Question
The following text describes tasks involved in processing of a medical insurance claim: Task A (Receive complete data from hospital regarding patient and procedure). This
The following text describes tasks involved in processing of a medical insurance claim: Task A (Receive complete data from hospital regarding patient and procedure). This takes 15 minutes per claim. There are four agents who each perform the data collection process. Task B (Adjudication of claim). A legal expert uses policy documents and Federal regulations to assess and ascertain the rightful claim amount, which requires 25 minutes per claim. There are five experts who each perform adjudication of claims. Task C (Payment). This requires an agent to set up transfer of payment to the hospital, which takes 10 minutes per claim. There are three agents assigned to take care of this step of the process. To cap the number of instances a processed claim is challenged by the hospital or the patient, the insurance firm has hired an expert to randomly evaluate 15% of the processed claims once the transfer payment has been set up (i.e., upon completion of Tasks A, B, and C). This expert takes 40 minutes to evaluate the claim and make any adjustments, if needed. Recently, the firm has been receiving a high number of complaints regarding settlements of claims. To further improve the quality of service, the manager decides to hire a graduate student intern, such that this intern will randomly evaluate P% of the processed claims once the transfer payment has been set up (i.e., upon completion of Tasks A, B, and C). The intern, due to lesser experience, will take 60 minutes to evaluate the claim and make any adjustments, if needed. What should be this P percentage, such that the rate of processed claims does not suffer/decline upon adding the graduate intern to the process? (Choose the highest possible value from options stated below.)
For the insurance firm question above, please provide a brief description of steps followed to obtain the answer.
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