ATTACHMENT 2: SLA SERVICE CREDIT TABLE 1 2 3 4 5 6 7 8 No. Performance Description The Bidder must provide the appropriate product and monthly quantity, as determined by the nursing assessment/reassessment. Shipment of incorrect product and/or quantity must be documented in the Client’s record and quarterly summary report to the HCA MES Program Manager and HCA Contract Monitor. Client obtain emergency products within 24 hours of notification. A valid prescription, i.e. inclusive of all required elements, is required for all products. Bidder must ship the requested product(s) as soon as a valid prescription is received from the ordering practitioner and the Client has chosen a sampled product; shipment must be received by the Client within three calendar days of shipment. Bidder must verify in ProviderOne, and other insurance eligibility of each Client within 1 (one) Business Day prior to shipping the order. Bidder’s licensed nurse must perform a telephonic initial nursing assessment for new Client within one business day after the intake and verification process is completed. Bidder’s licensed nurse must perform a telephonic nursing reassessment within two business days of a Client requesting products for a change in medical condition. Performance Criteria and Reporting Matrix Correct product and quantity is provided. Standard of Performance 95% monthly average of cases reviewed Incorrect product and/or quantity shipment is documented in Client record and quarterly summary report. 95% monthly average of cases reviewed $1,000 for each month out of compliance Emergency product is received within 24 hours. 95% monthly average of cases reviewed A valid prescription is present for all products. 100% monthly average of cases reviewed Bidder ships requested product(s) as soon as a valid prescription is received from the ordering practitioner and the Client has chosen a sampled product; shipment must be received by the Client within three calendar days of shipment. Bidder verifies eligibility within 1 business day prior to shipping the order. 95% monthly average of cases reviewed $2,000 for each month out of compliance $2,000 for each month out of compliance $1,000 for each month out of compliance 100% monthly, of cases reviewed $2,000 for each month out of compliance Bidder performs nursing assessment for new Client within one business day after the intake and verification process is completed.
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