Purpose of QRT IQRs

13. QRT IQRs

Introduction

This topic contains information about QRT IQRs, including

• purpose of QRT IQRs
• review criteria for QRT IQRs
• standard of review for QRT IQRs
• recording method for QRT IQRs, and
• QRT IQR-final review level and QRT coach responsibilities.

Change Date

August 31, 2026

8.13.a. Purpose of QRT IQRs

A review of the individual’s work is intended as a performance measure to ascertain the quality element in that individual’s performance standard.

A QRT IQR is intended to provide an evaluation of an individual PS’s work product to determine if the minimal standard for correctness has been met.

QRT IQRs are the review of five randomly-selected quality reviews per month (on average) conducted by the PS. This review determines the employee’s individual quality level as part of their overall performance evaluation.

The intent of the performance standard is to obtain an average of five per month over the entire FY for each employee to assess the quality element in the standard.

8.13.b. Review Criteria for QRT IQRs

PSs are responsible for performing IQRs identified by QMS and Genesys on other PSs. QRT IQRs, with cited errors, will be routed via QMS or Genesys to a QRT coach for QRTIQRFinal review. These reviews will consist of a random selection of work, based on the amount set forth in the national performance standards. The selection of actions, while random, will reflect an appropriate mix of work performed by the employee throughout the month (i.e., not from a single day or single week).

8.13.c. Standard of Review for QRT IQRs

The standard of review for QRT IQRs is to ensure accurate completions of the quality checklist used for LIE, FE, FAR, FSR, and LAS IQRs. The QRT IQR will encompass a thorough assessment of the QRS’s completed checklist in its entirety to ensure that the minimum standard for review has been met on the initial quality review which includes proper selection of yes, no, or N/A on the checklist task questions.

• If the response on the checklist is
• no, it must rise to the level of a CUE or be a clear violation of current regulations or directives
• yes, it must account for the proper actions implicitly or explicitly taken by the LIE, FE, FAR, FSR, or LAS for the transaction(s) under review, and
• N/A, it must not apply to the transaction(s) under review.
• Selecting the proper checklist responses to reflect the appropriate answer for each task is important to ensure the LIE, FE, FAR, FSR, or LAS receives credit for work completed correctly or ensuring the employee does not receive undue credit for work not applicable to the transaction under review.

Important:

• A PS performing a QRT IQR will select either AGREE or DISAGREE with the initial review performed. If an error is found on the initial review, to include only changing a task question from yes to N/A or N/A to yes, the reviewer performing the QRT IQR will identify the task question(s) in error in the comment box along with a complete error narrative.
• QRT Performance Errors are required when correcting question responses to reflect the appropriate answer for a task because it is important to ensure LIEs, FEs, FARs, FSRs, or LASs receive credit for work completed correctly or to ensure the employees do not receive undue credit for work not applicable to the transaction(s) under review.

Example 1: A PS is completing a review on an approved accounting. The previous PS marked the review correct. The PS conducting the QRT IQR determined that the approval of the accounting was incorrect because of an incorrect accounting starting balance. The PS will DISAGREE with the initial review and will include the following sample narrative in the comment box:

Error for incorrect accounting approval. The PS failed to cite an error for an approved accounting with incorrect starting balance.

Example 2: A PS is completing a review on the generating an award transaction. The previous PS cited an error because the award released the retroactive benefit payment. The PS conducting the QRT IQR determined that the release of the retroactive benefit payment was an appropriate award action. The PS will DISAGREE with the initial review and will include the following sample narrative in the comment box:

No error is present. The PS incorrectly cited an error for releasing a retroactive benefit payment.

8.13.d. Recording Method for QRT IQRs

In QMS, an IQR on a PS is identified as QRTIQR in the REVIEW LEVEL column in the MY REVIEWS view, which can be accessed by clicking on the REVIEWS LANDING PAGE tab. The IQR for a PS can also be identified by reviewing the REVIEW DETAIL screen. If QMS selects an IQR for a PS, the QRT PERFORMANCE REVIEW box is checked on the REVIEW DETAIL screen.

To open the review, click on the REVIEW NAME column, which will open the REVIEW DETAIL screen. To see additional information, select the REVIEW SUMMARY button from the REVIEW DETAIL screen.

The FCC will record results in accordance with local FCC procedures.

Follow the steps in the table below to record a QRT IQR.

Scroll sideways to see the full table.

Notes:

• A comment is required regardless of whether the AGREE or DISAGREE button is selected.
• If the reviewer agrees with the PS’s initial review, the reviewer will input a comment, select the AGREE button, and click SUBMIT. Once the PS selects SUBMIT, the review is complete.
• If the reviewer disagrees with the PS’s initial review, the checklist completed during the initial review will require modification and/or correction. When the DISAGREE button is selected, the reviewer is returned to the initial REVIEW PAGE that contains the claim information with the error citations and comments provided by the initial reviewer. The QRT IQR reviewer will cite any additional errors found, correct any of the errors called on the initial review, and/or correct any responses to the task question(s). After correcting the corresponding checklist, the reviewer selects the REVIEW SUMMARY button. The reviewer will also notate the error that was cited or that should have been cited from the applicable checklist, along with any changes to task question responses. Once the review checklist is updated and the error narrative is input in the comment box, the reviewer will select SUBMIT REVIEW button and the review is complete.

Reference: For more information on QRT IQR routing rules and procedures, see the QMS User Guide in the QRT SharePoint site.

8.13.e. QRT IQR Final Review Level and QRT Coach Responsibilities

QRT IQRs with cited errors will be routed via QMS to a QRT coach for QRTIQRFinal review.

All QRT IQRs that result in a Disagree are routed to the QRTIQRFinal review level. This level is directed to a QRT coach for their determination on the outcome of the review. The coach performs the review using the same steps listed above.

The FCC final review reconsiderations are routed and recorded in accordance with local FCC procedures.

Important: If the coach is agreeing with the changes to the review made by the last individual that reviewed the case, this indicates the QRTIQRFinal individual is approving the changes and the disagreement indicated by the QRTIQR reviewer. A disagreement at the QRTIQRFinal level is used if the coach does not agree with the subsequent reviewer’s determination.