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We’re moving backward. I mean, in some ways, as a company, we’re moving backward. What I mean by that is, once upon a time, we founded this company with the idea that we would use machine learning and artificial intelligence around RCM data to do some amusing things. We have found ourselves not doing just that (we’ll call that sort of “the top of the pyramid”) but moving to lower parts of the pyramid. 

We found ourselves going into many locations where there were large practices or even hospital systems, where they just weren’t capable of handling that kind of product. As they put it, they’re still in the real world. They can’t even see what one doc is doing year over year.

Moving backwards

We’ve moved to more accessible types of products, things that are a little bit easier to implement, more fundamental things. But even with that, we’ve moved backward again. What I mean by that is, we’ve dropped many analytics products into many places. These are often specific analytics products, where it might be something like denials management or charge reconciliation. Some of them fail. 

Frequently, we see something like denials routing be successful, or charge reconciliation, or bank reconciliation, or something that’s an apparent function. But when it comes to the analytics part of it, we have KPIs and some analyses that involve looking at problems and trying to solve them. Often, that fails.

We’ve been recently looking at why and wondering. Some things: Managers, billing managers, and other types of people don’t have enough time. It can also be things like training, where people don’t have much analytical experience, whether in the foundations of pivot tables and other things. It can also be priorities, which is you have so many fires going on that you can’t get to those types of things that are more preventative or trying to solve more significant problems.

What about incentive plans?

We see some of those things related to staffing levels or even incentive structures. Outside of the owner, if you don’t put in place some incentive plan or something that encourages somebody to get to those things or do those things, some individuals often don’t care about the results. There are great billing managers who are passionate and care, and then there are others that are just collecting a paycheck. But frequently, it’s less common to have that individual who is really, really passionate or cares about the client’s results, about how it’s done, and so on.

Those things are all-natural. Even attitude comes into play. We’ve seen billing managers who say something like, “Well, this creates more work for me, so why would I want to do this?” Those all exist. Those are real. Yet, the biggest problem is that it’s not even that nobody knows what to do. It’s really that most people aren’t willing to put in the time and the effort to get ahead of the game, be proactive, and create extra work now to prevent work in the future. For whatever reason, that might be: for time constraints, for incentives, for attitude.

We’ve seen many things fail, particularly on the analytic side. The net is, we keep going simpler, and more straightforward, and simpler. We used to focus more on machine learning and those types of things. And now, we’re just trying to lay building blocks on simple analytical outputs that either automate something that people are already doing or have an evident outcome. 

Reconciliation

Think of it like finding missing charges in something like a charge reconciliation, with the idea that, as we build potentially a culture around those types of analytical outputs within organizations (whether it’s within provider groups, whether it’s within a billing department or a billing company). Thus, the more of those kinds of things people implement, the more we’re effectively doing some analytics. 

We’re effectively creating data warehousing and stuff for people to build upon and review. How does it work? Both make functions in terms of technology and build upon culture and an organization and just rallying around and believing that these things can be successful and that they have real value and that it’s worth putting in the effort to get those outputs.

To summarize

We’re moving backward. That’s one way of putting it or one step back two steps forward. There are all kinds of different ways to look at this, I think. But the reality is, we’re simplifying things significantly and going really narrow. For example, simple implementation of things to allow people to advance and do more sophisticated things. Why? For us, honestly, it’s not just that’s where the most considerable amount of money is, but that’s really where the fun is. We love doing that complex and fun kind of stuff.

We hope you’ll come along on the ride with us and do some of those more accessible inputs once and build some track record. Then, we’ll move on to the more fun stuff.