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This is part two of the podcast “Rules in People’s Heads.” I wish we had a better name for it because that doesn’t exactly roll off the tongue. How do you say “the stuff people have in their heads that they don’t write down and that everybody else doesn’t have access to in your company” in a better way?

Enhance employee knowledge

This is about distributed knowledge in your company and your department. It’s clear that the more knowledgeable the people are in your department or business, the more successful you’re going to be. Building up knowledge is good. It is helpful.

The question is, “How do you deal with that to make it the most beneficial to the organization as a whole, not just that individual?” Yes, it’s great to have somebody gain knowledge and build up a bunch of rules and information that helps them to be more successful, in particular concerning billing, where they know what to do with a specific type of procedure, or a specific payer, or some combination of several different factors to make sure something gets paid, or that you don’t just beat your head against a wall not getting it paid, submitting it over and over again.

Create a knowledge database

The bigger question is, “What happens when somebody who has all this information in their head retires or is out sick or on vacation for a week?” We had this happen to us once. The person starts going through the purses of everybody else in the office and taking drugs out of their purse. That happened. We had that situation. It was a good employee, and we didn’t want to lose her. She had a lot of information in her head that we were trying to extract and get into systems constantly. And then, she kind of totally went sideways.

I think one of the challenges, of course, is everybody wants to be valuable. The more helpful you are perceived, the harder it is to get fired, and, of course, the harder it is to replace, or to lay off, or these other things. So it’s natural for employees, managers, and so on to want to store as much information personally and not share it as possible to make it, so they’re irreplaceable. We have some competing demands from what’s best for the organization versus what individuals might want to do to protect themselves.

Store knowledge centrally and improve access

Realistically, it shouldn’t be that way. An employee becomes more and more valuable; the more they systematize the knowledge, the more they acquire information and get it useful. “Do you have a way of getting some things so that the entire company is more valuable and more productive?” becomes a much greater value than simply, “Do you have those in your head?”

We repeatedly see that that information in people’s heads needs to be extracted and put into a centralized place for other reasons, other than just what we said that that person might fall off a cliff, metaphorically. There are not a lot of cliffs around.

Determine and fix misinterpretations

There are other issues too that we’re going to come across. For example, the rule that somebody has in their head might be wrong, and they might be acting off of incorrect information. It could be that the rule was misinterpreted once upon a time. It could even be, and we see this a lot, where somebody heard that you couldn’t do something with payer X: “Don’t do this,” “Do or don’t do that.” They internalize the information given to them, and they start using it and maintaining that as a rule. Yet, it was never right the first time.

Document rule and process standards

I can’t tell you how many times we ran into this as a billing company where we asked somebody, “Hey, what do you do with this?” or “What about this?” And they said, “Oh, a payer of Medicare. You can’t do blah, blah, blah.” We said, “How do you know that?” And it was because somebody told them that at one point. The person who said to them that got told by somebody else who got told by somebody else. Who knows if anybody was right in that chain ever?

Store and Distribute process rules to every stakeholder

Often, it could be that somebody just misconstrued that rule. So there was a rule. Somebody made something up by Medicare, and it just didn’t get interpreted correctly. My favorite example, wherever this happens, is, I remember once upon a time when my daughter was young, she was trying to make sense of the world. We were driving along the freeway, and she said, “Red cars break down.” I said, “What?!” She said, “Red cars break down.” I saw two cars by the side of the road. They were both broken down, and they were both red. Red vehicles break down. I just started laughing. That was so amazing. I was like, “Oh my God, that’s great! I love the little pattern recognition.” I think she was, too. 

And I thought it was so cute because I was like, “Oh, Daddy’s little analyst.” That wasn’t correct. Other times, there’s a situation where the rule once upon a time used to be accurate, but Medicare or UHC or whoever it was changed their policies over time, and that’s no longer correct.

In summary

We need to be able to get those rules out of people’s heads and out there into the company as a whole for a whole bunch of reasons, one of which is so we can systematize them and use them, but also so that we can find errors and prevent future problems. You can’t do that if you don’t have the rules coming out of people’s heads.

That’s part two. We’ll come back with more!