THE UNIT — DEFINED IN ONE SENTENCE
One unit is one claim, for one patient visit, that enters charge entry and must leave as a verified, submittable claim.
The four steps — and what each one kept
Every claim passes the same four steps, in the same order. A claim counted “out” of a step is a claim verified as complete at that step, on its first pass through it.
| Step | Units in | Verified out | Step yield | What “verified” means here |
|---|---|---|---|---|
| 1 · Charge entry — Priya | 240 | 228 | 95.0% | Charges keyed and matched to the visit note. |
| 2 · Coding review — Marcus | 228 | 216 | 94.7% | Codes checked against the note and signed off. |
| 3 · Submission prep — Elena | 216 | 204 | 94.4% | Claim assembled, eligibility confirmed, ready to send. |
| 4 · Final verification — June | 204 | 192 | 94.1% | Independent check passed; claim released for submission. |
| Whole line | 240 in | 192 out | 80.0% | Rolled throughput yield — see below. |
STEP YIELDS · 228 ÷ 240 = 95.0% · 216 ÷ 228 = 94.7% · 204 ÷ 216 = 94.4% · 192 ÷ 204 = 94.1%
Rolled throughput yield
Of every 100 claims that entered the line this week, 80 came out verified on their first pass, with no step sending them back. The remaining 20 needed rework at one step or another — they were finished, but they cost a second pass to finish.
The gauge — A × D × E
The weekly gauge combines three plain measures. Each one is something the team can see, and something the team can move.
A · AVAILABLE
92.0%
The share of planned working hours the team was actually staffed and on the work: 184 of 200 planned hours.
D · DELIVERED ON TIME
85.0%
The share of claims due this week that were submitted by their daily cutoff: 153 of 180 claims due.
E · EXACT
94.0%
The share of claims found error-free in the week’s independent audit sample: 47 of 50 claims sampled.