Weird Dreams

Here I am up at 4:45am after a bad dream, and blogging away at 5:30am.

While often times, I dream about things that happened in real life, or of people I know. But then there are times I dream about things that never happened, or just strange to be real.

Like just now.

By now, I can't remember all the details. But it was a case where I got into an organization, Arizona State University for some strange reason (I was never involved with them), and someone in the upper echelon of management saw me and decided to use me for some utilitarian purpose. They put into place a system that would exclude me from the normal path that all newcomers would go through, and fast-track me into position of great power.

In this organization, dubbed "AZSU", there was great turmoil in the form of power struggle, between the traditionalists who wanted to preserve the greatness of the institution, and the pragmatists who wanted to rebuild the organization into something completely beyond its original intent. Both the traditionalists and pragmatists occupied similar positions within the organization, and everyone had their duties. But the pragmatists could not move forward on their plans because everything had to have to approval of the "Board", and this Board had to allocate funds.

The Board, was the supreme decision maker, led by a person who acted as its foreman, though each board member shared equal power. I was being fast-tracked into this Board, but I didn't realize it until I found myself on its doorstep, almost like an abandoned newborn.

But membership to the Board was not easy. There were several checks and balances in place to ensure that Board members came from all walks of life, had the blessings of several positions of management, and could retain the delicate balance of power between the traditionalists and the pragmatists.

Except someone wanted me in this Board to upset that balance of power, and shift it towards the traditionalists.

In the dream, I can remember myself as a neophyte, practically naive about how political everyone was in the organization, and how everyone questioned every single piece of news. I was almost like a marionette on a set of strings. In the back of my mind, I had come to realize that I was being manipulated. However, I didn't care and accepted this fate as my calling in life.

And it was when I was meeting someone from the pragmatists, that I woke up. But just before I woke up, I was explaining to her the history of how I came into the position I was in, and before I could explain everything, she would jump to conclusions and make presumptions. I kept having to correct her by continuing on with my story. But I woke up before I could recite the whole story.

I suppose I may have lived out this dream in real life, with my employment at CompReview. Just prior to when CompReview sold out to HNC Software, there was a definite division in the ranks between those who held on to the company's traditional foundings and those who wanted to adapt to the changing times. I was just a low-level manager, but one who happened to report directly to the majority stockholder of the company, one of the two guys who started the company.

My role as the manager of Research & Development put me in charge of developing and maintaining the company's core competency. I was the one that everyone wanted to manipulate, but could not because my boss kept me "untouchable". My boss was actually among those who wanted to adapt to the changing times. I was indifferent to the struggles between these two groups, and only set my sights on improving the company's core competency. In that sense, I was still pure. My boss saw to it that I stayed that way.

But once CompReview sold out to HNC Software, my boss was out, and I reported through the same chain of command that everyone else did. I was now vulnerable to attack, and I didn't really know how to react after all those years of being protected. I simply wanted to focus on improving the company's core competency. But instead, I had higher-level managers tugging at me, and at the same time, stabbing me as a scape goat. I quit that place, and went to work for one of its competitors.

I guess, had I continued sleeping, my dream probably would have evolved that way.

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Posted:   Thursday, April 19, 2007
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My Career in Healthcare, and Fair Isaac the Giant

It seems like my family has been associated with the health care field.

My father's mother was a registered nurse. In her last position she was the Chief Nurse at a convalescent hospital in Washington.

My father spent 20 years in the Navy as a hospital corpsman. And then he spent another 25 years working in health insurance companies and local hospitals doing everything from claims handling to patient services.

I also spent 16 years in various positions within the health care industry, but in the area of finance.

I got my start in 1987, when mom helped me get a job at Healthcare Medical Center of Tustin, in Tustin, CA. She was working there cleaning rooms. She knew the Director of Business Services, and got him to hire me as a File Clerk. I routed mail, pulled charts, filed charts, and lots of other odd stuff.

Then I got promoted to a biller-collector, where I called health insurance companies and barked at them as loud as I could in hopes they'd expedite payment to us. I also set up payment plans for cash-patients, and managed their Medicare & Medicaid accounts.

I did this again at another hospital in Stanton, CA, called Midwood Community Hospital. About 8 months later, they converted into a psychiatric hospital. Psych accounts are probably the toughest to bill and collect. First because psychiatric care is not covered under the normal "Major Medical" coverage of health insurance. Rather, they're paid through a separate policy that attaches to Major Medical, and these policies are capped at very small amounts of like $50,000 lifetime.

And by the time a patient is admitted into a psychiatric hospital, the admitted psychiatrist has already used up half of that cap in doctor's visits.

And because these patients are psychologically deranged, they usually don't pay their bills.

And just about all psych patients stay in the hospital for several months at a time, and rack up monster bills costing $100K to $150K. And this was 15 years ago!

Anyways, after that I did some billing and collections work for various clinics and medical groups. Finally, I got laid off, and got a job doing medical bill review.

Medical bill review was quite fun, particular after having worked as a medical biller. Basically, a medical bill reviewer looks over the bills that get submitted to insurance companies. The insurance companies usually hire an outside review agency, like the one I was working for. We'd review each bill to identify excessive charges, unwaranted charges, miscoded charges, duplicate charges, and try to find other reasons why the insurance company shouldn't have to pay the charges.

I did that for about 2 years, and then I went into research and development.

CompReview was a company that built and designed claims ajudication software. The software specifically did medical bill review, but also performed utilization review (which is looking for services that doctors should not have performed). And it also provided electronic data reporting capabilities that interfaced with State agencies.

My job was to research all the state and federal laws and regulations pertaining to claims adjudication, medical bill review, utilization review, medical data reporting, and then write up implementation specs to our software programming team.

We basically designed artificial intelligence that was able to scan electronically submitted health care claims, and identify excessive charges, unnecessary charges, miscoded charges, duplicate charges, and all that other stuff, and then send the insurance company an electronic claims analysis, telling the adjuster how much to pay.

It was tons of reading, writing, and tracking of legistlative changes. I subscribed to probably a hundred different insurance-related journals, bulletins, and newsletters, as well as state registers and the Federal Register. I maintained a library (we had an actual room the size of a living room) filled with every book imaginable on the subject.

I joined national organizations on medical coding, EDI, utilization review, and any other group I felt was necessary to keep us in the loop on current industry trends.

It was a lot of work.

CompReview was bought out by HNC Software, in 1999. HNC developed "neural networking" software. This was scientific stuff that mimicked the thought processes of the brain. By analyzing millions of records of historical data, it could actually predict what would happen. The Pentagon actually used this software to help its guided missile systems learn from its mistakes!

HNC also developed credit card application software. Every time someone applied for a credit card, or any kind of loan, the software could predict your risk. This was actually HNC's flagship product.

Well, I ended up quitting HNC in 2001, and went to work for competitor company, Innovent Technology, which also produced similar automated claims adjudication software. I basically did the same thing there.

By the way, Fair Isaac Corporation bought out HNC Software in 2001, or 2002 I believe. Fair Isaac is the company that invented the FICO Score.

If you think about it, Fair Isaac now owns the claims adjudication system that I helped design. This system has contained in it, about several billion health care claims spanning back to the past 15 years. That's a lot of people, and a lot of health care history.

Then consider that Fair Isaac also own the credit card application software that also contains billions of credit card applications (the software is used all around the world).

This means that Fair Isaac can link the Social Security numbers found on the health care claims to the Social Security numbers found on the credit card apps, and build a pretty impressive profile on just about anyone in this country.

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Posted:   Friday, December 01, 2006
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Making a Difference in Someone's Life

I get e-mails from people saying that one of my sites made a difference in their lives.

Most of these come from two websites that I designed and own in a partnership basis: CousinConnect and AdopteeConnect.

CousinConnect is the older of the two, it was conceived by myself and my business partner, David. We added a third partner, Sheila, once construction began on the site.

To sum it up, it's a database that anyone on the Internet can use to help them find a distant relative that can provide additional information on their family's history. We launched it on January 1, 2001, and in those days, genealogy research was a very popular use for the Internet.

AdopteeConnect is very much the same, but it markets itself to people searching for family members separated at birth.

Both websites are free to use, we only earn income from affiliate marketing links.

We've helped people reunite with lost sons and daughters, lost brothers and sisters, even aunts, uncles, and grandparents. This is the same sort of stories you hear on the news where they show video of two people hugging and crying happily at the airport. Only, it's all private and there are no cameras.

Here's an e-mail we received earlier this month...

I was recently contacted by someone named Pat Tiffin who had taken the time to search for my Aunt from the query I left of CousinConnect.com. My Aunt Diane, whom my younger sister and I have not seen for 32 years, has been found!!! She is alive and well living in Kansas! We called her this past weekend. She was so glad to hear from us. We have a lot of catching up to do! My sis and I plan to visit her in early summer.

Thanks CousinConnect for making this all possible!

God bless you!
Reading these "success stories" is refreshing, in that reminds you that making money is not the only reason why you publish websites. Otherwise, you'd simply publish porn. If you can design a website that not only makes money, but also makes a big difference in someone's life, you've found a very special combination.

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Posted:   Monday, November 27, 2006
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Getting Feet Wet in Competition

Of all the websites teaching me the old school principles of competition, it's Menifee 24/7.

It's a blog that I started a couple of years ago as an experiment in local blogging. I had been publishing blogs to a national and global audience, but never to a local audience. I had relationships with advertisers that wanted national exposure, but never advertisers that wanted local exposure.

Since then, Menifee 24/7 has grown some, and is enjoying some notariety among local business owners here in Menifee.

But what's teaching me the old school principles of competition is another website, MenifeeLive. The guy who runs it, Ben, is a nice guy. I met him and chatted with him for a bit. We still trade e-mails.

He wants to build the most popular web portal focusing on Menifee life. Basically, I want to do the same thing with Menifee 24/7. However, we're taking completely different approaches. He started by building a large portal with articles, photos, calendars, weather, links, you name it. He's also fielding advertisers. On the other hand, I'm starting by building community participation through blogging, and have put off advertisers for the time being.

My strategy is to create an online community by signing up bloggers and encouraging others to post comments. Ben's strategy seems to create a comprehensive resource of information with the expectation of attracting visitors. His strategy is actually the preeminent strategy used by many other successful portals.

But remember, I built Menifee 24/7 as an experiment by taking the concepts of blogging and community building, to a small local level.

So, which strategy is winning? Well, I don't know yet. Right now, Menifee 24/7 is attracting about 5,000 unique visitors per month. I don't know what MenifeeLive is attracting. I do know that Ben has since added blogs to his website, and is asking people to join.

The old school principles of competition I'm talking about involve getting myself into the field by visiting organizations and businesses and pitching my idea to everyone. I'm handing out business cards, visiting Chamber mixers, getting involved in community events, and getting to know the movers and shakers in this town. I've never done that with any of my other websites. I suppose I ought to, except that I don't know who meet with since those websites are published to global audiences.

But it's been pretty fun meeting new people and learning about their stories. It makes Menifee seem a lot more smaller.

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Posted:   Friday, November 17, 2006
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