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.