D.01 QUALITY ASSURANCE AND SURVEILLANCE PLAN.docx
DOCX document 29 KB Posted
- Attached to
- DOE Hanford Third Party Administration of the Workers' Compensation Claim Processing Program
- Solicitation number
- 89303923REM00008
- Issued by
-
Department of Energy
About this file
This document is a Quality Assurance Surveillance Plan (QASP) for a third-party administration of workers' compensation claims processing program. The contractor will be responsible for communication and customer service, meetings and workshops with claimants and representatives, payments and accompanied services, quality assurance of claim administration handled in a timely and accurate manner, and reporting. Performance will be evaluated monthly based on acceptable quality levels defined in the plan across key metrics such as the number of incidents for accurate and timely customer service, soliciting and dispositioning of customer comments, meetings held as required, payments made on schedule, and ensuring claims are handled properly with accurate files. The Department of Energy Hanford site is seeking these services under solicitation number 89303923REM00008 to administer their workers' compensation claim processing program.
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Text version
ATTACHMENT
D.1 QUALITY ASSURANCE AND SURVEILLANCE PLAN (QASP)
Contractor’s self-evaluation of performance shall be submitted monthly, up to ten days after the end of each month being reported along with the contractor’s properly certified invoice, complete with backup and analyses for all work completed in performance of this contract.
a. Performance Requirements Summary (PRS)
The PRS defines services required by this contract. The government performs surveillance to determine if the contractor exceeds, meets or does not meet these standards. The PRS is incorporated within this QASP to include performance standards and incentives. The government shall use these standards to determine contractor performance to Acceptable Quality Levels (AQL) defined below for each performance requirement.
b. Surveillance Methods
DOE’s Contracting Officer shall use the surveillance methods listed below in the administration of this QASP.
1) Direct Observation - Direct observation shall be performed periodically or up to 100% surveillance.
2) Periodic Inspection - Evaluate performance on a periodic basis. Inspections may be conducted daily, weekly, monthly, quarterly, annually or as needed.
3) Substantiated Complaints - Substantiated complaints from claimants or agency personnel shall be passed to the contractor for correction.
c. Documentation
1) Acceptable Performance – Number of incidents at or below the AQL on the performance standards.
2) Unacceptable Performance – Number of incidents above the AQL on the performance standards.
The Contracting Officer shall inspect to ensure contractor compliance with the appropriate section of the SOW. Acceptable performance could lead to a rating of satisfactory or above in the applicable CPARS category, and/or exercise of option(s).
When unacceptable performance occurs, the Contracting Officer shall prepare a report of all discrepancies and present the discrepancy report to the contractor.
The contractor shall acknowledge receipt of the discrepancy report in writing. The report shall specify if the contractor is required to prepare a corrective action plan which shall document how the contractor will correct the unacceptable performance and avoid a recurrence. The discrepancy report shall also state how long, after receipt, the contractor has to present this corrective action plan to the CO, if required. The government shall review the contractor’s corrective action plan to determine acceptability.
Any discrepancy report will be used during CPARS evaluations and any related contractual actions.
During contract performance, the Contracting Officer shall periodically analyze whether the frequency of surveillance is appropriate for the work being performed, and shall meet with the contractor at least annually to assess and discuss performance.
Solicitation # 89303923REM000008 DOE-HANFORD Workers' Compensation Third-Party Administrator
Section D Attachment D.1
PERFORMANCE REQUIREMENTS SUMMARY
| Required Service |
| Performance Standard |
| AQL |
| Method of Surveillance |
Communication/ Customer Service
| Provide accurate, complete, clear, and timely customer service in the processing of claims in accordance with the requirements set forth in the SOW. |
| Three incidents per reporting period (Monthly) |
Periodic Inspection, Substantiated Complaints
| Solicit, gather, categorize, and disposition customer comments received in a timely and accurate manner in accordance with the SOW. |
| Two incidents per reporting period (Monthly) |
Meetings/ Workshops
| Meet with claimants and appropriately authorized representatives as requested |
| Two incidents per |
reporting period (Quarterly)
Direct Observation, Substantiated Complaints
Meet with Contractor Workers’ Compensation Representatives (WCRs) monthly One incident per reporting period (Annual)
Meet with DOE Hanford, WCRs, Hanford Site Union Representatives, Hanford Workforce Engagement Center Representatives, and other Stakeholders as appropriate monthly.
One incident per reporting period (Annual)
| Meet with DOE Hanford on a bi-weekly (every other week) basis |
| One incident per |
reporting period (Monthly)
Payments
| Make payments and perform accompanied services in accordance with the requirements set forth in the SOW. |
| One incident per reporting period (Quarterly) |
| Periodic Inspection, Substantiated Complaints |
Quality Assurance Ensure claim administration is handled in a timely and accurate manner. Maintain claim files in accordance with L&I regulations and DOE Hanford records disposition schedules.
One incident per reporting period (Quarterly) Periodic Inspection, Substantiated Complaints
Reporting Provide prompt and accurate monthly, quarterly, bi-annual and annual reports within the prescribed number of business days following the end of the reporting period.
Two incidents per reporting period (Annual)
Direct Observation
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