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Point System Criteria

*Effective 01/02/2025​


CCC will be implementing a sweeping point system to ensure the quality of service provided by our contractors.

The criteria list is dynamic and may change at any point as required. Good Points (GP) and Bad Points (BP) not yet listed below may be assessed by authorized CCC leadership at their individual or group discretion.

Each assessment is on a per-incident basis and may compound.


CM INVOICE SUBMISSIONS

  • Duplicate Claim: 2 Bad Points
  • Advanced Billing: 1 Bad Point
  • Invoicing @CCC Billing Department not @CCC Payables Department: 0.5 Bad Point
  • Disregarding Careplan Date: 0.5 Bad Point
  • Incorrect Proration: 0.5 Bad Point
  • Perfect Submission: 0.25 Good Point

CM WEEKLY REPORTS

  • No Weekly Report Note: 0.5 Bad Point
  • No Recorded Contact Attempt: 0.5 Bad Point
  • "Unsatisfactory": 1 Bad Point
  • "Needs Work": 0.5 Bad Point
  • "Satisfactory": 0.25 Good Point0.5 Good Point
  • "Flawless": 1 Good Point

CM MONTHLY MEETING ATTENDANCE

  • Late (Per 10 Min): 0.25 Bad Point
  • Absent (Availability Notice): 1 Bad Point
  • Absent (No Availability Notice): 2 Bad Points
  • Present (On-Time): 0.5 Good Point

QUALITY CONTROL MONITORING

  • Ignoring Supervisor Request: 3 Bad Points
  • Mistreating Colleague/Member/Third-Party: 5 Bad Points
  • Background Noise: 0.5 Bad Point
  • Recording Disclosure Omission: 0.5 Bad Point
  • Status Inconsistency: 0.25 Bad Point
  • Outgoing Call Before 8am: 0.25 Bad Point
  • Outgoing Call After 8pm: 0.25 Bad Point
  • Ace Call: 0.1 Good Point

CM DAR SUBMISSIONS

  • Mismatching Information/Requirement/Attachment: 0.25 Bad Point
  • Missing Information/Requirement/Attachment: 0.25 Bad Point
  • Excessive/Irrelevant/Inconsistent Document: 0.25 Bad Point
  • Incorrect File Name: 0.2 Bad Point
  • Attachment Not Mirroring: 0.1 Bad Point
  • Failure to Resubmit Corrections within Original DAR Thread: 0.5 Bad Point
  • Perfect Submission: 0.25 Good Point

CM LEGAL ASSITANCE REQUEST SUBMISSIONS

  • Missing Verbal Consent Attachment in CP: 0.75 Bad Point
  • Missing Required Information: 0.5 Bad Point
  • Incorrect/Missing Email Recipient(s): 0.25 Bad Point
  • Perfect Submission: 0.1 Good Point

INTAKE STRATEGIST 'NEW MEMBER' SUBMISSIONS

  • Missing Verbal Consent Attachment in CP: 2 Bad Points
  • Missing Careplan: 2 Bad Points
  • Incorrect/Missing Email Recipient(s): 2 Bad Points
  • Missing Required Information: 1 Bad Point
  • Next Day Email Submission: 1 Bad Point