{
  "name": "Actigy BPO AI Billing Pilot Scorecard",
  "version": "2026-10-18",
  "status": "Original planning framework, not a validated benchmark",
  "queue": null,
  "payer_segment": null,
  "specialty": null,
  "baseline_period": null,
  "pilot_period": null,
  "owner": null,
  "exclusions": null,
  "eligible_volume": null,
  "tool_coverage": null,
  "metrics": [
    {
      "name": "Reviewed work acceptance",
      "definition": "Reviewed items requiring no material correction \u00f7 all reviewed items. Record error severity.",
      "decision": "Does speed preserve work quality?",
      "baseline": null,
      "pilot": null,
      "threshold_agreed_before_test": null,
      "sample_size": null,
      "notes": null
    },
    {
      "name": "Total human effort",
      "definition": "Production, review, correction and escalation minutes \u00f7 all items handled.",
      "decision": "Is work being removed or merely transferred?",
      "baseline": null,
      "pilot": null,
      "threshold_agreed_before_test": null,
      "sample_size": null,
      "notes": null
    },
    {
      "name": "Exception aging",
      "definition": "Median and 90th percentile time from flag to resolution. Report still-open items separately.",
      "decision": "Are difficult cases accumulating?",
      "baseline": null,
      "pilot": null,
      "threshold_agreed_before_test": null,
      "sample_size": null,
      "notes": null
    },
    {
      "name": "Payer outcome",
      "definition": "For a mature, matched cohort: accepted, rejected, denied, paid and still pending counts.",
      "decision": "Did administrative improvement survive the next stage?",
      "baseline": null,
      "pilot": null,
      "threshold_agreed_before_test": null,
      "sample_size": null,
      "notes": null
    },
    {
      "name": "Full operating cost",
      "definition": "Labor, QA, software, integration and oversight costs \u00f7 handled items.",
      "decision": "Does the operating model improve unit economics?",
      "baseline": null,
      "pilot": null,
      "threshold_agreed_before_test": null,
      "sample_size": null,
      "notes": null
    },
    {
      "name": "Audit trace coverage",
      "definition": "Reviewed items with source evidence, tool version, reviewer and action history \u00f7 all reviewed items.",
      "decision": "Can another reviewer reconstruct the decision?",
      "baseline": null,
      "pilot": null,
      "threshold_agreed_before_test": null,
      "sample_size": null,
      "notes": null
    }
  ]
}