A Stalled Revenue-Cycle Team with an Absent Sponsor

Diagnosis - this is not a tooling deficiency. Six months with only Define complete, 40% attendance, an absent sponsor, and a silent remote contingent point to four distinct failures:

1. Unclear decision rights. Two members negotiating scope with the billing director means the team does not believe it has authority to decide.
2. Sponsor disengagement. Without a sponsor, the team cannot resolve the IT block or the scope conflict; it can only absorb the delay.
3. No process discipline. No action log means no visible commitments, so lateness is invisible and therefore free.
4. Virtual exclusion. Non-speaking remote members are usually a symptom of meetings designed for the room.

Next two weeks:

• Individual 1:1s with all nine members: what do you think this project is, what is blocking you, what would you decide differently? You are gathering the competing definitions of the problem.
• Re-confirm the charter with the sponsor - a 20-minute conversation with a specific ask, not a status report.
• Publish a one-page RACI: who decides scope, who decides data access, who must be consulted. This alone resolves most of the side-channel conversations.
• Start an action log and decision log effective immediately, reviewed at the top of every meeting.

Assume the block is legitimate risk management, not obstruction, until evidence says otherwise. The mistake is to frame it as a compliance problem.

Interest-based approach:

• Ask what the security review actually requires and how long it takes. 'No date given' usually means no one has scoped it.
• Shrink the ask. A six-month extract of five de-identified fields for one payer class is a far easier approval than 'all denial data.' Offer to have IT choose the minimum viable extract.
• Offer to do the scoping work: draft the data-use description, attend the security review, accept aggregation instead of record-level data.
• Put a date on it, agreed in the meeting, and record it in the decision log.

Escalate on schedule, not on emotion. If no date is set within one week, take it to the sponsor with a specific decision request: 'We need either the extract by the 15th, or a decision that Analyze runs on a 500-record manual sample. Which do you prefer?' Two options with costs attached get a decision; a complaint gets sympathy.

Also quantify the delay in project terms - three weeks of the remaining eight - so the cost of the block is visible to people who own the schedule, not to the person who owns the risk.

Do not silently slip. A missed date that nobody renegotiated is the failure mode that kills program credibility.

Restructure:

• Split into two workstreams with named leads - one on a single denial category (the highest-volume one), one on data capture and root-cause verification. Nine people in one weekly meeting is not a team, it is an audience.
• Weekly 30-minute stand-up plus biweekly steering; pre-reads and asynchronous updates so remote coders can contribute without competing for airtime in a 60-minute call.
• Rotating facilitator and timekeeper; agenda sent 24 hours ahead; last 5 minutes reserved for commitments and owners.
• Ground rules written and agreed, including 'decisions are made in the meeting or escalated, not in side conversations.'

Renegotiate scope with the sponsor in writing: 8 weeks supports Analyze plus a single-category Improve pilot, not a 30% enterprise reduction. Propose that explicitly, with what is deferred and when it restarts.

Escalation of last resort: if the sponsor will not engage at all, take the re-scope decision to the sponsor's manager - framed as a portfolio risk, with a recommendation, not a complaint about a colleague.