War-game an eligibility check SLA by proving each clock class has a named owner, a measured age-out, and a reverse path before draft clocks start governing every eligibility claim.
Eligibility check SLAs fail when "on time" means a status without a decision artifact, when teams dual-count a draft clock as both approved and live, and when high-risk payers still pin to one thin registrar because the clock inventory is incomplete. The review needs one written inventory of clock classes, one owner who can deny a risky shortcut, and a documented consequence when a failed clock ages past the deadline.
Pin the SLA under fire
State which eligibility families the SLA covers, the effective date, which check clocks change, how versions are stored, and what happens to registrations already in flight. Name the clinics that feel it first and the access promises that depend on coherent eligibility handling. If the memo mixes an eligibility check SLA with an observation status spike and a prior auth backlog cut, split them. A war game needs one move under fire at a time.
Write the decision you will make if the war game finds nothing new. Also write the reverse criteria: the missed clock, coverage gap, or patient deadline that would force an SLA rollback within a stated window.
Seat the eligibility room
- Patient access. Clock timing, age-out math, and what the eligibility forecast hides if exceptions soften after the policy.
- Utilization review. Observation lag, dual-counted checks, and the message that would leave orphan registrations open past lock.
- Claims ops. Authorization capacity, denial load, and relationship damage with payers when clocks jump overnight.
- Finance. Access-cost load, forecast promises that break in process, and the first ninety days of thinner remedies after a soft SLA.
- Skeptic. The claim that looks strongest and is least sourced.
Give every seat the same exhibits: open registrations, clocks in flight, protected eligibility classes, coverage commitments, and the age-out policy you intend to use. Private data for one seat invents agreement that will not survive the real room.
Pressure the soft clocks
Feed Pingpong the SLA memo, the clock exhibits, and the seating briefs. First pass steelmans the SLA. Later passes attack from patient access, utilization review, claims, and finance seats. Final pass turns surviving objections into phased clock rules, mitigations, or a changed recommendation. Agreement across passes is not proof. Keep the objections that still have evidence gaps.
Pair with the patient access lead seat, an observation status spike stress test, a prior auth backlog cut, and the claims ops lead seat. More operating decisions live in the war-game decisions hub.
Ship the SLA only when approved and blocked clock labels can be reproduced from stored eligibility exports without a verbal override.