InsuranceSimulation & what-if

Groundhog Approvals

A year-long calendar exposing approvals members must request again every cycle, priced in dollars.

Listen
Reason
Act
Verify
Learn
Closes 5 of 5: Listen, Reason, Act, Verify, Learn

The job

Finds approvals members must request again on a fixed cycle, such as insulin, dialysis, physiotherapy and repeat prescriptions for long-term conditions. Prices each cycle, replaces the costliest with standing approvals, then proves the repeat requests faded.

The moment

Example, illustrative figures
  1. A calendar of the past two years shows a bright red stripe on the first of every month: members calling to get the same approval again. It costs $360,000 to $460,000 a year, using the committee's own agreed cost assumptions.

  2. A new rule starts: approvals now stand for six months. The next month, the first-of-month square is grey for the first time, and about 1,900 fewer calls come in that week.

  3. The app marks the stripe as fading, with a verdict due after three cycles.

  4. Three cycles later, it is confirmed as faded, meeting the test that was set in advance.

What it does

  • Register a standing-approval rule
  • Record the verdict
  • Send stripe dates to WFM
  • Send the business case to the committee
  • Draft the AI agent's answer about the new standing approval
  • Open a day's requests

What you see

A year-long contribution calendar with recurring stripes, stripe playback, a what-if fade and a change register

  1. Screen 1: Calendar
  2. Screen 2: Stripe Playback
  3. Screen 3: What-If
  4. Screen 4: Change Register

What it moves

Repeat approval contacts per month for each treatment, handling and approval-desk costs avoided per year in dollars, and the number of repeat patterns that faded as predicted in advance.

Built for

  • Product & digital
  • Contact-centre operations
  • Finance
OnClarity

Bring the one question your current platform can't answer.

Our team will map it to the apps that answer it, then set them up on your own feedback.

Talk to our team

Examples use illustrative figures. Apps are set up with our team on your own feedback data, and setup varies by app.

OnClarity

Bring the one question your current platform can't answer.

Our team will map it to the apps that answer it, then set them up on your own feedback.

Talk to our team

Examples use illustrative figures. Apps are set up with our team on your own feedback data, and setup varies by app.

OnClarity

Bring the one question your current platform can't answer.

Our team will map it to the apps that answer it, then set them up on your own feedback.

Talk to our team

Examples use illustrative figures. Apps are set up with our team on your own feedback data, and setup varies by app.