Analysis · 2021
Claims cohort
Why did average days to pay a claim look calm while providers were furious?
Method
Rebuilt the metric at the claim-line grain. Split first-pass claims from rework. Stopped letting a reversed claim erase the wait that had already happened.
Finding
The average hid a long tail. Reworked claims sat for 41 days. First-pass claims were fine, and they were numerous enough to flatter the mean.
What moved
The operations review switched to a tail metric. Staffing moved toward the rework queue within a quarter.