At
M Hayes the way we ensure that we deliver on our mission is through
our Quality Assurance program. M Hayes‘ Quality Assurance
Program is comprised of seven interdependent processes. They
are:
- Standards
of Excellence - The Standards
of Excellence (SOE) for M Hayes’ QA Program assures
minimum service delivery requirements for all customers.
M Hayes consultants adhere
to these minimum standards of practice for all customers,
along
with any other additional instructions for that account
- Case
Trakker - Our SOE’s are an integral part of our Quality
Assurance program and are audited through Case Trakker,
our case management software
system. Case Trakker possesses a “rules based” system that consistently
compares consultant service delivery to our SOE’s as well as account
special handling guidelines and any diversion from these are noted in the prebill
process
which
highlights exceptions for management
- Case
Reviews - Case reviews are performed by the supervisor
on the consultants’ cases
every month. The review or audit of the file involves a rating of the
primary assessment areas in case management to include initial
contacts; initial
assessment; standard communication requirements; medical or vocational coordination
and delivery;
return to work/case coordination; reporting; and case administration.
- Quality
Assurance Survey - Another means of ensuring appropriate
and quality service delivery is through our Quality Assurance
(QA) Survey
process. The survey process is implemented through direct and indirect contact
with the
injured worker for verification and assessment of quality of case management
services delivered by the consultant.
- Report
and Bill Management - All reports and bills are reviewed
by the supervisor for quality
assurance prior to submission to the customer.
Report timeliness is critical to communication and our reports are required
every 30
days. Our bills are reviewed in tandem with the reports by the supervisor
for account handling and program compliance and billing accuracy. We also ensure
appropriate coding and confirm that the billing appears appropriate
to the activities
undertaken.
- Evaluating
for Excellence - On a quarterly basis the consultant’s
direct supervisor completes our Evaluating for Excellence (EFE)
form in which they evaluate performance and establish action
plans.
The supervisor assesses
the consultant’s service quality, accomplishments, billing
management, as well as their goals and objectives. The EFE is significant
to our QA program
as it is the tangible performance result that is driven by the
case review and audit rating system.
- Staffing
Principles - At M Hayes, we endorse staffing principles that
influence and enhance our service quality. As case management
is
clearly driven and effected by individual consultants, we produce better services
and outcomes
because of our adherence to these practices. They keep our staff
consistent in their philosophy, strategy, and approach.
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