Business Intelligence

Combining Force and Finesse

Sometimes, brute force gets a job done.  Sometimes, a little finesse is all it takes.  Other times, you need to combine the two to accomplish your goal!


picture of Todd HermanThis month's case study focuses on a client needing to make some big improvements in its inventory of items to be rebilled ---- and fast! Their answer was a brute force approach ---- pulling the regular Billing staff off their normal tasks to research and resolve rebills, and hiring temps to backfill the Billing positions and handle the day-to-day tasks.

Once work started, though, management saw that merely throwing more people at the problem would be insufficient to meet year-end targets. Yes, they needed more people to work the backlog ---- and they needed their staff to be more efficient and effective.

We worked with management to envision and implement quick technology hits to improve their peoples' productivity:

    • By providing these technology hits, we improved staff efficiency ---- we reduced staff time for the research or rebill activities.
    • By estimating the dollar impact each technology hit would have, and by ranking these so the biggest ones were implemented first, we improved staff effectiveness ---- we ensured staff did the right activities, and more of them.

Our ideas added an element of finesse to resolving these issues.

As you'll read in the case study, these force and finesse approaches complemented each other perfectly. Together, they yielded nearly a 40% reduction in the items awaiting rebilling, and quickly increased cash receipts.

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Todd L. Herman


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Case Study:  Applying Technology to Reduce Unbilled Charges

Our client performs lab tests on patient "draws" of blood and other samples for doctors' offices.  Every draw is called an "accession."  The entire healthcare industry is notorious for insurance coverage and billing issues.  

 For a variety of reasons, our client had accumulated a very large number (about 90,000) of:

· Accessions which had never been billed before, and

· Accessions which had been billed, rejected by the insurer, and never researched and re-billed.

These are known collectively as "unbilled accessions" and were having a material negative impact on cash flow.

Resolving unbilled accessions usually requires research by the Billing staff, and then follow-up to personnel in the physician office ---- whether Administration, Medical Records, or the Technician who performed the draw ---- to review the claim, describe the issue, and request additional information.  This is a labor-intensive process for both our client and the physician offices.

Our client decided to dedicate its internal Billing staff ---- fully during the week, and also working some weekend days ---- to working down the unbilled accessions, and backfilling the regular Billing staff with temporary staff.  Even with this brute force approach, reducing the unbilled accessions to normal levels would not be completed in the timeframe needed by our client.  In addition to the volume of unbilled accessions, they were quickly approaching the health insurers' 180-day "timely filing" deadline for many of these claims---- which meant they would not be able to resubmit those particular claims to the insurance company for payment.

Accession Inventory graph
At the start of the year, the unbilled accessions (charges) were at
a normal level of about 10,000, yet began increasing
by 8,000 to 9,000 per month for the next nine months.
As unbilled accessions steadily increased, cash receipts steadily decreased.
Solution: Create a list of Priority Items, and develop a plan to address those issues. 
We worked with our client's Billing, Call Center, and Information Systems personnel to develop a number of process-related and technology-related ideas to improve the productivity of their Billing staff.  We then estimated the approximate cost and impact of each idea, ranked it by priority, and presented all these for management consideration.

Management agreed with our top priorities and tasked us with working to implement them quickly. We did so, designing and developing several technology tools and rolling these out over a six-week period.  We then monitored the impact of these tools on staff productivity and impact on reducing the inventory of unbilled accessions. 

Priority List

We developed a list of over 24 ideas, grouped by functional area, to reduce unbilled charges ----and, more generally, to improve the entire order-to-cash process.  Some of these ideas were "quick hits" meant to address the unbilled charges, while many were medium-term to longer-term ideas meant to reduce the potential for denied or rejected claims ---- which create rebills ----by error-proofing all steps prior to the initial billing. 

To help management quickly understand why we gave a particular idea a certain priority ranking, we created a color-coded table plotting the ideas against both their estimated cost and anticipated impact.

Priority List tablePriority List boxes

Results & Benefits: Unbilled accessions dropped by nearly 40%, and stayed at acceptable levels.
Within three months, the level of unbilled accessions dropped nearly 40% and brought in several hundred thousand dollars of cash ---- just in time for our client's year-end.

Subsequent to year-end, our client went back to its normal staffing for Billing.  We then implemented additional ideas which allowed the regular staff to reduce unbilled accessions to acceptable levels.

Conclusion: The combination of Force and Finesse paid off

Combining additional personnel with enhanced technology allowed our client to quickly meet their timeline and cash flow targets.

To discuss how this type of project could be applied to the issues facing your business, call us at 336.297.4200 to schedule a no-obligation consultation.

Get a business boost now by calling Todd at 336.297.4200 or request information here.

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Todd Herman Associates


620 Green Valley Road
Suite 104
Greensboro, NC 27408

About Todd Herman Associates

Todd Herman Associates is a business technology consulting firm focused on non-routine technology issues such as replacing QuickBooks, getting two systems to "talk" to each other, shrinking process cycle time, and taming large volumes of data.