Claims ops

War-game an ERA posting SLA before soft clocks become the live path

War-game an ERA posting SLA by proving each clock class has a named owner, a measured age-out, and a reverse path before draft clocks start governing every remittance claim.

ERA posting SLAs fail when "posted" 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 clerk 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 posting ages past the deadline.

Freeze the SLA under review

State which payer classes the SLA covers, the effective date, which posting clocks change, how versions are stored, and what happens to remittances already in flight. Name the cash teams that feel it first and the close promises that depend on coherent ERA handling. If the memo mixes an ERA posting SLA with a denial writeback rule 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, cash gap, or close deadline that would force an SLA rollback within a stated window.

Seat the ERA posting board

  • Claims ops. Clock timing, age-out math, and what the posting forecast hides if exceptions soften after the policy.
  • Finance. Close lag, dual-counted remittances, and the message that would leave orphan ERAs open past lock.
  • Payer ops. File capacity, rework load, and relationship damage with plans when clocks jump overnight.
  • IT ops. Feed reliability, mapping debt, and the first ninety days of thicker remedies after a soft SLA.
  • Skeptic. The claim that looks strongest and is least sourced.

Give every seat the same exhibits: open ERAs, clocks in flight, protected payer classes, close 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 claims, finance, payer, and IT 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 claims ops lead seat, a denial writeback rule, a payer contract renewal stress test, and a prior auth backlog cut. 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 ERA exports without a verbal override.