Background & Challenge
In late 2017, fresh out of college at a 12-person startup, I was thrust into a billing meltdown: our revenue cycle partner collapsed, leaving us with paper records, unprocessed claims approaching $100K, and no internal billing expertise. We urgently needed to select and configure an EHR/Practice Management (PM) platform that could serve three critical services—medical, Physical Therapy (PT), and Applied Behavior Analysis (ABA)—without disrupting daily operations.
It was a true dumpster fire. Our initial rush to go-live, without comprehensive process mapping or stakeholder alignment, led to misconfigured workflows, a mounting backlog, and frustrated providers. Payroll hung in the balance, and I had no formal training in healthcare IT.
Key Achievements
Strategic Vendor Selection
- • Orchestrated multi-day workshops with clinicians, PT therapists, and ABA staff to define critical requirements, ultimately selecting AdvancedMD for its modularity and payer integrations.
Emergency Billing Continuity
- • Designed and deployed interim billing workflows in under 72 hours, training a contract biller on-the-fly to handle live claims.
Deep Process Analysis
- • Self-taught BPMN to map end-to-end flows for medical, PT, and ABA services, uncovering 15+ handoff failures that were silently sabotaging operations.
EDI & Payer Integration
- • Proactively engaged Blue Cross Blue Shield EDI specialists to diagnose and fix legacy PIN and taxonomy mapping issues blocking claim submissions.
Custom SQL Toolkit & Automation
- • Developed SQL stored procedures and automation scripts to extract, transform, and load AdvancedMD data into a reporting database. Automated exception alerts and drove real-time KPIs in Power BI dashboards.
Continuous Governance & Evolution
- • Established quarterly governance reviews to align platform updates, schema migrations, and user-role refinements with evolving clinical and regulatory needs.
Journey & Growth
Note: the core implementation was completed within the first six months, and I then led continuous enhancements and optimizations for eight years, making AdvancedMD a true business-critical platform.
- Immersive Learning: With the project spiraling, I dove into healthcare IT texts—BPMN guides, FHIR specifications, revenue cycle management books—and spent nights on message boards and in cold-emailing veteran implementers for best practices.
- Owning Mistakes: Our initial go-live missed essential scenarios for PT multi-code billing and ABA session documentation, forcing daily firefighting. I captured each failure in a "Lessons Learned" log and used it to drive our next sprint.
- Agile Iteration: Adopted bi-weekly configuration sprints—deploying process tweaks, updating workflows, and refining SQL tools based on direct user feedback—turning frustration into forward momentum.
- SME Development: Over eight years, I became the go-to expert for AdvancedMD—leading integrations, managing schema upgrades, and creating bespoke extensions that became core to our operations.
- Knowledge Sharing: Curated a library of over 50 internal knowledge articles, conducted regular training workshops, and maintained a living wiki of best practices—reducing AdvancedMD onboarding time from 4 weeks to 1.
Impact & Results
| Metric | Result | Timeline |
|---|---|---|
| Backlog Resolution | ~$100K in outstanding claims cleared | Within 6 months |
| Operational Efficiency | 60% reduction in manual reconciliation | Consolidated workflows |
| Reporting Efficiency | 75% reduction in monthly reporting tasks | SQL toolkit automation |
| Onboarding Time | Reduced from 4 weeks to 1 week | Knowledge sharing system |
- • Scalable Framework: The process-first governance model and custom tooling now underpin all digital transformations across the organization.
Lessons & Takeaways
Deep Curiosity Wins
When you lack expertise, immerse yourself—books, forums, mentors—to build domain knowledge rapidly.
Process Comes First
Skipping detailed workflow mapping leads to costly rework; invest time upfront to clarify handoffs.
Iterate Fearlessly
Treat failures as data; rapid sprints maintain momentum and build trust.
Share Your Knowledge
Document and teach relentlessly to build organizational resilience.
Pre-Sales Preparation
Before any new implementation or sales meeting, I create foundational documentation—process maps, stakeholder interviews, and workflow analyses—to accurately scope projects, align expectations, and identify potential risks or requirements.
This project was my crucible—transforming chaos into a structured, evolving system and shaping my philosophy: never accept limits as given, and always strive for continual improvement.