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CRIS

WORKFLOW & ACTION MANAGEMENT

Important work should not depend on someone remembering to follow up.

They lose control because work moves between people without a clear system for ownership, priority, deadlines and closure.

CRIS Workflow & Action Management turns issues into visible, assigned and trackable work so teams know what needs attention, who owns it, when it is due and what happens next.

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CRIS WorkflowOpen work item
Denied claim

Appeal documentation required

Claim 28461 · $12,840 outstanding

High priority
OwnerEmily Carter
DueToday, 3:00 PM
StatusFollow-up
Next actionConfirm supporting document and submit appealDue today · 3:00 PM
Visible ownershipKnow who owns the next action.
Clear priorityFocus attention where delay matters most.
Defined timingSee what is due, overdue or approaching an SLA.
Accountable closureKnow what was done and why the item was closed.

FROM SIGNAL TO OWNERSHIP

The problem is rarely knowing that something is wrong.

The problem is making sure someone acts on it.

A dashboard may show that a claim has been denied. A report may show that money is outstanding. But knowing about a problem does not automatically make the problem move.

Someone still needs to take responsibility. Someone needs to know what to do. A deadline may need to be met. And eventually, the organisation needs proof that the matter was actually resolved.

CRIS connects that journey.

Turn information into action.One connected chain
01IssueProblem becomes visible
02OwnerResponsibility is assigned
03Due dateTiming becomes explicit
04Follow-upNext action stays attached
05EscalationDelay reaches the right level
06ResolutionOutcome and evidence remain visible

MY WORK

Give people a clear place to start their day.

A user should not need to search through reports, emails and spreadsheets every morning to figure out what needs attention.

My Work

Thursday, September 18

Due Today124 high priority
Overdue7Oldest: 4 days
Waiting9External response
Escalated3Manager attention
High
Appeal documentation requiredClaim 28461 · Due today, 3:00 PM
$12,840
Overdue
Follow up unpaid claimClaim 28117 · 2 days late
$8,420
Waiting
Payer response pendingClaim 27984 · Next check Sep 20
$5,960
Escalated
High-value payment varianceClaim 27610 · Manager review required
$18,300
Priority & SLALive workload
Critical
4Immediate attention
High
12Time-sensitive
Normal
20Expected working period
Low
7After urgent work
8Due soon
12Due today
7Overdue
84%Completed on time
Denial review
92%
Payment variance
81%
Appeal submission
68%
Customer query
95%

PRIORITY & TIMING

Not every task has the same urgency.

A task due next month is not the same as an appeal deadline tomorrow. A low-value enquiry is not the same as a high-value unresolved payment.

Priority should help people decide what to do next rather than simply adding another label to the screen.

Every important task should have a due date.

CRIS allows work to carry a clear expected completion date so users can see what is due soon, due today, overdue, completed on time and completed late.

Some work has more than a due date.

Service levels or SLAs can make expected response periods practical by showing when a deadline is approaching or has been missed.

FOLLOW-UP

Follow-up should not live in somebody's head.

A payer is contacted about an outstanding claim. The payer says: “Call us again next Tuesday if the payment has not appeared.”

CRIS allows the next follow-up to remain attached to the work itself. The account stays visible until the next required action has happened.

Stop asking, “Did anyone follow up?”

CRIS can help show who followed up, when they followed up, what happened, what was promised, whether another follow-up is needed and when that follow-up is due.

Task historyClaim 28461
Task createdDenial received and review task created automatically.System
Assigned to Emily CarterHigh priority · Due Sep 18.Revenue Cycle Team
Supporting document requestedClinical documentation requested from Health Information Management.Emily Carter
Follow-up due todayDocument has not yet been received.Next action: follow up by 3:00 PM

CONTROLLED ESCALATION

When work stalls, the right person should know.

A task may remain unresolved beyond its due date. A financial value may exceed the employee's authority. A critical issue may require management attention.

CRIS can escalate work when predefined conditions are reached.

Escalation should be controlled, not chaotic.

0–24 hoursOwner reminderTask remains with the assigned person.
→
24–48 hoursSupervisor alertDelay becomes visible to the team lead.
→
High value / SLA breachManager reviewMaterial or repeated delay receives management attention.
→
Critical conditionExecutive escalationImmediate attention where policy requires it.
When a denial is received → create a review task. When a task becomes overdue → notify the owner. When it remains overdue → notify the supervisor. When an appeal is submitted → schedule the next follow-up.

MANAGEMENT CONTROL

Managers should see where work is getting stuck.

Managers do not need to read every note from every task. They need the bigger picture.

Operational control

Workload & accountability

Last 30 days
Open work146+8 this week
Overdue3121% of open
Waiting3826% of open
Resolved on time84%+5 pts vs prior period
Open work by teamOpen vs overdue
Denials
43 / 11
Collections
36 / 8
Payments
27 / 5
Appeals
40 / 7
Two teams. Same count. Different condition.100 open tasks each
Team A
90 recent · 10 overdue
Team B
20 recent · 80 overdue
Closure controlsTask 28461
Ready for review

Appeal outcome received

Required before closure:

  • Outcome recorded
  • Supporting evidence attached
  • Payment confirmation received
  • Supervisor review pending
Closure becomes available when all required conditions are complete.

CLOSURE & EVIDENCE

Closure should mean something.

An item should not be considered complete merely because someone clicked Close.

Depending on the work, closure may require a recorded outcome, a reason, a comment, supporting evidence, an approval, a payment confirmation or another defined condition.

Know why something was closed.

A closed item may have been successfully resolved, paid, appealed successfully, corrected, written off, cancelled, rejected, transferred or closed because no further action was available.

The purpose is to make closure represent completed work, not a cleared inbox.

ACCOUNTABILITY WITHOUT EXTRA WORK

Move from chasing people to managing work.

The work itself carries its owner, status, priority, due date, reminders, history and next action.

Individual userMy assigned tasks

Know exactly what needs attention and when.

SupervisorMy team's workload

See overdue work, waiting items and where intervention may be needed.

Department headOverdue and escalated work

Focus on bottlenecks and recurring delay.

ExecutiveWhere important work is being delayed

See material exceptions without reading every task note.

Know what was done, not simply what was supposed to be done.Created → Assigned → Due → Action → Reminder → Escalation → Outcome → Closure

FROM ISSUE TO CLOSURE

The real benefit is not more tasks.

It is fewer things falling through the cracks.

CRIS Workflow & Action Management brings queues, assignments, priorities, due dates, service expectations, follow-ups, notifications, escalations and closure into one connected operating model.

“This is the issue. This person owns it. This is when it is due. This is what has happened. And this is what happens next.”
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