The problem
Where the time was going
With federal budgets under pressure, agencies were told to do better with less, but most teams struggle to change a process without making it worse. The Veterans Administration Customer Accounts Center set out to find the inefficiencies in its own work and to understand how hard its people were actually working.
The center is a call center and collection operation: when a veteran visits a hospital, their insurance details are captured, and the center then bills the insurer or the veteran and handles follow-up and collection. This site, covering seven hospitals across Tennessee, Kentucky, and West Virginia, was a pilot, and if it worked the model would be rolled out nationally.
The priority was clear and, until then, unanswered: find the full-time-equivalent utilization so unnecessary activities could be consolidated. Put plainly, the team wanted to know what percentage of the time its employees were genuinely busy, lay the process out clearly, and train people where it would pay off.
What we modeled
Mapping the process, then testing the fix
ProcessModel mapped the billing-and-collections process from end to end, from capturing a veteran's insurer data through billing, follow-up, and collection. Two weeks of interviews with employees grounded the model in how the work actually ran before any resources were applied to it.
With the people modeled against the processes they performed, the charts and graphs that came out of the model made utilization visible department by department, turning a question outside consultants and even the Government Accounting Office could not answer into a number on the page.
The result
The proof, and the payoff
The standout finding was in the Insurance Identification and Validation department, the group that calls carriers to verify benefits. It was running at only 30 to 35 percent utilization. Staff were reassigned to where the work actually was, and that department climbed to 90 to 95 percent, which also drew down a backlog elsewhere and helped the other departments run more smoothly.
The model also showed that the Customer Service department was maxed out and overworked, while Billing ran at 75 to 80 percent of capacity. The VA felt it had recovered its investment on this finding alone, because nobody it had hired before, the Government Accounting Office included, had been able to tell it how well its people were used.
- 30-35% to 90-95%
- utilization in insurance identification and validation
- 75-80%
- capacity in the billing department
- Maxed out
- customer-service department identified as overworked
Part of our work in military and defense.