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It was overcoming resistance in analytics projects. We recently ran into a situation where a US manager at a billing company was given our denials management software as part of an implementation. One of the modules is the denials management routing. How does it work? Well, it is designed to help improve productivity for billers and accounts receivable specialists because it takes those denials. So, they come back and say, “Okay, all the ones that need medical necessity information or need to pull documentation or clinical information go to this place. The ones that need to have patient eligibility or other checks like that are sent to these people. Coding gets us to the coding department.” It applies some rules and helps automate some of that process. That’s basically what the denials routing does.

How they respond

When the US manager received this output, they didn’t know what to do with it. When they got it, they were completely confused by essentially what looks like a giant report. It’s a huge data table or a series of data tables. For instance, they had to go to the owner and get an explanation. However, the good news is, the owner is on board. The owner receives it. He wants to improve things. He was the one pushing it. Other managers in the organization used it for their clients, so we’re rolling it out to other systems and other clients within that organization. After the explanation from the owner, the billing manager was excited to have her team be more productive and reduce work for her, and more.

Data issues

A massive piece of analytics implementations, regardless of what type of implementation it is, is, “Now, I have data. What the hell am I going to do with it?” I can’t tell you how many times we see this. After the implementation, after using it, the manager’s response was, “This helps me. I have less stress.” That’s phenomenal. We love those tiny quotes. “This helps me. I have less stress” – Isn’t that what every billing manager wants? But why is this so hard?

Working with billing managers

It’s hardest to get the buy-in from billing managers more than billers or anything else. Again, there are exceptions, but most billers are just going to do what they’re told to do and clock in and clock out. Billing managers are a little bit more complex. For example, they have more skepticism and fear. In addition, change can be difficult. They’ve been burned a lot in the past with all kinds of different things. Whether it’s some change that happened and that hurt them, it might also involve some promise that was made that didn’t come through, or an organization was sold, or clients were taken away, or all kinds of things. I mean, who knows?

The net is, just because a solution will help them doesn’t mean that it will work. We’ve seen many implementations that just never got off the ground, or they never got used. There’s a perception that the analytics failed, whatever the project was.

Focus on the human component

The net of this is that we got to focus on humans, particularly how people feel, what it is that’s going to help them figure out what to do in particular to answer that question, “What do I do with it?” We’ll come back in some other podcast and talk more about the challenges, but we’re focused on this at this point. After having solved so many data and analytics problems and then seeing the challenges where you can lead somebody to water, and they don’t drink (which drives me crazy), it seems like this is the most crucial part. It is people and, in particular, the billing managers. 

Final thought

I see a lot of owners of billing companies or the top person in a billing organization, whether it’s internal, they’ve got 100 people, or whatever it might be, they’re on board. The billing managers, who have 10-25 people reporting to them (whatever the number), are struggling. The message isn’t getting down to them. As a result, they don’t understand what’s going on. Also, they don’t know what to do with it. They don’t have the training, whatever it might be, but that’s where I think we have to focus.