Simplifying insurance claims
Re-designing CHA-Online, an online service for pharmacies in The Netherlands to claim medication expenses to insurance providers.
Image from Apotheek Salentijn
Clearing House Apothekers (CHA) is a company that handles insurance claims for pharmacies and insurance providers. They have more than 10 years experience in the business and were looking for a new design for their core offer: CHA Online.
The result is a new version of CHA-Online, where the tool guides pharmacies through the claims handling process and uses data to reduce the risk of mistakes; which translates in less time and effort from the employees as well as speeding and easing claim approvals.
Clearing House Apothekers partnered with User Intelligence to create the new version of CHA-Online and I was a part of the team as UX Consultant in the concept and initial development phases.
By means of a “Vision” workshop with the company’s stakeholders, it became clear that the challenge implied more than updating the tool’s design by implementing the new visual style and common interaction patters. It meant a bigger effort with three focus areas: 1) Putting customers at the centre by creating a service that would revolve around each of the target groups core tasks. 2) Updating front & backend structures. 3) Incorporating UX capabilities and using Scrum development process in the organisation.
To further understand the challenge we conducted interview sessions with the different target groups: individual pharmacies, pharmacy chains, insurance providers and internal CHA users. This enabled us to define each group in terms of main goals, priority tasks & overall motivations. For example: for pharmacies is about how much money they can claim back each month while for insurers it is about how much they need to pay. Another seemingly small but highly impactful finding was the variations in jargon across target groups; for instance pharmacies refer to people that come for a medicament as patients while insurers call them clients.
The differences and similarities across groups resulted in creating a modular concept where each target could be provided with the core functionalities that would serve their main tasks and align with the user’s motivations. Moving to a modular, focused concept was a decision supported by quantitative data from the current site’s usage statistics, where it was visible which functionalities were used by each target audience.
This implied a significant effort in terms of interface and backend structures since at that point, every customer could access every functionality, regardless of which entitlement contract or purpose they had the service for. On the other hand, having a modular solution would enable CHA to introduce the new platform one customer group at a time
With a concept and clear user understanding we were able to create a backlog. Both detail concept design and development took place in parallel. We organised two main teams seating by each other: one with a focus on design (including Front End) and one focused on Backend development. Because users were a priority, each sprint included a round of research at the end, these sessions varied from paper prototype concept validations to usability testing using the clickable product. Moreover, internal actors participated in several feedback sessions in order to provide further feedback and increase internal acceptance of the new service with its radical changes.