RevOps – A Manager’s View

Insights learned over a decade as Founder and President of a billing service company:

  • We observed provider organizations and outside billing companies hire and train thousands of individuals. Despite best efforts to maintain consistency in onboarding, we observed individuals with the same job responsibilities being trained differently, even to the smallest degree, causing variation in performance. To state the obvious, humans aren’t machines and machines aren’t human. The minor variations in how tasks were completed always manifested itself in the inability of RevOps, whether internal or external, to maintain consistent levels of service quality and scale in a meaningful manner.
  • When it comes to “yield maximization” – collecting all that providers earn, the practice followed by all RevOps, without exception – the industry’s dirty little secret, is to work from high dollar value to low. When a month inevitably ended and new items such as claims come due for follow up, the same approach is applied. This leaves a significant number of “low value” items untouched.
  • Looking to purchase a technology solution, we discovered there weren’t, and still aren’t any, meaningful off-the-shelf applications available. In over a decade, legacy system vendors released “upgrades” for RevOps, but these new “features” were all of compliance nature, mandated by HIPAA. Not much help for RevOps.
  • We estimated that up to 80% of billing and insurance-related tasks can be automated. This would free up staff to focus on tasks that require decision making and problem-solving – work that is more meaningful and enjoyable.
  • We further estimated that the combination of non-standard work and practice of abandoning low-value items as previously mentioned as an example results in up to 15% of charges not being collected, by provider organizations.
  • We have set out to change this. It is time for RevOps to have its own industrial revolution. It is time for RevOps to have standard interchangeable parts, bill of materials, processes, best practices, and yield optimization, AKA – Revenue Optimization.