The Cost of “We’ve Always Done It This Way” in the Revenue Cycle
When a Process Outlives the Problem It Was Built to Solve
Few healthcare organizations intentionally design an inefficient revenue cycle.
Inefficiency usually arrives much more quietly.
A payer changes a requirement, so the team adds another verification step. A denial creates a problem, so someone introduces an additional review. A system cannot track something the team needs, so a spreadsheet is created. An exception occurs often enough that an employee begins checking for it manually.
Each decision makes sense at the time.
Years later, however, those individual fixes can become a complicated web of approvals, trackers, workarounds, handoffs, and manual checks. New employees inherit the process. Technology changes. Payer requirements evolve. Departments reorganize.
Yet the steps remain.
Eventually, someone asks why a particular approval, spreadsheet, or manual check exists, and the answer is familiar:
“We’ve always done it this way.”
For healthcare executives, that phrase should not simply signal resistance to change. It can signal something more important: a process that has accumulated complexity faster than the organization has evaluated whether that complexity still creates value.
Revenue Cycle Processes Accumulate Over Time
Revenue cycle workflows rarely remain exactly as they were originally designed.
Eligibility, prior authorization, billing, claims, denials, payment posting, and accounts receivable all operate within an environment that continuously changes. Payer requirements evolve. New technologies are introduced. Regulations change. Organizations grow. Employees identify gaps and develop practical ways to keep work moving.
The result is something similar to operational layering.
A workflow begins with five steps. A new payer requirement adds a sixth. A recurring error creates a seventh. A reporting need creates a spreadsheet alongside the process. Someone starts checking that spreadsheet every morning because the core system does not provide the right notification. Another employee begins maintaining a second tracker because a different department needs slightly different information.
None of these decisions is necessarily wrong.
The problem emerges when organizations continue adding steps without regularly asking whether older ones can be removed.
Complexity accumulates.
And because each individual addition is relatively small, the total burden can remain difficult to see.
The Most Expensive Step May Be the One Nobody Questions
Revenue cycle leaders spend significant time examining obvious performance indicators: denial rates, days in A/R, collections, cost to collect, staffing, and productivity.
But operational inefficiency can also live inside the workflow itself.
Consider a manual review introduced several years ago because claims from a particular process frequently contained an error. Since then, the technology may have changed. The underlying issue may have been corrected. Automated validation may now catch the same problem upstream.
Yet the manual review remains.
One employee checking one account for an extra minute may not seem significant. When the same unnecessary action occurs hundreds or thousands of times, however, the organization is spending workforce capacity protecting itself against a problem that may no longer exist.
That is what makes legacy process complexity difficult to identify.
The step still happens, so everyone assumes the step must still matter.
Executives should occasionally challenge that assumption.
Workarounds Have a Way of Becoming Workflows
Temporary solutions are particularly good at becoming permanent in healthcare.
A spreadsheet is created “for now.” An employee checks a payer portal until a system issue is resolved. A manager adds an approval because of a handful of costly mistakes. A team develops a manual process because two systems cannot communicate.
Then the workaround works.
That is precisely why it survives.
Months later, the original problem may have changed, but the workaround has become embedded in daily operations. Employees are trained on it. Managers expect it. Reports depend on it. Removing it begins to feel riskier than keeping it.
Eventually, the organization is no longer managing an exception.
It is managing the workaround created to manage the exception.
This is how healthcare teams can end up with sophisticated enterprise technology while employees still spend significant portions of their day copying information, checking statuses, updating trackers, and confirming that routine processes happened as expected.
Every Extra Step Has a Cost
An additional process step does not need to be expensive individually to become expensive operationally.
Every unnecessary approval introduces waiting time. Every manual check consumes attention. Every spreadsheet requires maintenance. Every handoff creates another opportunity for information to be delayed or misunderstood. Every duplicate entry increases the possibility of inconsistency.
Those costs can compound across the revenue cycle.
A five-minute task repeated occasionally is minor. A five-minute task repeated across thousands of accounts becomes workforce capacity. If that task also delays the next stage of the workflow, the impact extends beyond labor into throughput, A/R, revenue realization, and potentially patient experience.
This is why executives should think beyond whether a process “works.”
A better question is:
How much work does it require to make the process work?
A workflow can technically produce the correct result while consuming far more organizational capacity than necessary.
Automation Can Preserve Bad Processes Too
There is another risk when organizations modernize legacy workflows: automating them exactly as they exist.
If a process contains ten steps but only six are still necessary, automating all ten may make the process faster without making it better.
That distinction matters as healthcare organizations expand their use of AI and advanced automation.
The goal should not be to look at every manual activity and ask, “Can we automate this?”
Leaders should first ask why the activity exists.
What problem was it originally designed to solve? Does that problem still exist? Is another system already performing the same check? Does the step require human judgment? Could the issue be addressed earlier in the workflow? Could the step disappear entirely if information moved differently between systems?
Sometimes automation is the answer.
Sometimes deletion is better.
The best automated task may be the task that no longer needs to exist.
Process Transformation Starts With Subtraction
Healthcare transformation is often discussed in terms of addition.
Add AI. Add analytics. Add another integration. Add another platform. Add another capability.
But meaningful operational transformation can also begin with subtraction.
Executives can examine high-volume workflows and identify where complexity has accumulated over time. Look for duplicate approvals, repeated data entry, secondary trackers, manual status checks, unnecessary handoffs, and processes that depend on employees remembering what should happen next.
Then ask a simple question:
What would we design differently if we were building this workflow today?
That question removes the assumption that the current process is the correct starting point.
Instead of forcing new technology around an inherited workflow, organizations can reconsider how the work should move from beginning to end.
Where Jorie AI Fits
Jorie AI approaches revenue cycle transformation from the perspective of connected workflows, not isolated tasks.
Its virtual AI employees can work across existing healthcare technologies to extract and return information, coordinate routine activity, monitor workflow progression, and support processes across eligibility, prior authorization, claims, denials, accounts receivable, payments, and reconciliation.
That orchestration approach matters because healthcare organizations do not necessarily need to replace every existing system to improve how work moves between them. Jorie is designed to work within existing technology environments, helping reduce the manual coordination that often develops around disconnected systems.
With more than 3,500 payer connections and over 12 billion transactions processed, Jorie's healthcare-specific infrastructure is built around the complexity organizations already face.
But technology alone is not the strategy.
The larger opportunity is identifying which work should be automated, which workflows should be connected, and which legacy steps should simply stop happening.
That is the difference between digitizing an old process and redesigning how the work gets done.
“We’ve Always Done It This Way” Is a Starting Point
There will always be processes in healthcare that require multiple reviews, human judgment, and careful oversight. Complexity is not automatically inefficiency.
Unexamined complexity is different.
When nobody remembers why a step exists, when a temporary spreadsheet becomes essential infrastructure, or when employees spend their day checking that other systems completed routine actions, the workflow deserves another look.
Not because the people who created it made poor decisions. In many cases, those processes were smart solutions to the problems healthcare teams faced at the time.
But yesterday's workaround does not automatically deserve a permanent place in tomorrow's operating model.
For revenue cycle leaders, the opportunity is to periodically question the inherited process before adding another layer to it.
Another approval may not be the answer. Another spreadsheet may not be the answer. Another manual check may not be the answer.
Sometimes the most valuable transformation begins by asking why the work exists at all.
Because “we've always done it this way” explains how a process got here.
It does not explain why it should stay.
Jorie AI helps healthcare organizations rethink legacy revenue cycle workflows by connecting existing systems, orchestrating work across processes, and applying advanced automation where it can create meaningful operational value.
Ready to rethink what your revenue cycle has been doing “because it always has”? Request a Jorie AI demo.
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