Empowering Your Implementation Team and Other Practical Advice to Help You Survive (and Thrive) During Your Claims System Transition

Transitioning to a new claims administration system is not easy. And you should not trust any vendor that tells you otherwise. At VBA, we have an experienced team to help guide you through the implementation and ensure your success. Whether you are in the early stages of contemplation or embarking upon your implementation in the near future, our team has put together some advice that will get you started on the right path.


1. Empower the Implementation Team

This may seem obvious, but many organizations struggle to give the team the decision-making authority they need to drive the project forward and create true change in the organization. While you should expect the team to communicate key information along the way, they will not be able to make progress if they are constantly having to stop and get buy-in from multiple levels before they can make any decisions. It is critical to have a highly engaged Executive Sponsor to help clear the way and support the team throughout the implementation.


2. Commit to Business Process Re-Design

One of the main reasons payers update their claims administration system is to gain operational efficiencies. And yet, time and time again, we see companies try to replicate the same inefficient processes from their old system and put them into their new system. This approach does not allow the organization to gain the full benefits of their technology investment. There is no better time to rethink your business processes than during the implementation of a new claims administration system.

Challenge your implementation team and your entire organization to step out of their comfort zone and explore all the ways the new system can support their daily workflows. Starting with flowcharts and clear documentation of existing processes, along with the business needs that are supported by those processes, can go a long way in helping the implementation team come up with new and better ways to get things done.


3. Choose the Right Cut Over Approach for Your Organization

Whether you choose to go all in with your system conversion or take a more measured approach, the cutover decision is critical. This is one example of when it makes sense to gain buy-in from all areas of the company before making your decision. Often there are business reasons why payers need to move all their customers over to the new system at the same time. But if you have the time to do a phased-in approach, you can start with a smaller population that is lower risk and use that as a test case to make sure everything in your configuration is spot on.


4. Engage with Your VBA Team Early and Often

Think of your implementation team in the broadest sense, and that means including your VBA team as part of your implementation team. Getting to know the people on your VBA team and starting to form authentic relationships early on in the process will help everyone get on the same page quickly so they can all work together to achieve your organizational goals. The more the team feels connected to each other, the more you will start to see synergies happening and that is how the most creative solutions begin to take shape.

The same attitude and approach should also apply to your vendors. The sooner you can engage them in the planning process, the more likely you are to meet your timelines in terms of getting file layouts and completing testing. Vendor delays can slow down your implementation progress, so setting your expectations upfront and checking in with them often will help keep things on track.


5. Define Success Criteria and Set Measurable Goals

A successful implementation is more than just completing a series of project tasks within a defined time frame. While having a defined project plan is important, it is even more important for your organization to set meaningful goals related to your operations. Start by setting goals for each functional area at the onset of the implementation. These goals should be realistic and measurable. At the same time, allow for some flexibility for your goals and objectives to evolve as you move through the process and gain more information and insights into your business. Take time to socialize these goals throughout the organization and gain consensus so everyone knows what success looks like and how to achieve it.

When it comes to your claims system implementation, persistence pays off. It is a long road, but at the end you will have transformed your operations into a well-oiled machine that can quickly adapt to any challenges you may face in the future.


VBA is Here to Help

Contact us for a free consultation and to learn more about our deep discovery process to get you started on your journey toward more efficient healthcare operations.