Quality Assurance

Delivering the best local quality is possible through QualTrak, our technology enabled program that embodies our processes and systems that ensure best practice.  QualTrak is rules based and drives proven business processes.  Central to the M Hayes QualTrak program are processes to ensure our customers receive only the best case management outcomes.  We perform the following eight best practice processes:

• 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.
• Quality Audits - An important part of our QualTrak program is the quality audit. Performed outside of the operations area of M Hayes where QualTrak processes are implemented, these audits are a function of our Quality Assurance division. The audit function is formally implemented throughout the company and performed within all regions. Quality audits assist the Quality Assurance division in reviewing and analyzing quality trends that assist in planning and implementing staff training. Identifying areas needing improvement as well as evaluating how practice standards result in better outcomes assists M Hayes to constantly improve services.