1. Zero Voucher Defects Ensuring Timely Payments to NQC Coaches
An NQC Quality Improvement Project

2. AIM Statement
NQC seeks to have a zero rejection rate of coach vouchers forwarded by NQC staff to Health Research, Inc. (NQC’s fiscal agent). NQC also seeks to ensure that the accurate and complete vouchers are processed in three weeks or less.

3. Purpose of this Project
Anecdotal reports to NQC staff indicate that there may be a problem in the past few months with coach voucher being paid in a timely basis. Various factors can contribute to this but NQC examined the actual time it has been taking for the period May 2013 to June 2013 and compared it to January 2013 and February In addition, NQC wanted to examine the accuracy and completeness of the vouchers received by NQC from its coaches contain the correct information including dates of services, contract numbers and supporting paperwork

4. Data Collection
NQC established a baseline period of Jan. – Feb and compared it to the period of May 2013 through Jun
NQC has used the Contract Management System (CMS) available through the AIDS Institute which provides data on when a voucher was received at HRI, the date it was paid and the coaches budget balance

5. Voucher Flow Chart

6. Developing New Measures
NQC developed the following measures to meet the aim of this project:
Percent of monthly invoices rejected by HRI
Percent of monthly invoices paid within three weeks of receipt of correctly completed voucher by NQC Coach

7. Rational for Measures
It was decided that NQC would look at the time it takes for the check to be issued by HRI to the coach. This was chosen rather than looking at the time the check was received by the coach because many NQC coaches have busy travel schedules and this would add days or weeks of delay of reporting the receipt of the check. Also, it puts an additional burden on our coaches to report to NQC when they received the check. The percent of invoices rejected by HRI is a final quality check on NQC’s voucher analysis. Our goal is to have no vouchers rejected by HRI to ensure expedited payment to the coaches.

8. Results of Rapid Payment Study

9. Discussion of Rapid Payment Study
The data confirm the anecdotal reports of an increase in late voucher payment processing. The beginning of 2013 indicated that all vouchers were paid in a timely manner. This is consistent with a similar study NQC conducted in 2007 and The results of the May through June data reveal that thee vouchers encountered some sort of problem in the payment cycle. One issue of concern is the lack of a full time staff person who is familiar with all NQC procedures and policies as well as those of HRI’s. The position is currently being staffed by a temp worker who has performed admirably but experienced a learning curve as any new employee would. NQC recognized the need for additional training for the temp worker until such time as permanent staff are in place. NQC also recognized that information becomes problematic when a voucher is rejected by HRI because the system “looses” track of it and tracking becomes a manual procedure. A log was not kept to track if a voucher was rejected or could be processed as submitted. An improvement opportunity was lost because instructional tutorials could be developed to guide the coach in submitting complete vouchers. This has been addressed as well.

10. Discussion of Rejection Study
No invoices were rejected by HRI in either period studied. This indicates that NQC provides careful screening of invoices received from coaches and NQC coaches have been effectively trained resulting in the submission of accurate and complete invoices.

11. Improvement Ideas
Routine tracking and reporting should occur every month to ensure timely payment of invoices
Survey coaches and staff at least annually to solicit ideas for improvement
Have an internal mailbox specifically for improvement ideas from coaches and staff and discuss ideas at staff meetings