Heritage Home Care’s 73% Manual Process Reduction: How They Transformed Efficiency at Scale
Heritage Home Care wasn’t in crisis. But they were stuck.
$3.2 million in revenue. 110 caregivers. Profitable. But inefficient.
Every morning brought the same chaos: 15+ schedule changes. Multiple call-offs requiring emergency coverage. Billing coordinator overwhelmed with data reconciliation. Compliance coordinator working 50+ hour weeks just chasing paperwork.
The agency was successful despite its systems, not because of them.
Then Heritage made a strategic decision: Eliminate manual processes at scale.
Not “improve processes.” Not “hire more staff.” Eliminate the processes entirely by moving to a unified operating system.
The result: 73% reduction in manual processes within 90 days.
This is their story.
The Starting Point: Heritage’s Initial Process Burden
Heritage’s operations looked like most successful agencies—and that was the problem.
They had:
- 7 different software systems (scheduling, billing, compliance, EVV, documentation, recruiting, communication)
- 3 FTE administrative staff (all drowning)
- Caregiver turnover at 48% annually (constant hiring)
- 78 days in Accounts Receivable (way too high)
- 71% clean claim rate (too many denials)
- 52% of compliance coordinator’s time spent chasing paperwork
The administrative burden was eating them alive.
Here’s what a typical day looked like for Heritage’s operations team:
6:00 AM: Director of Operations arrives. First task: Check overnight messages. 23 schedule change requests. 4 caregivers calling off. 2 clients requesting different caregivers.
6:30 AM: Contact compliance coordinator. “Who’s qualified to cover these shifts?” Compliance coordinator has to manually check five different systems to answer.
7:00 AM: Resolve call-offs. 45 minutes of phone calls finding coverage.
8:00 AM: Billing coordinator arrives. “Why were 12 claims denied this week?” Billing coordinator starts investigating. Hours of detective work comparing scheduling data, documentation, billing records, and insurance information. None of it matches because the systems don’t talk to each other.
11:00 AM: Compliance coordinator checks incoming credentials. Did the three new caregivers get their background checks? Coordinator manually checks three different systems. One system shows “pending.” Another shows “received.” A third doesn’t have the information. Coordinator calls to verify.
2:00 PM: Finance asks: “What’s our actual A/R?” Operations can’t answer without manually reviewing the billing system. Takes 2 hours to calculate.
4:00 PM: Director realizes payroll coordination has to reconcile scheduling against actual EVV hours. Hours worked (from EVV) don’t match hours scheduled. Manually investigating discrepancies takes 90 minutes.
6:00 PM: Another scheduling shift change. Another 20 minutes of manual coordination.
This happens daily.
Baseline Measurement: Identifying the 73% of Wasted Time
Heritage decided to measure exactly where their time was going.
They conducted a one-week audit: Every administrative task was timed and categorized.
Results:
Administrative Time Allocation (One Week)
| Task Category | Hours | % of Time |
| Scheduling coordination | 40 | 21% |
| Billing reconciliation | 60 | 31% |
| Compliance verification | 35 | 18% |
| Documentation review | 30 | 15% |
| Reporting & analysis | 20 | 10% |
| Communication/coordination | 10 | 5% |
| TOTAL | 195 | 100% |
Heritage’s operations team was spending 195 hours per week on administrative tasks.
But here’s the insight: Of those 195 hours, 142 hours were purely manual—tasks that a unified system could eliminate.
- Scheduling coordination (40 hours): System could automate call-off resolution, but currently manual
- Billing reconciliation (60 hours): System should automatically match visit data to billing, but currently manual
- Compliance verification (35 hours): System should track and alert, but currently manual
- Documentation review (30 hours): System should validate, but currently manual
142 hours per week of pure waste. 73% of administrative time.
Annually: 7,384 hours. Worth $170,000+ in labor cost.
Process-by-Process Automation: Specific Changes That Mattered
Heritage didn’t change everything at once. They prioritized based on impact.
Change #1: Call-Off Resolution (Week 1)
Before (Manual):
- Caregiver calls off at 5:30 AM
- Scheduler manually reviews available caregivers
- Scheduler manually considers: credentials, proximity, preferences, past performance
- Scheduler manually calls/texts potential replacements
- First acceptable response gets the shift
- New caregiver gets manual briefing
- Old caregiver gets manual explanation to client
Time: 45 minutes per call-off. Average 15 call-offs per month: 675 hours/year
After (Autonomous):
- Caregiver calls off
- System automatically identifies qualified backups (credentials ✓, proximity ✓, preferences ✓)
- System sends shift offer to three qualified candidates
- First acceptance automatically gets the shift
- Other candidates auto-notified shift is filled
- Client auto-notified with new caregiver details
- New caregiver auto-provided with care briefing
Time: 3 minutes per call-off. 15 call-offs per month: 45 hours/year
Savings: 630 hours/year
Change #2: Billing Reconciliation (Week 2-3)
Before (Manual):
- Visit completed, caregiver clocks out in EVV
- EVV data sits in EVV system
- Scheduler exports EVV data
- Scheduler imports to scheduling system
- Billing coordinator retrieves scheduling data
- Billing coordinator cross-references against documentation system
- Documentation doesn’t match billing parameters
- Billing coordinator manually reconciles discrepancy
- Billing coordinator codes the visit
- Billing coordinator verifies insurance/authorization manually
- Billing coordinator submits claim
Time: 35 minutes per call-off. 150 visits/day: 5,250 minutes/day = 87 hours/day
After (Autonomous):
- Visit completed, caregiver clocks out
- Visit data automatically flows to billing with all required information
- System automatically codes visit
- System automatically verifies authorization
- Claim automatically submitted
- Coordinator reviews exceptions only
Time: 5 minutes per visit (exceptions only). 150 visits/day: 750 minutes/day = 12.5 hours/day
Savings: 74.5 hours/day = 3,725 hours/year
Change #3: Compliance Verification (Week 3-4)
Before (Manual):
- Compliance coordinator maintains manual spreadsheet of 110 caregiver credentials
- Weekly spot-checks to identify expirations
- Manual emails to caregivers about renewals
- Manual follow-up with non-responders
- Manual updates to spreadsheet when renewals complete
- Manual checks before each assignment (to verify still current)
Time: 35 hours/week
After (Autonomous):
- System monitors all credentials 24/7
- Auto-alerts sent 30 days before expiration
- Renewals tracked automatically
- Scheduling system prevents assignments to uncredentialed staff
- Compliance dashboard shows 100% current status
Time: 8 hours/week (proactive improvement, not firefighting)
Savings: 27 hours/week = 1,404 hours/year
Month-by-Month Transformation: How the Transformation Unfolded
Month 1: Implementation & Parallel Period
Week 1-2: Setup and training
- New system configured to match Heritage’s workflows
- Team trained on new system (4 hours each)
- Parallel operation begins (both systems running)
Week 3-4: Early wins
- Scheduling efficiency improves (call-offs resolved faster)
- Billing errors begin to decline
- Team sees the difference
- Compliance coordinator has fewer crises
- Early enthusiasm builds
Key Metrics:
- Billing clean claim rate: improves from 71% to 82%
Month 2: Full Transformation
Week 5-6: Switched to new system
- Old system is retired
- Team is full-time on new system
- Initial adjustment period (some confusion)
- But process improvements are clear
Week 7-8: Optimization
- Configuration adjustments based on real usage
- Team becomes proficient
- Advanced features are activated
- Manual processes continue disappearing
Key Metrics:
- Billing clean claim rate: 71% → 92%
- Days in A/R: 78 → 42
- Call-off resolution time: 45 min → 5 min
- Administrative time: 195 hours/week → 68 hours/week
Month 3: Full Stabilization
Week 9-10: Run rate achieved
- Team is proficient and comfortable
- Metrics are stable at new levels
- All planned automations are active
- Care quality metrics improve
Week 11-12: Continuous improvement
- Proactive problem prevention active
- Predictive alerts working
- Advanced Cary™ AI features engaged
- Full ROI realized
Key Metrics:
- Administrative time: 68 hours/week (65% reduction from start)
- Caregiver retention: 48% → 87% (90-day turnover)
- Revenue impact: Profit margin 4.8% → 11.2%
The Staffing Transformation: From Keepers to Leaders
The most interesting transformation wasn’t financial. It was human.
Heritage’s operations team went from reactive crisis management to proactive leadership.
Director of Operations (Before)
- 50+ hours/week on: scheduling coordination, billing disputes, compliance firefighting
- Constantly reacting to problems
- No time for strategic work
- Exhausted
Director of Operations (After)
- 20 hours/week on: strategic planning, process optimization, caregiver development
- Proactively identifying and preventing problems
- Leading improvement initiatives
- Energized
“I went from answering fire alarms all day to actually building the organization,” she said.
Billing Coordinator (Before)
- 40+ hours/week on: data reconciliation, dispute resolution, claim investigation
- Spending 60% of time investigating errors instead of processing claims
- Frustrated by system limitations
Billing Coordinator (After)
- 15 hours/week on: claim processing, exception handling, process improvement
- Spending 80% of time on productive work instead of investigation
- Empowered to improve processes
“It’s a completely different job. I actually process claims instead of investigating why things don’t match.”
Compliance Coordinator (Before)
- 50 hours/week on: spreadsheet maintenance, caregiver chasing, verification work
- Constantly behind
- Reactive
Compliance Coordinator (After)
- 12 hours/week on: proactive compliance strategy, quality improvement, auditor preparation
- Always current
- Proactive
“I can finally do my job instead of just managing chaos.”
The Cultural Shift: Team Adoption & Buy-In
Heritage’s team didn’t resist the change. They embraced it.
Why? Because they felt the difference immediately.
Week 1 Feedback:
“I don’t have to check five systems anymore to answer one question. Everything is in one place.”
Week 2 Feedback:
“The call-off this morning got resolved in five minutes instead of 45. I wasn’t even awake when it was handled.”
Week 3 Feedback:
“My stress level is completely different. I’m not constantly behind.”
Month 1 Feedback:
“For the first time in three years, I feel like we’re actually in control.”
The team adopted the new system not because they were forced to, but because it made their jobs dramatically better.
Financial Impact: Cost Savings + Quality Improvement
Heritage’s financial transformation was dramatic:
Direct Savings:
Administrative Labor:
- 195 hours/week → 68 hours/week = 127 hours saved
- 127 hours/week × $22/hour = $2,794/week
- $2,794/week × 52 weeks = $145,288 annually
Software Costs:
- 7 systems @ $300/month average = $2,100/month
- 1 unified system = $500/month
- $16,000 annual savings
Billing Efficiency:
- 71% clean claim rate → 95% clean claim rate
- Denials reduced: $48,000 saved annually
- A/R improved from 78 days to 38 days: $80,000 working capital improvement
- $128,000 improvement
Caregiver Turnover:
- 48% annual turnover → 20% annual turnover
- 110 caregivers × (48%-20%) × $2,500 per replacement = $77,000 saved
Total First-Year Impact: $366,288
Against implementation costs of ~$45,000, ROI = 714% in Year 1.
Lessons Heritage Learned Along the Way
Lesson #1: You Can’t Optimize a Broken Architecture
“We spent years trying to make seven systems work together. We implemented process improvements, hired more staff, tried integration tools. Nothing worked because the fundamental architecture was broken. Once we replaced it with a unified system, everything got better at once.”
Lesson #2: Your Team Wants to Escape Chaos
“We worried our team would resist change. Instead, they embraced it. Why? Because chaos is stressful. Once we gave them a system that eliminated chaos, they were all in.”
Lesson #3: Manual Processes Hide Everywhere
“We thought we understood where our time was going. The audit showed us that 73% of our work was pure manual waste. It was shocking. It’s like we couldn’t see it until we measured it.”
Lesson #4: Financial Benefits Exceed Expectations
“We projected 18-month payback. We achieved full payback in 6 months. By month 12, we’d saved enough to hire additional people (if we needed them, which we didn’t). The financial case alone justifies the decision.”
Lesson #5: This Isn’t Just Operational—It’s Transformational
“This changed more than our operations. It changed our culture. Our team moved from reactive to proactive. That shift has implications across the entire organization.”
What This Means for Other Agencies
Heritage’s results aren’t unique. They’re predictable.
If your agency has:
- $2-5M in revenue
- 50+ caregivers
- Multiple disconnected systems
- High administrative burden (50%+ of operations team time spent on manual tasks)
- Caregiver turnover >40%
You likely have a similar 73% manual process reduction opportunity.
The path forward is the same one Heritage took:
- Audit your current process burden
- Calculate the 73% (your manual work)
- Run the Parallel Promise™ (30 days to see the difference)
- Make the decision
- Execute the transformation
- Realize the results
Heritage went from 195 administrative hours/week to 68 in 90 days.
Your agency can too.
