While Synergy Billing creates standard operating procedures for each core process, breakdowns in process can occur. By asking the below questions and following these steps, this can help with issue resolution.
Defining an Issue
Definition of an Issue
- A problem or scenario that relates to people, process, or technology and has a negative impact to Synergy Billing or our clients.
- A problem or scenario that impacts revenue or efficiency and can be quantified in terms of claim count or dollars impacted.
- A problem or scenario that has a pattern of occurring 7 or more times.
- A problem or scenario where there is a strong likelihood of reoccurrence if not properly diagnosed.
Identifying the Issue
- Identify the problem. This may require gathering information from different sources, such as users, logs, or system alerts.
- Understand the nature of the problem and identify the symptoms that led to the discovery of the issue. This is critical for determining the appropriate resolution steps.
- Consider all information available to get a comprehensive understanding of the issue.
- Collect as much information as possible about the issue, such as its severity, who it affects, system impacts, and any error messages related to it.
- Quantify the impact (claim count, balances, etc.).
- Is the issue you are experiencing already published to the Knowledge Base?
- Have you reported the issue dependent on the situation you are experiencing?
- Have you noted the ticket number of the issue in the appropriate location?
- Conduct root cause analysis.
- Reproduce the issues for understanding its behavior.
- Consider utilizing tools or software designed for diagnostic purposes, depending on the nature of the issue.
- Engage with all parties involved, including client, payers, or internal teams, to gather their insights and perspectives.
- Have I assessed the total impact of the issue?
- Have I diagnosed the root cause of the issue?
- Have I done everything I can to resolve the issue?
- After identifying the root cause of the problem, start thinking about potential solutions. Always consider multiple options, comparing the risks and rewards of each. This might involve multiple tasks, personnel, and tools. The solution might be a permanent fix, a workaround, or a strategy to mitigate the impact.
- Use research and past experience to assist with this step.
- When appropriate, confer with team members and higher-level management.
- Ensure chosen solution aligns with both the problem at hand and company policy.
- After choosing a solution, create a plan to implement it.
- Coordinate with relevant personnel and teams.
- Detail every step, including who is responsible for what, what is needed at each step, and realistic timelines.
- Account for potential risks and include contingency plans in the event the main plan fails.
- Do I have the right people working to solve the issue?
- Has there been an update to the ticket in the past 30 days?
- Have I done everything in my power to help resolve the issue?
- Implement the solution according to the established plan. Monitor the progress closely and adjust strategies if needed.
- Communication is key during execution phase. Keep all parties informed of the progress.
- After resolution, evaluate the process and thoroughly test it to ensure it effectively resolves the issue.
- Were the actions taken successful?
- What could have been done better?
- Track the system or function's performance and note any unusual occurrences or recurrences of the issue.
- Make sure the solution does not introduce new issues or negatively affect other areas.
- Take the opportunity to learn and improve future problem-solving endeavors.
- Facilitate a meeting to discuss lessons learned.
- The final step of issue resolution is to communicate the resolution to all relevant parties. This could include end-users, client representatives, team members, and other stakeholders. Be clear, concise, and transparent in your communication.
- Document the issue, its impact, and the steps taken to resolve it for future reference and learning.