5.0 Performance
Readiness Validation (PRV)/performance Readiness Assessment And
Verification (PRAV)
During transition, the
incoming contractor’s performance readiness status regarding customer service
activities will be subject to PRV/PRAV reviews as described below.
5.1 Customer
Service PRV
5.1.1 The contractor shall offer an automated telephone
critique to 100% of toll-free service line callers who interact
with a live customer service representative. No later than 120 days
prior to SHCD, the contractor shall initiate validation of call
center capabilities.
5.1.1.1 The validation shall assess the contractor’s
ability to receive calls, document calls, provide correct answers,
have supervisors ready to assist with difficult calls, and perform
any handoffs to other contractors. The contractor shall provide
the Government with a comprehensive briefing on the processes, test
results, and findings of the 120 day validation. This briefing should
summarize information that was reported to the Government via the
Weekly Integrated Master Plan/Integrated Master Schedule (IMP/IMS)
Status Report. Results shall be briefed as validated performance
against desired performance levels and contract standards and/or
requirements.
5.1.1.2 The validation
shall measure the contractor’s ability to meet the following standards:
• Blockage
Rates less than 5%.
• Call Abandonment Rates
less than 5%.
• Average
Speed of Answer less than 45 seconds.
• On hold Times less
than 30 seconds 95% of the time.
• Call resolution in
first call 85% of the time.
• Response accuracy
90% (Responses provided by Call Center staff shall be accurate and complete
according to the terms of the contract and all applicable TRICARE
programs and policies).
5.1.2 Sixty days
prior to SHCD, the contractor shall validate its call center operational
capabilities. The contractor shall test its ability to receive calls,
document calls, provide correct answers, have supervisors ready
to assist with difficult calls, and perform any handoffs to other
contractor personnel with no problems. The validation will include
accuracy and stress testing of all aspects its call center. The
contractor shall test its capability against each of the standards
referenced above and provide the results to the Government. The
contractor shall provide the Government transition team with a comprehensive
briefing on the processes, test results, and findings of the 60
Day validation. This briefing shall summarize the information that
was reported to the Government via the Weekly IMP/IMS Status Report.
Results shall be briefed as validated performance against desired
performance levels and contract standards and/or requirements.
5.1.3 Sixty
days prior to SHCD, the contractor shall validate its customer service
staff is fully trained and knowledgeable about TRICARE and is able
to utilize multiple means of contemporary communication media (e.g.,
electronic mail, web page, telephone texting process, smart phone applications
and social media outlets) to accurately answer customer questions.
The validation shall include a demonstration that the staff is full
trained. The contractor shall provide the Government with access
to training documents and response scripts. The validation shall
include a demonstration of a fully functional customer service data
exchange and interface with the claims processing system. The validation
results shall be briefed to the Government 55 days prior to SHCD.
5.1.4 Thirty
days prior to SHCD, the contractor shall repeat the validation process
described in
paragraph 5.1.3 and brief the results to the
Government 25 days prior to SHCD.
5.2
Customer
Service PRAV
5.2.1 The contractor shall comply with the Government’s
approach for assessment and verification of the contractor’s performance
readiness regarding customer service activities as described above.
If, after review, the Government finds the contractor’s performance
readiness for customer service to be deficient, the contractor must
submit a detailed mitigation plan no later than 10 business days
following the Government’s findings.
5.2.2 Specific PRAV activities,
assessment techniques, and performance readiness thresholds will be
identified by the Government during the Transition Specification
Meeting.