2. Father of Scientific Management – Frederick Winslow Taylor
Published “The Principles of Scientific Management” in 1911.
Four Principles:
1. Replaced rule of thumb work methods with scientific
study of tasks;
2. Scientifically select, train, teach and develop the
employee vs. the employee choosing their own work
and training methods;
3. Provide detailed instructions, supervision of
performance, and cooperation with employees to
ensure methods are followed;
4. Equal distribution of work between management and
labor where management assumes the role of planning
using scientific methods.
3. Typically based on survey data;
2500 accounts per FTE;
◦ 119 accounts per workday (21 day month);
Variables effecting comparison:
◦ Outsourcing;
◦ Payer mix;
◦ Workflow model (level of specialization);
◦ Level of automation.
4. Average length of call = 4 minutes;
Paid hours = 8;
Productive hours = 7 (2 - 15 minute breaks +
30 min slack);
Max capacity = 49 calls with no wait or hold
time;
Contact rate = 20%;
Assigned inventory = 245 accounts per day
or 5,145 accounts in linear model (predictive
dialer, auto queuing, and hunt groups).
5. Data Gathering:
◦ Management reports:
Telephony report tools
Available System Data:
HIS
EDI Billing Systems
Other Ancillary Systems
◦ Observation
Task Assessment Tools:
◦ Process Diagram
◦ Matrix Analysis
6. Research and
837
Resolve
Download
Errors
Billing
Edits
Applied
Claim
Correction
Complete
Failed Claim
Review
Claim File
Transmitt
ed
Research
Yes
Required
Claim
No
Reconciliaton
7. Total
Max # of Average Daily Required Man
Task Description Min Time Elapsed FTE's
Time Observations Time Frequency Minutes Hours
Time
1 Download 837 20 45 300 10 30 1 30 0.50 0.06
2 Apply Edits 5 30 200 10 20 1 20 0.33 0.04
3 Failed Calim Review 5 20 100 10 10 100 1,000 16.67 2.08
4 Claim Research 5 45 300 10 30 5 150 2.50 0.31
5 Finalize corrected claims 2 10 50 10 5 1 5 0.08 0.01
6 Transmit Claim 5 10 50 10 5 1 5 0.08 0.01
7 Reconcile Transmission 5 60 200 10 20 1 20 0.33 0.04
Total 47 220 1,200 70 120 110 1,230 20.5 2.56
8. Goal = Optimal Efficiency:
◦ Frank & Lillian Gilbreth
◦ Reduced bricklaying tasks from 18 to 5
Skill/knowledge based task grouping;
Exception Management by Design;
Specialization – deskilling the job;
Measurement baselines and Reporting
Systems:
◦ Productivity
◦ Quality Control
9. Identify critical criteria as core requirements:
◦ Regulatory compliance;
◦ Tolerances – accuracy rating;
◦ System management and maintenance;
◦ Workload management;
◦ Adherence to P&P
Establish Methodology;
◦ Frequency
◦ Sampling vs. Data Mining
10.
11. Establish baseline using the minimum
expected from a trained employee (FTE
Model);
Consider the effect of indirect time/tasks;
Establish measurement system and
methodologies.
13. Base Rate $ 18.00
Mark-up 20%
Adjusted Hourly Rate $ 21.60
Estimated Payroll $ 3,985.20 Claims Per Hour
Total Paid Hours $ 184.50 9.73
Indirect Hours 32.50
Total Direct Hours 142.00 12.65
Work Days 21 Hourly
Total Claims Worked 1,796 12.65
Target Claim Volume 994 7.00
Variance 802.00
Cost per Claim $ 2.22
Target Cost per Claim $ 4.01
Variance $ 1.79
14. Rating
Performance Standard O AA C M U Comment
SECTION I PRODUCTIVITY
Works an average of 7
accounts per hour.
SECTION II QUALITY
Average quality score
SECTION III GENERAL COMPETNENCIES
1. Demonstrates detail
knowledge of assigned
payer claim adjudication
and billing protocols.
2. Requires minimal
supervision.
15. RATING SUMMARY
Section I Score 4
Section II Score 3
Section III Score
Outstanding 2 x 5 = 10
Above Average 5 x 4 = 20
Competent 12 x 3 = 36
Marginal 1x2=2
Unsatisfactory 0x1=0
Note: any rating of U is an automatic failure for the section (pass fail)
Total 68 20 (Number of Standards) = 3.4 Section III Score
OVERALL RATING = 3.46 (average of all sections)
16. Fear of job loss as a result of performance
improvement;
Sandbagging – fear of increase expectations
if employees work at full capacity;
Wasted time relying on rule-of-thumb
methods.
17. Recognition Awards:
◦ Luncheons
◦ Plaques
◦ Etc.
Pay for Performance:
◦ Group
◦ Individual
◦ Goal = Align compensation with performance
