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 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.