Attachment 5-QUALITY ASSURANCE SURVEILLANCE PLAN (QASP) -Ambulette 2020.docx

ATTACHMENT # 3: PERFORMANCE SURVEILLANCE PLAN / MONITORING PROCEDURES:

The Quality Assurance Surveillance Plan (QASP) is designed to monitor contract compliance. The COR will implement the plan to provide effective and systematic surveillance of all aspects of this contract. The surveillance plan will employ various monitoring methods.

The COR or designee will implement a quarterly review of contract compliance and report to the CO findings and assessments.

Performance Requirement Summary Performance Objectives Performance Standard Acceptable Quality Level (AQL) Method of Monitoring Incentive

1) Timeliness Scheduled patients need to be at their appointments no more than 30 minutes prior to the appointment and no later than the appointment time. Pick up for these patients need to be no more than 30 minutes after the Contractor has been notified of completion of the patient appointment.

Response times for unscheduled trips need to be within sixty (60) minutes.

99% Review of Ordering Log Positive Past Performance & Exercise of Option Period

2) Licensing of Employees and Vehicles Contractor maintains current licenses for drivers, vehicle inspections and insurance.

100% COR or designee will periodically perform site visits/request copies of current licenses Positive Past Performance & Exercise of Option Period

3) Invoice Errors Invoices comply with Invoice Procedures of the Contract and agreed upon Mileage Guide.

Guide.

99% COR or designee will perform random sampling of Positive Past Performance & monthly trip tickets against monthly invoice

Exercise of Option Period