Health Insurance KPIs

Health Insurance Metric Definitions, Benchmarking Data & Reports

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KPI NAME
KPI DEFINITION
DATA
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Showing results 1 through 31 of 486 records
Medical Loss Ratio The total amount (in dollars) of claims, and other expenses that improve the quality of care, paid to members/providers by the insurance company over a certain period of time divided by the total premium earned during the same time period, as a percentage. See data (12615)
Calls Offered by Call Reason: Medicare The total number of incoming calls from customers inquiring about Medicare coverage over a certain period of time. This number includes both calls answered ("handled") by call center agents and calls that are abandoned before an agent picks up. See data (908)
Total Handle Time by Call Reason: After-Call Work - Medicare The total amount of time required to handle the after-call work of a call from a customer inquiring about Medicare coverage over a certain period of time. See data (908)
Calls Handled by Call Reason: Medicare The total number of incoming calls from customers inquiring about Medicare coverage over a certain period of time. This number only includes calls answered ("handled") by call center agents. See data (908)
Total Hold Time by Call Reason: Medicare The total amount of time that customers inquiring about Medicare coverage wait on hold during calls over a certain period of time. See data (908)
Total Talk Time by Call Reason: Medicare The total amount of time required to handle a single incoming call from a customer inquiring about Medicare coverage, not including after-call work (wrap time) or hold time. See data (908)
Calls Handled by Call Reason: Application Inquiry The total number of incoming calls from customers related to the status of their insurance application over a certain period of time. This number only includes calls answered ("handled") by call center agents. See data (907)
Total Hold Time by Call Reason: Application Inquiry The total amount of time that customers wait on hold during calls related to the status of their insurance application over a certain period of time. See data (906)
Calls Handled by Call Reason: Benefits Inquiry The total number of incoming calls from customers inquiring about their health plan benefits over a certain period of time. This number only includes calls answered ("handled") by call center agents. See data (906)
Total Hold Time by Call Reason: General Inquiry The total amount of time that customers with a general inquiry wait on hold during calls over a certain period of time. Calls that can not be segmented into a more specific call reason category are counted here. See data (906)
Total Hold Time by Call Reason: Benefits Inquiry The total amount of time that customers inquiring about health plan benefits wait on hold during calls over a certain period of time. See data (906)
Calls Handled by Call Reason: Billing Inquiry The total number of incoming calls from customers inquiring about their bill(s) over a certain period of time. This number only includes calls answered ("handled") by call center agents. See data (906)
Total Hold Time by Call Reason: Billing Inquiry The total amount of time that customers inquiring over their bill(s) wait on hold during calls over a certain period of time. See data (906)
Total Talk Time by Call Reason: Application Inquiry The total amount of time required to handle a single incoming customer call related to the status of their insurance application, not including after-call work (wrap time) or hold time. See data (906)
Total Talk Time by Call Reason: General Inquiry The total amount of time required to handle a single incoming call from a customer with a general inquiry, not including after-call work (wrap time) or hold time. Calls that can not be segmented into a more specific call reason category are counted here. See data (906)
Total Talk Time by Call Reason: Benefits Inquiry The total amount of time required to handle a single incoming call from a customer inquiring about health plan benefits, not including after-call work (wrap time) or hold time. See data (906)
Calls Offered by Call Reason: Payment Inquiry The total number of incoming calls from customers inquiring about making a current bill payment, or about a recent or upcoming bill, over a certain period of time. This number includes both calls answered ("handled") by call center agents and calls that are abandoned before an agent picks up. See data (906)
Total Handle Time by Call Reason: After-Call Work - Payment Inquiry The total amount of time required to handle the after-call work of a call from a customer inquiring about making a current bill payment, or about a recent or upcoming bill, over a certain period of time. See data (906)
Total Talk Time by Call Reason: Billing Inquiry The total amount of time required to handle a single incoming call from a customer inquiring about their bill(s), not including after-call work (wrap time) or hold time. See data (906)
Calls Offered by Call Reason: Provider Inquiry The total number of incoming calls from customers inquiring about network healthcare providers over a certain period of time. This number includes both calls answered ("handled") by call center agents and calls that are abandoned before an agent picks up. See data (906)
Total Handle Time by Call Reason: After-Call Work - Provider Inquiry The total amount of time required to handle the after-call work of a call from a customer inquiring about network healthcare providers over a certain period of time. See data (906)
Calls Offered by Call Reason: Eligibility Inquiry The total number of incoming calls from customers inquiring about their health plan coverage over a certain period of time. This number includes both calls answered ("handled") by call center agents and calls that are abandoned before an agent picks up. See data (906)
Calls Handled by Call Reason: Payment Inquiry The total number of incoming calls from customers inquiring about making a current bill payment, or about a recent or upcoming bill, over a certain period of time. This number only includes calls answered ("handled") by call center agents. See data (906)
Total Handle Time by Call Reason: After-Call Work - Eligibility Inquiry The total amount of time required to handle the after-call work of a call from a customer inquiring about their health plan coverage over a certain period of time. See data (906)
Total Hold Time by Call Reason: Payment Inquiry The total amount of time that customers inquiring about making a current bill payment, or about a recent or upcoming bill, wait on hold during calls over a certain period of time. See data (906)
Calls Handled by Call Reason: Provider Inquiry The total number of incoming calls from customers inquiring about network healthcare providers over a certain period of time. This number only includes calls answered ("handled") by call center agents. See data (906)
Calls Handled by Call Reason: Eligibility Inquiry The total number of incoming calls from customers inquiring about their health plan coverage over a certain period of time. This number only includes calls answered ("handled") by call center agents. See data (906)
Total Hold Time by Call Reason: Provider Inquiry The total amount of time that customers inquiring about network healthcare providers wait on hold during calls over a certain period of time. See data (906)
Calls Offered by Call Reason: Application Inquiry The total number of incoming calls from customers related to the status of their insurance application over a certain period of time. This number includes both calls answered ("handled") by call center agents and calls that are abandoned before an agent picks up. See data (906)
Calls Offered by Call Reason: General Inquiry The total number of incoming calls from customers about a general inquiry over a certain period of time. Calls that can not be segmented into a more specific call reason category are counted here. This number includes both calls answered ("handled") by call center agents and calls that are abandoned before an agent picks up. See data (906)

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