A national Third-Party Administrator (TPA) experienced significant, rapid growth. An increase in the number of new client implementations, in conjunction with the need to support existing clients, led to multiple technical (e.g., interface development) and operational (e.g., claim overpayment processing) backlogs. Operational backlogs, including claim issues reviews, overpayment processing, and configuration change requests, resulted in growing dissatisfaction among current customers, while technical backlogs resulted in implementation delays for new customers. The TPA anticipated further growth which would require increasing operational support and development tasks. The combination of business growth and customer dissatisfaction created an imperative to reduce the backlogs to address customer concerns and ensure capacity for upcoming implementations.
crankfrog defined, mobilized and executed a “SWAT” program management office to manage and coordinate multiple workstreams focused on the operational and technical backlogs. We developed a budget management process to infuse the business with additional resources, both temporary staff as well as technical investment, needed to accelerate backlog reductions. Where appropriate, we ensured a clear understanding of the breadth of the problem, projected additional resources required to accelerate backlog reduction, and managed the budget request, approval, and monitoring process. We implemented additional reporting to improve backlog tracking and measure progress towards backlog reduction. crankfrog provided day-to-day program and project management oversight, establishing a “burndown plan” that was closely managed to track progress and adjust as necessary.
The SWAT effort established a process for addressing acute backlog issues with a short-term, highly focused set of resources. Capacity planning and burn-down plans were created to enable detailed planning and tracking, while budget forecasts were implemented to closely monitor SWAT investment.
Through an organized and focused effort, crankfrog assisted the TPA in accelerating backlog reduction and enabled the organization to improve support for the existing client base and prepare for future implementations. Overall backlog reductions included:
- 38% in claim overpayment backlog greater than 30 days old, impacting $2.5M of overpaid claims;
- 80% in technical operations backlog (support tickets), freeing up support resources;
- 50% in benefit configuration;
- 70% in open claims.