Case Study

National Health Insurer

Challenge

  • Australian health insurance provider processing centre reviewed digital and manual health insurance claims from its members
  • Customers were leaving at higher than historical rates due to very poor experiences waiting for insurance claims to be assessed

Current Situation

  • Average waiting time was 12 days for members
  • The actual processing time was 2-5 minutes
  • Leadership had no visibility ofthe number of claims waiting to be processed, nor was this a metric that anyone worried about
  • Queue size ranged from 15,000 – 20,000
  • Team leaders were largely focused on the escalation of potentially fraudulent claims, rather the performance improvement of their teams and therefore customer experience

Solution

Implemented Capacity Planning and Visual Management systems to highlight current performance and enable management to make decisions as soon as deviations from plan arise

1. Workload capacity planning tool spreadsheet

  • Spreadsheet was projected on a TV screen at daily planning meeting
  • Managers were able to discuss and calculate capacity applied to each customer queue in order to hit their daily customer focused targets
  • Spreadsheet was referred to multiple times throughout the day to adjust capacity allocations based on live performance

2. Work-in-Progress Tracking Board

This live active visual management whiteboard was situated right in front of the team and gave management the ability to:

• Set daily targets for each hour of the day
• Communicate targets to team
• Track actual performance vs planned
• Take action when actual drops below target
• Use chart as a motivator for workers

3. Skills Matrix

  • Skills matrix boards were also created for all teams and provided a clear and fast pathway for all team members to become cross skilled
  • The matrices indicated the level of  competency of each team member for each skill and displayed a date they would achieve the next level of competency by
  • The matrices also enabled the effective allocation of staff to queues based on their skills sets

Results

Time to process customer claims reduce from ~12 days to 5.5 days in 2 weeks

  • Total WIP across all queues reduced 53% in just over 2 weeks
  • 18,500 down to 8,800

Hourly tracking of work and more active upskilling of workers drove a 17% increase in
productivity resulting cost reduction of $7.3M pa

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