Quality Process Overview
1. Quality Assurance (QA) vs. Quality Control (QC)
Quality Assurance (QA): Asynchronous audits conducted to capture errors in delivered work based on predefined criteria. QA data feeds into quality metrics and helps inform process and product improvements.
Example: Application Submission Audits to detect errors after submission.
Quality Control (QC): In-process review of work before it is delivered. All QC-detected errors are corrected, impacting efficiency rather than client-facing quality.
Example: LIC & PE applications reviewed by specialists or automated tools before being sent.
2. Definitions
Client-Facing Quality: Defined as how our clients perceive the quality of our product, focusing on customer satisfaction. It is measured using our audit data to calculate the Perfect Delivery Rate.
Perfect Delivery Rate (PDR): Reflects requests processed without major or critical errors. It serves as the "North Star" metric for quality tracking across our operations.
Impact Severity: Audit elements are categorized into 1 of the following impact severity categories.
No Error: No error found.
Minor (Inconspicuous): Errors that do not impact client experience. Such as incorrect status usage, which is quickly corrected.
Major (Noticeable): Errors visible to clients that do not significantly affect the overall request health. Such as confusing update notes.
Critical (Consequential): Errors with potential long-term impacts that could harm provider status or security, such as PII leaks, resubmissions or missed renewals.
Audit Process Overview
1. Purpose and Tool Description
The Audit Tool is central to tracking client-facing errors and determining quality metrics. It captures data not available through automation, establishing a baseline for quality improvements across departments.
2. Audit Types and Attributes
Audit: A collection of steps representing various processing stages, such as submission, follow-up, and resubmission. These audits are populated through automated scripts and sampled based on specific criteria.
Audit Attributes: A particular step within an audit to review the impact severity of a particular element of the processing stage being audited.
3. Error Disputes and Feedback Loop
Error Disputes: A defined process allows specialists to dispute errors within two weeks. QA managers review disputes to update audit results if necessary.
Feedback Mechanism: Audit data is reviewed continuously to adjust processes and product, enabling continuous quality improvement.