Product Designer
Medical billing can be complex and risky for hospitals
Medical billing involves many steps and moving parts. Businesses and hospitals must comply with standard requirements in order to receive payment.
The teams in charge of different parts of this process carry the weight of the work. They have to move fast and accurately in order to remain in business.
This makes it even larger of a challenge when a lot of the systems and data are spread across many platforms.
Our target audience's pain points
Medical billing teams face a lot of barriers to their own success during the work day:
- The software has a lot of features and ways of doing things because it's used by a lot of different types of clientele.
- It takes a long time to master medical billing concepts and workflows in the tools.
- Users often need to open different screens, apps, and tabs to perform tasks today.
- Some billing ore pre-billing specialists need to troubleshoot over 80 case records a day to keep up with their quota; as such, they have ways of quickly deciding which work to prioritize and need to move quickly.
- When troubleshooting medical claim and case errors, users often hunt to find the issue.
- When using the previous offerings, the system helps users assist in fixing errors and users rely heavily on it.
- Most teams we spoke with have their managers assign tasks through spreadsheets and emails today.
- When checking insurance eligibility, it's hard to easily scan through the benefits responses from insurance payers.
- Users have a hard time accessing previous eligibility checks in certain cases, and sometimes lose the eligibility checks in progress if they take too long to finish.
- There are opportunities to bring certain pieces of data to top focus for users to help them complete their work.
The process for end-users
- Billing specialists switch between different apps.
- There are a lot of tasks and logic checks.
- The Eligibility and claims process can vary depending on the organization.
- Volume and speed are prioritized day-to-day.
- Data comes from many sources and employees check various places.
- Billing specialists prioritize “easy” cases that are not “priority”.
Key changes we made
- Build progressive disclosure for workflows.
- Enable quick action in the system.
- Keep users on a single page during workflows.
- Modernize the experience while increasing usability.
- Provide system feedback to help users troubleshoot.
- Provide ways to manage and assign workflows.
- Recommend key actions based on risky data.
- Unify important data into a single source.
Key strategies
Chunk the process
Billing teams handle specific parts of the lifecycle, and need to focus on specific parts. We designed the experience to focus on chunks of information at a given time based on the workflows we learned about. This helps people quickly complete the step they own.
Allow users to control the logic
A lot of the client's customers had unique operations for billing. The system needed to be modular and able to be flexibly controlled by hospitals who have different needs. We built this architecture from the ground up.
Reduce learning curve
We learned it takes months, if not years, to fully learn medical billing systems today. The steep learning curve comes from medical billing jargon and confusing structures of information. We designed an experience that breaks things down for people at every step. This helps both inexperienced and experienced take les time to learn the system.
Show what the system is doing
The complex systems behind the scenes may be doing things that users don't know about. We learned a lot of errors happen in the old systems when billing teams are trying to troubleshoot errors. The experience we designed shows visual feedback about what's going on behind the scenes. This helps teams make decisions faster, and make less errors.
Stay on the same page
The billing systems that teams use today are open across many different browser tabs. People switch between websites and apps to finish their work. This adds a lot of time to workflows. We designed an experience that keeps users on the same page when adding, editing, or removing data in the workflow. We measured a huge decrease in time to task completion because of this.
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How it's going so far
The results were mixed. We noticed some resistance to change.
Through usability testing task analysis, we found that tasks were sped up. But people reported things differently. Some teams using the old product appreciated the shift in where the information was displayed. Others reported that the new tools will take more time than it's worth.
We decided to propose we do more live testing with customers of the product to explore the resistance further.
What we learned while testing the changes
- Keeping the user on screen increased satisfaction on the product.
- People are resistant to change in their workflow even if it's currently complex.
- Data must be available and accurate for teams to make the most use out of the new features.
- People who were open to change reported that this experience would save them time.
- We effectively centralized data across business functions for multiple departments to work more efficiently.
Future recommendations
- How might we overcome resistance to change in the software?
- How might we evaluate specific steps in the medical billing workflow more?
- How might we improve accuracy and readiness of data across teams?
- How might we measure the effectiveness of changes after the product is launched at market?
- How might we streamline user-friendliness of tools within the product?