Technology promises to make research billing compliance easier, but systems only work as well as the processes and people behind them. This session looks honestly at what a CTMS, an EMR research build, and the integrations between them can and cannot solve. We will discuss study calendar builds, charge routing, flagging research encounters, and where manual review remains essential. The session also addresses change management: what to do when systems disagree, when staff work around them, or when a protocol amendment outruns the build. Attendees will leave with a realistic framework for balancing automation and human judgment.