Readiness Checklist
Use this per patient or treatment opportunity. Coverage tier and outreach readiness are intentionally separate.
Practice and patient reference
Coverage tier
Coverage tier describes insurance status. It does not determine outreach readiness.
Current active coverage confirmed.
Coverage or benefits need verification.
Plan-year timing is not yet clear.
Use treatment and payment pathway instead of insurance benefit messaging.
Exception management
Every open exception should have an owner, next action, and due date.
| Exception | Status | Owner | Next action | Due date |
|---|
Outreach readiness gate
Move a patient to outreach only when the available information supports accurate communication and a real appointment path.
Weekly Tracker
Track movement from selected population to verified, outreach-ready, contacted, scheduled, exception, and resolved status.
| Week | Population selected | Verified | Plan-year confirmed | Capacity slots available | Ready for outreach | Contacted | Scheduled | Capacity blocked | Benefit exceptions | Cost-related holds | Unreachable | Exceptions resolved | Waitlist fills | Owner notes |
|---|
KPI Dashboard
Calculated from the Weekly Tracker. These metrics show readiness, bottlenecks, and conversion rather than activity alone.
KPI definitions
| KPI | Calculation | What it tells the operator |
|---|---|---|
| Verification completion | Verified ÷ population selected | How much of the working population has current verification completed. |
| Plan-year confirmation | Plan-year confirmed ÷ population selected | How much of the population has benefit-cycle timing confirmed. |
| Outreach ready | Ready for outreach ÷ population selected | How much of the population can move forward without unresolved blockers. |
| Outreach to scheduled | Scheduled ÷ contacted | How effectively outreach converts into booked appointments. |
| Open exception burden | Benefit exceptions + cost holds + capacity blocked - exceptions resolved | How much unresolved work remains in the operating queue. |
| Exception resolution rate | Exceptions resolved ÷ total exceptions logged | How quickly the practice clears operational blockers. |
| Waitlist fills | Total waitlist fills | How much capacity recovery is being created from cancellations or newly opened slots. |
