| Mark the completeness of the process | Consumer |
Metric for performance as seen from the SIPOC is
1) Average Time to Settle a Claim:
This metric measures the average amount of time to settle a claim. It's imperative to distinguish between different types of policies since different policies may vary greatly in terms of how long it takes to settle. A common example is the difference between regular commercial medical insurance claims or Auto accident claims or Personal Injury claims.
Swimlane Diagram for insurance process Hospital | Insurance provider | Consumer | Incomplete forms are received from the processing department.
Hospital sends the claim forms along with requisite documents (original bills, documents and reports) | Processing department receives claims date and time stamps and checks for completeness. Complete forms sent to authorization and incomplete back to hospital.
Customer service department generate confirmation email and mark completeness of the