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400 agent actions in. 210 out.
Four hundred actions in a claims workflow. An action missing any one of the four elements is not partly defensible — it is indefensible.
Completeness
47.5%
Indefensible
210
Consequential gaps
107
Examination ready
no
| Element | Missing | Share | |
|---|---|---|---|
| What it did | 0 | 0.0% | |
| What it read | 18 | 4.5% | |
| How sure it was | 80 | 20.0% | |
| What would have changed it | 150 | 37.5% |
| Workflow | Actions | Defensible | Rate |
|---|---|---|---|
| appeals | 100 | 47 | 47.0% |
| claims-adjudication | 100 | 46 | 46.0% |
| claims-intake | 100 | 49 | 49.0% |
| provider-verification | 100 | 48 | 48.0% |