Designing a Comprehensive and Intuitive Claim Details Interface

Practice Automations • 2023

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WORKING FOR Practice Automations (PAPM) Practice Automations (PAPM) is a Texas-based healthcare startup set to transform the RCM sector with its advanced SaaS product. Despite the digital age, the industry remains paper-based and fragmented, grappling with the complexities of the US healthcare billing system. PAPM is determined to change this by developing user-friendly, AI-driven solutions for these companies.
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ROLE Product Designer & Information Architect
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TEAM Jennifer Surban, Product Manager Mike Gonzalez, UX Lead & UX Researcher Shahid Bashir, Engineer
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Introduction / Problem:

While the overview of the “All Claims” page provided a bird's-eye view for AR managers and billing clerks, there was a pressing need for a deeper dive into individual claims. Each claim, with its unique history, stages, and statuses, required a dedicated space where users could access comprehensive details and take specific actions. For PAPM’s software, the challenge was to design a "Claim Details" page that was both informative and actionable, allowing users to understand and manage each claim effectively.

Approach:

To design a page that truly met the needs of the users, we first sought to understand the depth and breadth of information required for each claim. This involved revisiting our knowledge of the claim billing cycle, focusing on the individual intricacies of each claim. We also conducted additional interviews with AR managers and billing clerks, aiming to understand what specific details they frequently accessed and what actions they commonly took.

Given the complexity of individual claims, with their myriad of stages, statuses, and associated actions, we recognized the importance of a comprehensive yet clear, organized layout. We also considered the potential need for users to navigate between the "All Claims" overview and the detailed view of a specific claim seamlessly.

Lastly, it was crucial for us to maintain constant communication with the engineers. This helped us gain a deeper understanding of what was achievable within the product timeline. By keeping the technical limitations in mind, we were able to accelerate our progress and make more confident decisions.

Process

With our approach defined, we initiated the design phase. We started with rough sketches and wireframes, laying out the structure of the "Claim Details" page. These preliminary designs were then presented to a group of subject matter experts for feedback. Their insights were invaluable in refining our design, ensuring that the layout was intuitive and that all necessary information was easily accessible.

We also continued to collaborate closely with developers during this phase, ensuring that our design for features and solutions remained not only user-friendly but also technically feasible. Multiple iterations were made, each time refining the design based on user feedback and technical considerations.

Solution:

Meet the “Claim Details” page:

Claim Details Header
Claim Details Header
“Summary & Billing” section overview
“Summary & Billing” section overview
“Service Details” section overview
“Service Details” section overview
“Financial” section overview
“Financial” section overview
“Documents” section overview
“Documents” section overview

Conclusion, Reflections & Learnings

The process of envisioning and creating the "Claim Details" page was an exciting exploration of RCM billing, providing us with valuable insights and knowledge.

1. The Devil's in the Details: The complexity of claim details highlighted the need for thorough research and comprehension. Every claim has its own narrative, and each detail is essential. It was vital to make sure that all information was accessible and understandable. This project emphasized the significance of a designer's role in making complexity more straightforward.

2. Collaboration is Key: Working closely with stakeholders, from AR Managers to Clerks, highlighted the value of diverse perspectives. Their insights were invaluable, ensuring the design was not only intuitive but also aligned with real-world needs. This collaboration emphasized that the best solutions often come from collective input.

3. Never Overlook Workflow Design: The “Claim Details” contains numerous workflows related to many features and jobs-to-be-done. Mapping and making sure these workflows worked intuitively and flawlessly proved to be one of the most challenging aspects of this project.

4. Always Keep Developers Close by: Given the module's extensive details, we recognized the importance of regularly consulting with developers. This routine ensured our solutions were not only effective but also feasible within our time constraints.

Reflecting on the 'Claim Details' page, it was more than just a design project. It was a deep dive into the heart of RCM billing. By utilizing research, working together, and focusing on the user, we were able to create solutions that truly addressed the needs and challenges of our users.

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🚀 Stefano Tavanielli

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