Health Insurance drives me crazy. And I work in Pharmacy Receivable, which is one of the working parts of heath care. Extensive automation means 98% of our claims load into our system, and the insurance company pays them, and the claims clear, without any work on my part.
Believe you me, if the rest of the health-care sector could achieve that kind of efficiency, your insurance premiums would fall dramatically. Because what happens when you DON’T achieve this kind of efficiency?
You get my current Nightmare, a perfect storm fueled by the ever-shining lazy sun of Corporate America, and the rising tempest of an unruly and incompetent Team India.
Back in March, my team identified a large number of unapplied EFTs for a certain company. For those not in the know, accounting systems work by receiving money in a bank account, and then “applying” the funds to different accounts. Say, you work at Chase, and you get a $3,000 check from Joe Sixpack. You know this is because Joe has a mortgage with you, and you “apply” the $3,000 to Joe’s mortgage account.
"Unapplied" means you have that $3,000 just sitting there at the bank. And the Collection Agency calls Joe Sixpack because Joe’s account is $3,000 behind.
This is called “running a shitty business.”
We implemented a “process improvement,” under the advice of the insurance company, to fix this.
Instead, the insurance company deleted our entire electronic payment system. The entire company started issuing paper checks. Thousands of paper checks.
To our stores, instead of our actual bank account.
This is also called “running a shitty business.”
Here’s the thing about retail stores: They are busy. Especially pharmacies. Ever been in a pharmacy at 4 PM? It’s a madhouse, with constant phone calls, whiny patients, drug spills, etc. A check for a few hundred dollars doesn’t seem important to them. They’ll file it away for “later”: I’m still occasionally receiving checks from 2009.
And an entire line of business operating like this?!!!!!!!! That’s millions of dollars down the toilet.
Finding these checks required a lot of manual work. As in, more time than any American already working 50 hours a week has. So, of course, we did the logical thing, and outsourced this whole, routine, simple task to the India team. They would look up claims, find check numbers, check dates, and check amounts, and then we could cancel the checks, and reissue them.
Two weeks later:
“oh yeah, we didn’t find anything.”
“Yeah, we sampled five claims, there wasn’t anything.”
Livid doesn’t begin to describe my reaction. Entire days have been sacrificed on this account, to carry us forward to our current position. For years….years and years, this account had suffered through all kinds of neglect, millions of dollars expensed to bad debt, claims unexamined for months at a time, liabilities to Medicare exploding faster than the actual Medicare budget.
A known issue was found, and….they “researched” five claims?
I shot off a quick email detailing an actual review of 10 claims, showing that every single one had a missing check. Every single one. This review took 5 minutes to do, which was slow given the molasses-grind of the servers.
I demanded they review every single claim in the account. EVERY. SINGLE. ONE.
Two weeks later, my Account Manager says to me:
“Hey, ADBG, they say they’ve found $17,000 so far. Does that seem right?”
My heart skips a beat. Our estimated dollar impact was at least half a million dollars.
“Yeah, they said they’ve reviewed 200 claims so far in 3 days.”
They have two people on this project. Let’s do some rough math. That’s 33 claims per person per day. Basically 4 an hour, 5 if they are lucky.
Again, I reviewed 10, in 5 minutes.
And they found….only $17,000?
This is what we call “Running a Shitty Business.”
Whenever I get too confident in my own skills or my own intelligence, work does a fine job slapping me back into place. I know for a fact that I am no Sigma, no Alpha, not even Vox Beta. All of those types have the social skills and status necessary to gather allies to fix problems like this. Sometimes intrinsically from their status, sometimes just from the social skills which let them rise to that status in that first place.
Me? I’m bottom-rung on the corporate totem-pole. Like the old saying goes, “Shit flows downhill.” My daily work usually involves a lot of menial tasks. Even if they have a large dollar impact, Upper Management doesn’t care enough to even ask about them. Their way of thinking about the company revolves around power points and reporting. Actual work flow and the narrative of daily grind means nothing to them.
Which generally means no support from Upper Management.
And while I can socialize with my work colleagues, getting them to actually do anything is essentially a non-starter. We’re already two heads down in the department, and most people are not cross-trained. They couldn’t help me even if they wanted to.
There’s definitely your ass-kissers that get more support from upper management…marginally more, since ass-kissing goes up, not down. And then you have the few popular people in the department who can demand whatever they want from colleagues and generally get it (or at least an attempt to help).
This isn’t me. So I grind on by myself. This corporate position more or less mirrors my socio-sexual position Pre-Game: low Delta, at best.
While we talk a lot about context, IE, “This guy is so Alpha at work, but with his wife he’s such a Beta bitch!” I find most hierarchies reproduce themselves across all social domains. That’s the natural result of personalities, coupled with self-reinforcing views about one’s place in the hierarchy. I came into my current position as uncertain of myself and my status as I did when I came into puberty: it’s not at all unusual that my social position replicated itself.
I could lie to myself, delude myself, say I am actually “Sigma.” Hey, other departments like me! I get accolades from them! I don’t actually do things the way my boss or accounting manager says and I still get results!
But, occasionally, you’re left with a shit-storm like the India Team telling you they only found $17,000, and you don’t have the resources or the leverage to find the actual missing money, and you just see your own shitty position in life. And there’s no lying your way out of it.
A recurring theme on this blog will be the normal trials, tribulations, and rewards of modern Western Life. I do not spend the long hours of my day wondering about negs, shit-tests, or scoring HB8s. You might say this is because I am married.
This did not preoccupy my thoughts even before my marriage, even before I met my Wife.
Neo-Masculine Men are mostly Western men that have the same worries and concerns as normal Western Men. We need to pay bills. We hate our bosses. Our cars need oil changes. Our Wi-Fi is spotty. Our differing philosophy on gender relations does not color our views on these issues, the most basic issues concerning modern Western life.
Because of that, this blog will not revolve around Gender Relations. My discussions concern my life, which is influenced by the Neo-Masculine thoughts humming in the back of my brain. Most readers will find that I, like most Neo-Masculine men, are no more threatening nor alien than many of the other people in their lives.
Actually, I hope to show that we are a far bit more stable, “normal,” and productive than many of the people in your life, who are addicted to credit, shopping, wasteful time sinks, and mindless entertainment.
When possible, I will show how my Neo-Masculine thoughts have aided, not hindered, my daily life. And how embracing Neo-Masculine thinking in general might aid the reader’s life.
This will hopefully color the reader’s perceptions when reading other Neo-Masculine blogs, which by and large do revolve around discussions of Gender Relations. When reading things that anger you, because they run contrary to the current PC discourse, or your own deeply held beliefs, remember that Neo-Masculinity is not principally driven by a desire to abuse, demean, or subjugate women. Not at all. For the most part, women and sexual relations are subordinate to other concerns in our lives.
This is, in fact, the first dictate of Neo-Masculinity. You will not make your woman your mission. You will have your own mission in life. This mission comes first.
“I will be inflexible in my goals, and Flexible in my Methods.”
If you asked College-aged ADBG what defines his work philosophy, he’d have no clue what you meant. And modern ADBG still struggles with this question.
Thing is, you only have so many hours in a day, and a lot of things to do. You can devote your time to all sorts of projects and get nowhere. You could make your focus building relationships and getting ahead, or building relationships and developing organizational capital. You could make your focus the daily grind, or finding process improvements.
Saying, “I show up and get the job done” means nothing. What do you prioritize? What’s your vision of a perfect company? What do we need to fix to get this done?
Over at Just Four Guys, Buena Vista said that he only wanted to hire the absolute best of the job. And his philosophy was that we could always get more money, but we can never get more time.
So you can picture the kind of workplace he built. The best minds, working together, to develop extremely complex optimization solutions that maximized efficiency. I think he said his industry was optimization for industrial purposes, which in my mind sounds like Soviet-style linear programming.
My work involves millions of claims, and millions of dollars. Even if you work hard, you can burn an entire day (or 3 days if you are Team India) and accomplish almost nothing.
The worst part? We have a great deal of dependency on other companies and departments. In certain cases, we cannot accomplish anything without the support of other teams. Who, by and large, don’t want to do anything to help us.
My philosophy? My goal is to figure out what other teams need to help us. That’s the most value-add, and that’s what I can drive on a daily basis. Most people throw their hands up in the air and say to hell with it. That’s an easy stance to take: that’s how you get millions of dollars in losses and double your bad debt expense in one year.
But that’s not acceptable, not to me. In fact, that’s the reason for my existence at this company: If we tolerated that kind of nonsense, we could just let Team India plug away all day long.
My philosophy is to set a goal, and find a way to accomplish it. This sounds stupid. Certainly there are some problems that just can’t be solved?
True, but we’re not talking about Fermat’s Last Theorem. In most cases, the software exists, the know-how exists, and the capital exists to solve virtually any problem thrown at us. What doesn’t exist is the organization and the will.
This entire line of business above? The rest of the company wrote it off. My Account Manager had no idea what the hell was going on. Our overpayment department determined we owed millions of dollars but couldn’t find a way to repay the funds. Team India…well, you can just imagine what Team India thinks about anything more complicated than 2+2=4. And Upper Management just saw an issue, considered it a fact of life, and moved on.
“It’s not any worse than Illinois Medicaid,” was the philosophy.
It took a month of deep-diving into the account to figure out how to work it. It took reviewing years of deposits and checks, matching bank ACH reports with internal ledgers, poring over data to find useful fields, and a few mistakes to get us to where we are at. But we’ve eliminated almost our entire legal liability, and recovered hundreds of thousands of dollars owed to us. For the first time in years, our older periods are balanced, and we can do a proper write-off in the account, knowing confidently what money is actually bad debt and what caused it.
In this case, we took the issue out of Team India’s hands. We found that the insurance company’s website can provide a complete list of all checks. We can cross-reference that with the checks in our system. Unfortunately, this only gives us a list of outstanding checks, and doesn’t tell us what claims specifically are unpaid….but at least we can get the money into our account with time.
We found $757,000, left a complete list with Accounts Payable, and sent off a request to our contact at the company to follow up with A/P.
A damn sight better than “I reviewed five claims and didn’t find anything.”
Friday ended on a high note.