Flagship engagement
Find the operational causes of prior-authorization delay, rework, denials, and staff dependency.
A fixed-fee, principal-led Diagnostic that gives leadership a measured baseline, root-cause view, and 90-day improvement plan.
Duration
15 business days
Fee
$25,000 fixed
Scope
One PA workflow or segment
Delivery
Principal-led, remote by default
Buyer fit
Buy this when leadership needs a defensible next decision.
The standard scope covers one organization, one defined prior-authorization workflow or specialty/payer segment, up to 10 stakeholder interviews, and one executive sponsor.
- Denials, turnaround time, backlog, or staff effort are moving in the wrong direction.
- Different locations, specialties, payers, or team members produce inconsistent results.
- Critical payer or escalation knowledge lives with a few experienced people.
- Leadership is considering automation, a vendor change, centralization, or more headcount without a trusted baseline.
- Teams disagree about whether the problem is documentation, workflow, capacity, policy, technology, or ownership.
Questions answered
A measured view of where work breaks and what leadership can change.
Client inputs
What TKO needs from the client.
No production-system access is required for the standard scope. Do not submit PHI through the website.
One executive sponsor; one bounded workflow; a working client contact; access to 6–10 stakeholders; and existing volume, approval/denial, reason, turnaround, payer, specialty, and staffing evidence where available.
TKO also reviews current workflow documents, standard work, queue reports, and selected appropriately de-identified examples. The proposal records evidence availability and any material limitations before work begins.
15-business-day plan
A bounded path from evidence to executive decision.
Days 1–3
Frame and baseline
Confirm the decision, scope, evidence boundary, stakeholder set, KPI definitions, and available baseline.
Days 4–8
Trace the work
Interview stakeholders and map intake, documentation, routing, payer variation, exceptions, escalation, follow-up, and rework.
Days 9–11
Diagnose and size
Separate symptoms from addressable causes, establish responsible opportunity ranges, and test where technology or controlled automation may help.
Days 12–14
Design and sequence
Create the target workflow, clarify decision rights, define measures, and prioritize the 90-day backlog.
Day 15
Executive readout
Present the evidence, tradeoffs, recommendation, and decision required. Final artifacts incorporate agreed factual corrections.
Deliverables
The concrete decision package.
The work succeeds when leadership accepts one fact base, agrees on the top priorities, assigns accountable owners, and can decide what to fund within 10 business days of the readout.
Commercial terms
$25,000 fixed fee
50% at scheduling and 50% at executive readout. Travel, unusual data remediation, clinical or coding specialists, expanded interviews, and additional workflow families require a revised scope.
The Diagnostic does not obligate the client to buy implementation. TKO may recommend internal execution, an existing vendor, a specialist partner, no further implementation, or the 90-Day Sprint.
Exclusions and claim boundary
The standard scope excludes PHI ingestion by default, clinical criteria or medical-necessity decisions, legal or regulatory advice, payer contracting, claims adjudication, production integrations, vendor procurement, custom software, and implementation.
The Diagnostic does not guarantee denial, cost, staffing, reimbursement, or revenue results. It creates the baseline and implementation case required to set a responsible target.
FAQ
Questions to resolve before engaging.
Do we need clean data or production-system access?+
No. Existing reports, appropriately de-identified examples, workflow documents, and stakeholder interviews are enough to begin. No production-system access or PHI ingestion is required for the standard scope.
Is this an AI or software assessment?+
No. The Diagnostic starts with the prior-authorization workflow and measurable operating problem. Automation or AI is considered only after workflow stability, evidence, exceptions, decision rights, controls, and expected value are understood.
Does the Diagnostic guarantee denial reduction or savings?+
No. It does not guarantee denial, cost, staffing, reimbursement, or revenue results. It creates the baseline and implementation case required to set a responsible target.
Do we have to retain TKO for implementation?+
No. TKO may recommend internal execution, an existing vendor, a specialist partner, no further implementation, or the 90-Day Sprint. The Diagnostic creates no implementation obligation.
What happens if the scope is broader than one workflow?+
The proposal will narrow the work to one organization and one defined PA workflow or specialty/payer segment. Additional workflow families, interviews, data remediation, or specialist needs require a revised scope.
Diagnostic fit call
Decide whether this is the right 15-day scope.
The first call is a 30-minute working conversation with Todd about the trigger, workflow boundary, evidence, sponsor, timing, and decision leadership needs to make.