A workflow can submit requests faster while creating more rework, pends, or unsupported information. A balanced measurement program tracks patient access, case quality, staff effort, and system reliability across the complete authorization journey.
Measure the full case timeline
Capture timestamps for intake, requirement discovery, documentation completion, submission, payer response, additional-information exchange, appeal, and final disposition. Report both medians and high percentiles because difficult cases disappear inside averages.
Segment by payer, service line, procedure, location, and outcome to reveal where burden actually concentrates.
- Referral-to-complete-intake time.
- Complete-intake-to-submission time.
- Submission-to-decision time.
- Total time to therapy or scheduled service.
Pair speed with quality and effort
Track first-pass completeness, requests for additional information, avoidable denials, resubmissions, and appeals. Count manual touches and active work time, not only elapsed calendar time.
Measure automation exceptions and human overrides. These show where policy, data, or integration quality needs improvement.
Use comparable definitions
Write a data dictionary for each metric, including start and stop events, exclusions, and ownership. Preserve raw events so definitions can evolve without losing history.
Compare pilot and baseline populations carefully. Changes in payer mix or case complexity can otherwise look like workflow improvement or deterioration.