People perceive and interpret quality in different ways. There are ‘beautiful’ definitions by many Management and Quality Gurus, BUT, to keep it simple we say -

• Quality is the degree to which we’re able to satisfy customer requirements
• We’re a quality company if we’re capable of meeting/exceeding our customer’s requirements

From the time of inception, Quality control process in Promantra is able to make some positive significant changes in the operational functions which is not just related to quality accuracy but also gained huge efficiencies such as improved customer service and cost reduction.

In this article we will learn some of the key elements that are practised and put in action by the Quality control team in Promantra.

QUALITY OBJECTIVE

ZERO DEFECTS, ZERO COMPLAINT CONFORM TO CONTRACTUAL and REGULATORY STANDARDS

QUALITY COMMITMENT & CORE VALUES

Quality, Efficacy and Safety must be the utmost importance.

• To excel in the implementation of total quality management system.
• To inculcate a strong teamwork spirit.
• To encourage continuous improvements and innovations.
• Quality is not tested for but has to be built in.
• Quality is our service to God and mankind.

Providing Quality Daily Operational Support:

All process performance measures are captured in process dashboards available to our clients that help summarize the stability and capability of the process at any given point in time. Historical information for any given time period pertaining to the health of our processes is also made available to our clients.

Apart from the seven basic QC tools (Cause-and-effect, fishbone" or Ishikawa, Check sheet, Histogram, Control chart, Pareto chart, Scatter diagram and other Stratifications) which are very commonly known, Promantra QC team also applies other below mentioned critical Statistics to control the processes efficiency and accuracy.

Statistics:

• Statistical Process Control (SPC) to assess stability & Process Capability
• Six Sigma for process improvements
• Business Forecasting to facilitate the operations planning process

Key points that keep Promantra QC team on Horizon:

Process level analysis:

QC team here spend 6 hours in a day working on transactional audits. Rest of the two working hours are spent on performing process level analysis. Analysis such as -

• Aging analysis - Is A/R aging performing smooth, or is a disproportionate amount being aged?
• Denial analysis - What are claims rejection and denial rates, and how are they trending?
• Bucket Aging – Analyze the volume, aging and trends of the claims which are moved to the define buckets by AR analysts for next level resolution
• Work order analysis
• Mapping documentation – Mapping Production data vs. System reports Vs. Workorder to analyze the variance in documentation and number variation which is projected to client

Process Improvements:

Few guidelines to understand what triggers Process Improvements in Promantra -

• When a process in NOT in statistical control (Unstable)
• When a process is in statistical – control but NOT capable w.r.t meeting customer requirements
• When a process is in statistical control and capable but NOT profitable
• When all the above are met BUT CSAT is low OR when we aim at delighting customer

It is important to understand that every process improvement has to go with a business justification such as return on investment, cost, time, etc.

• Approach towards Process Improvement Projects
• Defining the problem and understanding the impact of the problem
• Identifying the causes of the problem
• Solving the problem
• Monitoring & Controlling to ensure the problem does not reoccur
• Perform trend analyses to identify potential problem areas and work with Ops Managers to implement action plans

FTE Utilization analysis :

This analysis helps to give an overview of how FTE resources are being utilized and/or going to be utilized. This report helps to analyze quantity of manpower resources are used and displays a breakdown of how the hours are paid. This report helps determine whether or not changes could be made to scheduling in order to better utilize available resources.

Toll gate process :

This is the process in which any new joiner (new employee/Internal movement) in the process will be put in to four level of Toll gate audits which will have higher % of sample starting from 100%. Rep needs to get through the defined benchmarks in each level to reach the online production process.

Performance improvement program :

Auditors will play a major role in improving the quality accuracy of operations team by placing the required reps (reps who fail to achieve the quality target) in to focus programs such as CAPA / PIP. Individual daily feedbacks are taken and daily reports are shared with the management group as per the defined policies.

Knowledge Sharing :

Monthly and Quarterly trainings and assessments based on the last six months errors and process requirement. Also, conduct trainings on numerous healthcare& RCMS topics. Establish email and discussion groups to facilitate development and sharing of “tips and tricks” to improve the way problems are diagnosed and resolved.

Quality team also considers the yearly Quality team anniversary program as an opportunity to conduct various knowledge based programs and celebrates while spreading and sharing the knowledge. Example – Kaizen hunt program to hunt the best ideas from all the employees of the organization and work on same accordingly.

Also read : "Denial Management Best Practices" .

Contact us for more information or write to us at info@promantra.us

Pradeep KV
Manager - Quality & Compliance
pradeepkv@promantra.net