when coordinating with the contract provider.

Customer Feedback The contractor is expected to establish and maintain professional communication between its employees and customers. The primary objective of this communication is customer satisfaction. Customer satisfaction is the most significant external indicator of the success and effectiveness of all services provided and can be measured through customer complaints.

Performance management drives the contractor to be customer focused through initially and internally addressing customer complaints and investigating the issues and/or problems but the customer always has the option to communicate complaints to the [CO, COR], as opposed to the contractor.

Customer complaints, to be considered valid, must set forth clearly and in writing the detailed nature of the complaint, must be signed, and must be forwarded to the COR along with a recommended resolution from the contractor which addresses the issue. The COR will accept those customer complaints and investigate using the Quality Assurance Monitoring Form – Customer Complaint Investigation, identified in Attachment 3.

Customer feedback may also be obtained either from the results of formal customer satisfaction surveys or from random customer complaints.

Acceptable Quality Levels The acceptable quality levels (AQLs) included in Attachment 1, Performance Requirements Summary Table, for contractor performance are structured to allow the contractor to manage how the work is performed while providing negative incentives for performance shortfalls. For certain critical activities such as those involving systems availability, Customer Support, and HelpDesk support, the desired performance level is established at 100 percent.

QUALITY ASSURANCE DOCUMENTATION

The Performance Management Feedback Loop The performance management feedback loop begins with the communication of expected outcomes. Performance standards are expressed in the SOW and are assessed using the performance monitoring techniques shown in Attachment 1.

Monitoring Forms The government’s QA surveillance, accomplished by the COR, will be reported using the monitoring forms in Attachments 2. The forms, when completed, will document the government’s assessment of the contractor’s performance under the contract to ensure that the required results [or service or quality levels] are being achieved.

The COR will retain a copy of all completed QA surveillance forms.

ANALYSIS OF QUALITY ASSURANCE ASSESSMENT

Determining Performance Government shall use the monitoring methods cited to determine whether the performance standards/service levels/AQLs have been met. If the contractor has not met the minimum requirements, it may be asked to develop a corrective action plan to show how and by what date it intends to bring performance up to the required levels.

Reporting At the end of each month, the contractor will prepare a written report for the COR summarizing the overall results of the quality assurance surveillance of the contractor’s performance under the QASP. This written report, which includes the contractor’s submitted monthly report and the completed quality assurance monitoring forms (Attachment 2), will become part of the QA documentation. It will enable the government to demonstrate whether the contractor is meeting the stated objectives and/or performance standards, including cost/technical/scheduling objectives.

Reviews and Resolution The COR may require the contractor’s project manager, or a designated alternate, to meet with the CO and other government IPT personnel as deemed necessary to discuss performance evaluation. The COR will define a frequency of in-depth reviews with the contractor, including appropriate self-assessments by the contractor; however, if the need arises, the contractor will meet with the COR as often as required or per the contractor’s request. The agenda of the reviews may include:

· Monthly performance assessment data and trend analysis

· Issues and concerns of both parties

· Projected outlook for upcoming months and progress against expected trends, including a corrective action plan analysis

· Recommendations for improved efficiency and/or effectiveness

The ASPE COR must coordinate and communicate with the contractor to resolve issues and concerns regarding marginal or unacceptable performance.

The ASPE COR and contractor should jointly formulate tactical and long-term courses of action in writing. Decisions regarding changes to metrics, thresholds, or service levels should be clearly documented. Changes to service levels, procedures, and metrics will be incorporated as a contract modification at the convenience of the CO & COR.

ATTACHMENT 1: PERFORMANCE REQUIREMENTS SUMMARY

Required Service

Performance Standard

Acceptable Quality Level (AQL) Note: all days are business days; availability % excludes scheduled downtime Monitoring Method to be Used

Program Management and Administration

Timeliness

Adaptability and Continuous Improvement Provide finalized overall project management plan at the end of Transition Period

Provide Weekly Status Report by the beginning of the following work week

Provide Monthly Status Report at the beginning of each month and all information for reporting categories and requirements.

Provide all invoices to the appropriate centralized billing office by the 10th of the month for the preceding month Resolve all invoice errors (100%) within one (1) billing cycle

Creation of Traceability Matrix within 6 months of contract award which addresses the unique services and support required by ASPE

Service Adaptation: Be prepared to adjust services and coverage options to meet the evolving needs of participants and the ASPE program, including managing multiple tiers of service coverage if required.

Innovation: Introduce innovative solutions and technologies to enhance the efficiency and effectiveness of program administration, such as telehealth services, mobile health applications, and predictive analytics.

Health and Travel Insurance Industry Expertise and Consultation: Provide health insurance expertise and related consultation capabilities on industry standards, laws, trends, and more, as needs arise from the ASPE Program.

Meets: =100% on time Unsat: < 100% on time

Meets: = 100% on time

Meets: < 5 days Unsat: > 5 days

100% Inspection

100% Inspection

Program Management and Administration

Quality Assurance

Participant Enrollment and Eligibility Management

Claims Processing, Adjudication, and Coordination of Benefits

Health Benefits Management

(Processing and Adjudication)

Claims Denial and Appeals Process

Sophisticated Data Management for Reporting

Global Pharmacy and Medical Benefit Services Management

(Pharmacy Claims Management)

(Seamless Access to Healthcare Globally)

Healthcare Consultation and Support

(Pre-Departure and Ongoing Healthcare Support)

(Telehealth Services)

Emergency and Routine Medical Evacuation and Repatriation

(Medical Evacuation (Medevac))

(Repatriation of Mortal Remains)

Extensive Provider Network

Traceability Matrix updated accordingly after every major event or quarterly COR & Contractor coordination meeting

Operational Standard Operating Procedures will be reviewed, modified, and published as needed

1) Enrollment Processing: Develop and manage a secure, efficient enrollment system for all ASPE-covered participants. Ensure that enrollment is completed prior to participants' arrival in their host countries. Primary responsibility for enrollment is designated representatives from recipients of ECA federal awards (grants).

2) Eligibility Verification: Maintain accurate records and verify that participants meet the eligibility criteria for coverage, which is permitted only while they are active exchange program participants in a host country.

3) Health Coverage Certificates: Prepare and issue certificates of health coverage and identification cards to participants, adhering to the policies issued by ECA. These documents serve as proof of coverage and are essential for compliance with visa and program requirements.

1) Comprehensive Claims Management and Coordination of Benefits: Process and adjudicate claims for covered medical expenses, including medical care, mental health services, crisis support, mental health and crisis support hotline, medevacs, repatriation, and pharmacy services. Ensure that claims are handled promptly and accurately in accordance with ASPE policies and procedures. Manage coordination of benefits when participants are eligible for payment of claims under more than one health care benefit plan (their primary coverage). Manage and apply all program cost-containment processes and strategies, including re-pricing and related services for all ASPE-related claims, services, and expenditures. Provide payments to provider entities in local currencies.

2) Policy Adherence: Verify that all claims align with the scope of coverage defined by EX Executive Director, assessing the necessity and appropriateness of services claimed, and ensuring costs are reasonable and customary for the location where services were provided.

3) Denial Management: Manage claims denials by providing clear explanations to participants, detailing reasons for denial, and guiding them through any available appeals processes.

Detailed Claims Adjudication: The TPA is responsible for processing claims (domestic and international) related to medical care, mental health services, mental health support hotline usage, crisis support, pharmacy services, and more. Claims processing includes verifying eligibility, ensuring that the services provided are necessary and covered under the ASPE policy, and confirming that the costs are reasonable and align with customary local healthcare rates.

Claims Categorization: Claims must be categorized based on multiple parameters, such as:

---Type of Service: Medical, mental health, mental health support services hotline, pharmacy, emergency.

---Geographic Location: Country of treatment and specific provider details.

---Program Names and Categories: Title of ECA exchange program and location ---Denial Reasons: Provide specific categories for claims that are denied, including reasons such as non-covered services, eligibility issues, or policy limitations.

---Adjudication Timelines: The TPA must establish and adhere to clear timelines for claims adjudication, including:

---Initial Processing: Complete processing of initial claims submissions within 10 business days of receipt.

---Review and Appeal: Complete reviews and appeals of claims denied within 15 business days.

Claims Denial Communication: When a claim is denied, the TPA must provide a detailed explanation of the denial, including the specific reason, policy reference, and guidance on how to appeal the decision.

Appeals Management: Participants must be given a fair opportunity to appeal denied claims. The TPA will manage an organized appeals process, ensuring all appeals are reviewed by qualified personnel and resolved promptly. The TPA must track and report on appeals outcomes to ECA for continuous improvement.

Data Analytics: The TPA must use advanced data analytics to manage all claims data, including prescriptions, categorize claims, and generate insights for program improvements. Reporting must be specific to different parameters such as participant demographics, claim types, ECA program titles and locations, and geographic trends, including denied claims, types, and reasons for denial. All data analytics and reporting will be routine (not ad hoc) and must be provided in both raw and finished formats, to include visual graphs that illustrate program usage and expenditures, trends, and more.

Reporting Requirements: The TPA must generate regular reports, including :

---Monthly Claims Report: Includes a summary of paid and denied claims, categorized by exchange program, type, country, costs, and participant demographics.

---Quarterly Performance Report: Evaluates claims turnaround time, customer service response, and program utilization trends.

---Annual Summary Report: Provides a comprehensive overview of program usage, participant satisfaction, financial performance, and recommended improvements.

Prescription Processing: Manage prescription claims and ensure participants have access to required medications without hardship and in compliance with legal limitations that exist in program host countries. The TPA must work with a global network of pharmacies to negotiate rates and ensure timely access to medications.

Specialty Medications: Establish systems for handling claims related to specialty medications, including those that require specific storage or handling. The TPA must ensure participants have access to these medications in a timely manner, regardless of their location.

Formulary Management: Maintain a formulary that ensures participants can access the most required medications at a reasonable cost and assist with alternatives if a prescribed medication is unavailable.

Participant Prescription and Medication Consultation Services: Provide customer service and support to participants in addressing questions and potential solutions regarding the availability of medications within their host countries and / or ability to ship medications to host countries

Global Provider Network Development: Develop and maintain an extensive network of healthcare providers globally, including general practitioners, specialists, hospitals, and emergency care providers. Ensure coverage in both urban and rural areas to meet participants' needs.

Guaranteed Payment Arrangements: Establish guarantee of payment (GOP) agreements with network providers to facilitate seamless access to care for participants, ensuring they are not required to make upfront payments.

Clinical Programs: Implement clinical programs that support the appropriate use of prescription drugs and optimize participants’ health outcomes. This includes utilizing real-time analytics to identify opportunities for intervention and support.

Pre-Departure Orientation: Provide participants with detailed information on the healthcare system in their host country, including how to access services, what to expect, and any special considerations. This includes guidance/advice on obtaining necessary vaccinations, medications, medical records, and submitting claims, self-care planning, and more, prior to departure to the host country

Ongoing Healthcare Advice: Offer continuous support for participants throughout their stay, including consultation on accessing healthcare providers, understanding their benefits, and managing any chronic conditions under the limitations of the ASPE policy and local rules, laws, and customs, world-wide. Support must be available in multiple languages and ADA accessible formats, with culturally competent representatives who understand the unique challenges of accessing healthcare in a foreign country.

Telehealth Capabilities: Provide a secure telehealth platform that enables participants to consult with licensed healthcare professionals remotely. Telehealth should be available to program participants for general medical consultations, mental health services, mental health and crisis support hotline, and follow-up appointments.

Accessibility and Availability: Ensure telehealth services are accessible 24/7, particularly for participants in remote, rural, or underserved areas where in-person care is not readily available.

Emergency Coordination: Coordinate and manage medical evacuations for participants who require urgent medical care that cannot be provided in their host country. The TPA must have the capability to arrange air or ground transportation, including professional medical and non-medical escorts if necessary.

Global Operational Capability: The TPA must maintain partnerships with international medevac service providers to ensure rapid response capabilities and seamless coordination in the event of an emergency, in any area of the world where ECA exchanges operate, including remote and rural locations and areas of political instability.

Compassionate Management: In the unfortunate event of a participant's death, the TPA must manage the repatriation of mortal remains with sensitivity and respect. This includes coordination with local authorities, compliance with international laws, and providing support to the participant's family.

Regulatory Compliance: Ensure compliance with all relevant laws and regulations related to the repatriation process, including obtaining permits and handling logistics across jurisdictions.

Meets: level > 100% Unsat: level < 100%

Periodic Inspection

Monthly Coordination Update

Required Service

Acceptable Quality Level (AQL) Note: all days are business days; availability % excludes scheduled downtime Monitoring

Support Processes and Tracking

Timeliness & Quality

Objectives of the Third-Party Administrator Modifications to any internal software which supports the ASPE contract will not impact on the availability of critical services for ASPE participants.

Emergency Customer Service response time:

1) Initial response to call for service

2) Response to Requests for Information (RFI) from customers

Efficiency and Accuracy: Implement efficient processes for enrollment, claims processing, and customer support to ensure services are delivered promptly and accurately.

Participant-Centered Service: Provide high-quality, accessible services that prioritize the needs and experiences of participants, including culturally competent support and communication.

Compliance and Integrity: Maintain strict adherence to all policies and procedures issued by ECA under the authority of the Executive Director, as well as all applicable laws and regulations.

Data Security and Ownership: Protect all participant data in compliance with federal regulations, recognizing that all data generated under this contract is the property of the U.S. Government.

Continuous Improvement: Utilize participant feedback and data analytics to continuously improve services, adapt to changing needs, and introduce innovations that enhance program effectiveness.

Meets: < 2 days Unsat: > 2 days

Meets: < 2 Hours Unsat: > 2 hours

Meets: < 1 Day Unsat: > 1 Day

100% Inspection

(No less than Annual)

Required Service

Acceptable Quality Level (AQL) Note: all days are business days; availability % excludes scheduled downtime Monitoring

Digital Platform and Technology Integration

Data Management, Reporting, and Compliance

Secure Online Portal and Mobile Application: Develop and maintain a user-friendly digital platform that allows participants to manage their health benefits, submit and track claims, access telehealth services, and receive important updates.

Data Security and Compliance: Ensure that all digital systems comply with federal regulations regarding data ownership, privacy, and security, including adherence to the Health Insurance Portability and Accountability Act (HIPAA) and other relevant rules and laws.

Advanced Data Analytics: Utilize sophisticated data management systems to collect, categorize, and analyze claims data and other relevant metrics. Provide detailed reports to ECA on a regular basis (monthly, quarterly, bi-annually, and annually), regarding all ASPE program activity and data collection points and elements, highlighting trends, utilization patterns, all program activity and related expenditures, claims denial types and reasons, and areas for potential policy adjustments. Vendor must have the ability to access and maintain all program data for the entire life of the contract and be able to produce reports on all contract data during the entire life of the contract when requested, to include the base year and option years that may have concluded. All reports will be accompanied with finished visual reporting and graphs and charts to illustrate trends to include program names and types, locations, types of claims, and more, and will be provided as standard and routine reporting deliverables and not ad-hoc reporting.

Regulatory Compliance: Ensure all operations comply with applicable federal, state, and local laws, including policies issued by ECA under the authority of the Executive Director. Maintain up-to-date knowledge of regulations affecting the ASPE program and implement necessary adjustments promptly.

Data Ownership: Acknowledge that all data generated under this contract is the property of the U.S. Government and must be handled in accordance with federal rules on data ownership and privacy.

Meets: = 100% Unsat: < 100%

Meets: = 100%

100% Inspection

Required Service

Acceptable Quality Level (AQL) Note: all days are business days; availability % excludes scheduled downtime Monitoring Method to be Used

Participant Emergency Support Requirements Gathering and Project Documentation

Healthcare Provider Network Management

Emergency and Crisis Management

Program Staff, Program Partner, and Program Participant Education and Engagement

Customer Service and Support

(Customer Support) (Help Desk Support)

The Contractor shall carry out the requirements gathering related to emergency support services processes to document all activities that occur more than one (1) time. These documented requirements are to include and not limited to:

1) Definition of Requirements

2) Prioritizing of Requirements and actions

3) Development of internal processes and documentation captures to insure records are maintained

Inform the Business Owner of the functionality that is to be incorporated and developed in each business process/ SOP. The Contractor also may be requested to provide detailed information to the following:

1) Number of instances of emergent emergency/routine care

2) Average cost encounters to support emergency/routine care

3) Regional breakdown of where emergency/routine care is occurring.

4) Other explanatory supporting information

Develop and maintain System Requirement Specification (SRS) and Traceability Matrix for each development effort

Develop user/training guides for each completed support project. The external user guides are required and will be integrated into ASPE support documentation. Contractor assistance may be required for the development of the internal user guide

Global Network Development: Establish and maintain extensive primary and secondary healthcare provider networks, within the U.S and globally, ensuring participants have access to high-quality medical services without the need for upfront payments.

Primary and Secondary Provider Networks: Develop both primary and secondary healthcare provider networks to provide participants with multiple options for medical care. This should include hospitals, specialists, and primary care providers who meet quality standards. Assist participants with locating local providers in network that will accept ASPE for coverage.

Credentialing Providers: Implement a comprehensive credentialing process to verify that all providers within the network have the necessary qualifications and comply with local regulations and ASPE standards.

Guaranteed Payment Arrangements: Secure guarantee of payment (GOP) agreements with network providers to facilitate seamless access to care for participants. This includes GOP to “non-network” providers within the U.S. and overseas locations providing care top program participants.

Credentialing and Quality Assurance: Implement a robust credentialing process to verify the qualifications and compliance of all network providers, ensuring they meet the required standards of care and service and will accept ASPE for coverage. Verify qualifications and compliance of domestic and overseas providers as part of customer support.

Medical Evacuation and Repatriation Services: Coordinate emergency and routine medical evacuations (medevacs) and repatriation of mortal remains as needed, operating with global capability and sensitivity to participants' needs during critical situations

Crisis Intervention Support: Provide immediate assistance and coordination during medical or security crises, including licensed medical and mental health professional support and mental health and crisis support hotline and related services, liaison with local authorities, emergency services, and providers to coordinate emergent care for program participants and serve as an interlocutor between program participants, providers, services, and more.

Education and Marketing Campaign: Develop and execute an education campaign tailored to program staff, program partners, and program participants to inform participants about their health benefits, how to access services, and their responsibilities under the ASPE policy. Materials must be clear, accessible, and available in multiple formats, media, platforms, and languages as necessary. All materials, formats, and platforms must be 508 compliant and screen reader accessible. Education and marketing campaigns will include but will not be limited to crisis management and intervention training for program staff and program partners (i.e., offering courses taught by licensed and experienced professionals on topics such as mental health first aid for non-mental health professionals, education on the basics of the US healthcare system and healthcare systems globally, and more.

Orientation Sessions: Coordinate with the relevant stakeholders to conduct pre-departure and ongoing information sessions to guide participants in understanding and utilizing their health benefits effectively.

Feedback Mechanisms: Implement bi-annual electronic surveys and other feedback tools to gather participants input on the quality of services provided, using this data to drive continuous improvement and provide the results of these surveys to ECA. The vendor will provide ALL data collected via any feedback mechanism that is utilized by the vendor for the ASPE program.

24/7 Multilingual Support: Provide around-the-clock customer service in multiple languages to assist participants with inquiries about their health benefits, claim status, accessing medical care, and other support needs. Availability of translation services to provide customer service, support, and translation of documentation and related materials for claims, case management, and exchange participant support.

Multilingual Contact Center: Operate a contact and customer service and support center that provides 24/7 support in multiple languages, offering assistance with claims, accessing medical care, medical care and records translation, and other medical related services. This support should include phone, email, chat, and digital self-service options.

Crisis Response Team: Ensure that crisis intervention services are available 24/7, including access to mental health professionals and mental health and crisis support hotline who can assist participants in emergency situations, worldwide Readiness: All support representatives must be trained in readiness competence, ensuring that participants receive support that respects their collective and varied backgrounds.

Support Platforms: Provide multiple and ADA-compliant platforms for participants to access support, including mobile apps, secure messaging, and traditional contact methods to accommodate collective and varied situations.

Multiple Communication Channels: Offer support through various platforms, including telephone, email, live chat, and a secure online portal or mobile application, ensuring accessibility for all participants regardless of their location or time zone.

Provide monthly Help Desk summary from reports from received requests for information or support to COR and provide trend analysis Help Desk report each month to better identify root cause for submitted Help Desk tickets

Documentation for obtaining records of complaint and/or QA Assessments is complete and accurate, complies with HIPAA requirements and NIST guidance, and requires no or minimal edits upon COR review

Meets: approval and sign-off by COR and Business Owner Unsat: are due to other reasons

Meets: = 24/7/365 coverage Unsat: Validated complaints of participants not being able to communicate with customer support.

Meets: =< 5 days Annual Outage Unsat: >5 days Annual Outage

100% Inspection

Periodic Review

Biannual Review

ATTACHMENT 2: SAMPLE QUALITY ASSURANCE

MONITORING FORM

SERVICE or STANDARD:

SURVEY PERIOD:

SURVEILLANCE METHOD (Check):

Random Sampling 100% Inspection Periodic Inspection Customer Complaint LEVEL OF SURVEILLANCE (Check):

ANALYSIS OF RESULTS:

Narrative of Performance During Survey Period:

PREPARED BY: ___________________________________ DATE: _________________

11SBU - CONTRACTING AND ACQUISITIONS