New Member Enrollment (Manual) Cycle Time

New Member Enrollment (Manual) Cycle Time

KPI Details

New Member Enrollment (Manual) Cycle Time measures the number of business days required to manually (non-electronic) enroll a new member or policyholder into a health plan, from the point-of-sale until the new member is enrolled into the health plan they applied for. A relatively high value for this metric is typically related to a few common factors, including inefficient call script and customer communication policies, poor customer contact tracking and management (i.e., tracking of customer communications and contact information), unclear enrollment application submission instructions, and sub-par health insurance back office employee training and performance. Each of these factors can lead to increased error rates (i.e., enrollment applications that contain errors, missing information, missing documentation, etc.), longer enrollment cycle times and increased customer dissatisfaction which can vastly increase operating expenses (i.e., rework, time spent fixing errors and obtaining needed information from customers, etc.) and customer attrition rates.

KPI Definition

The number of business days required to manually (non-electronic) enroll a new member or policyholder into a health plan, from the point-of-sale until the new member is enrolled into the health plan they applied for.

KPI Best Practices

• Proactive communication with the health plan applicant to ensure all documents are submitted and complete
• Regularly evaluate rules to speed up the manual underwriting process based on income, past health issues, etc.
• Be transparent about service levels and typical enrollment cycle times to increase accountability

KPI Calculation Instructions New Member Enrollment (Manual) Cycle Time?

The calendar dates/times of two events are used to derive this KPI: (1) the point-of-sale of the health plan (i.e., when the potential customer applied for the health plan), and (2) the date in which the potential customer has been successfully enrolled in the health plan they applied for. Completed enrollments are considered to be enrollment applications that results in a customer being approved to receive a policy from a health insurance company. Customers who wish to enroll in a health plan typically need their Social Security Number (SSN), birth date, paystubs, W-2 forms (or other forms that describe the potential customer’s income), policy/member numbers for any current health coverage, information about any health coverage from a job that is available to the potential customer or their family, etc.

KPI Formula :

(Sum of New Member Manual Enrollment Times) / Total Number of New Member Manual Enrollments