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Getting Your Budget for new A&G Solutions Approved

Authored by: Pat Goetz

As a business director, you’re skilled at communicating with unhappy members, efficiently managing the appeals and grievances process and ensuring that the work gets done correctly. But when you do your job well, your manager might question the need to invest in new technology. After all, you’re already doing a great job. 

 

It’s a fair question – especially if all they see is the new solution’s price tag without any details about the payoffs that solution will bring. With this approach, your budget request might get declined or put off until a future unknown date, which can be frustrating. 

 

Want your request to get the careful consideration it deserves by your manager? Change your approach by providing insight about the solution’s value. 

Building a business case: Why your proposal is getting turned down 

The Appeals and Grievances department may report to the VP of Member Services, the VP of Compliance or another relevant business unit. Your manager likely oversees several different areas and all compete for a slice of the budget. And here’s an added challenge: You don’t know what other initiatives may need funded, so your request might get turned down simply because it appears “less urgent” than other requests. 

 

The easiest way to elevate your request from a “nice to have” to a “priority” is to show the payoff.  To do this, you need to highlight existing inefficiencies and the associated costs and risks. This way, when you present the solution, you’re also providing your manager with more context as to how the solution will deliver improved member service, increased efficiencies and reduced risks. Seeing these will help your manager not only see the return on the investment but motivate them to fight to fund it. 

Two different situations: Growth and sustainability 

Most appeals and grievances departments find themselves in one of two situations. They are either in growth mode or seeking to sustain their current levels. With growth, it’s far easier to get your business case approved. Your organization is getting bigger, expanding into new areas and there is a demonstrated need to support this activity. You’ll still need to show ROI with your request but adding resources that support growth is generally a valid reason for investment. 

 

The second scenario is where ROI is critical. When your company’s enrollment is steady, and the workload is not expected to grow, your manager will (and should) ask, “Why do we need to invest when your team is already doing great?” 

 

This is where assigning costs to duplicative work and inefficient processes not only reveals the opportunities for improvement, but the potentials savings that awaits with new technology. 

Proving your case 

The key to getting your budget approved is changing how your manager views the request. You need to shift from thinking of the request as an “expense” to an “investment.” 

 

Take inventory of the time-consuming processes required of your team. How much time does each process take? For example, maybe it takes an hour for an employee to create an incoming case. With the new solution, perhaps this time is reduced to 10 minutes. If you process 20,000 cases each year, saving 50 minutes on each case adds up fast. 

Take this example a step further: How much does the person completing the task earn? Now, do the math: Multiply the total hours saved by the hourly wage and assign a dollar amount to the annual savings. 

 

With this information in hand, you can walk into your manager’s office and say, “I’ve done the math, and I can save us roughly X dollars over the next year by adopting this solution.” With this approach, you’re shifting the conversation. You’re no longer talking about spending money; you’re talking about saving it. 

 

Now, of course, there are other considerations, such as retiring a legacy system. But, if adopting the new system allows you to retire older systems, there’s another significant savings opportunity. 

Creating a plan for improvement 

Your manager receives many budgetary requests each year. And maybe you’ve considered adopting a new appeals and grievances solution for some time but your past request was denied or delayed — and you feel stuck. A numbers-based approach to presenting your case empowers you to compete more effectively with everyone else making budget requests. 

 

If you aren’t sure where to start, download our cheat sheet. We’ll give you ROI calculation examples and the exact talking points to present the case to your manager. Use it to make a stronger case to your manager and get your budget approved. 

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