Case study 05 / Process improvement

Insurance workflow Kanban

An eligibility-to-patient workflow was owned end to end by one person, and the queue grew to 18 days. We made the work visible, measured each step, put more heads where the time actually was, and rotated tasks so the team could cover the whole flow.

Client anonymised. Figures are the reported outcome; the board layout is illustrative.

Client
Anonymised · insurance services
Role
Business Analyst
Scope
Eligibility to patient contact · end-to-end
Method
Kanban · step-time analysis · task rotation
Before · end-to-end 11–18 days

Typical completion time

Backlog 18 days

Before the change

After · end-to-end 5 days

Backlog cleared

01 / The question

Why does one slow step set the pace for the whole case?

The workflow had five steps — insurance eligibility check, qualifying, document review, insurance confirmation of coverage, and contacting the patient. Each case was handled by a single person end to end. That created a capacity problem: the longest step set the pace, work piled up in front of it, and the backlog reached 18 days. Cases that should have moved in days were taking 11–18.

The fix was not to ask people to work faster. It was to make the flow visible, find where the time actually went, and put capacity where the process was constrained.

02 / The approach

Kanban, measured step times, and heads that match the work.

  1. Make the work visible

    Put the five steps on a Kanban board so every case had a visible position, WIP was explicit, and the queue in front of each step could be seen rather than discovered at the end of the month.

  2. Measure average processing time per step

    Timed each step rather than assuming all steps were equal. That showed where cases were actually waiting and which step was the real bottleneck.

  3. Allocate heads by duration

    Assigned fewer heads to fast steps — eligibility check — and more heads to longer steps such as insurance coverage verification and document review. Capacity followed the measured time, not headcount tradition.

  4. Rotate tasks across the end-to-end

    Rotated people through the full workflow so no one specialised in a single step. That reduced single-point dependency, balanced load, and gave the team the ability to cover the whole case rather than only their column.

01 Eligibility check relative time 1 HEAD 02 Qualifying relative time 1 HEAD 03 Document review relative time 2 HEADS 04 · BOTTLENECK Coverage verification relative time 3 HEADS 05 Contact patient relative time 1 HEAD Illustrative board — heads scaled to measured step time. The longest step gets the most capacity. Task rotation lets the same team cover every column end to end.
Illustrative: capacity follows the measured step time, not a fixed one-person-per-case model.

03 / What changed

The queue moved from 18 days to 5.

  • Backlog fell from 18 days to 5 days.
  • End-to-end completion moved from 11–18 days to 5 days.
  • Capacity was concentrated on the longest steps instead of spread evenly across a single-owner model.
  • Task rotation reduced single-point dependency and let the team cover the full workflow.

The result was not a faster individual — it was a flow with fewer waits, clearer WIP, and staffing that matched the actual work.

04 / Limitations

What this approach depends on.

Kanban only works if WIP limits and the board are respected; otherwise the queue simply becomes visible without improving. Head allocation is a snapshot of current step times and needs revisiting as volumes, document quality and insurer response times change. The reported 5-day outcome reflects this workflow and period, not a universal guarantee. Client and account details are anonymised.

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