ResumeAbout

Adjustment Tracking System

I lead the design initiatives to build a brand new Adjustment Tracking System for Delta Dental ERP software which reduced human error by 20%, expedited task completion by 170%, and increased visibility for key business users by 80%.

Themes
Enterprise
Qualitative Research
Information Architecture
User Experience Design
User Interface Design
Team
BSA
Business Users - Accounting
Business Users - Claims
Product Manager
Director of Engineering
Design
Sketch
Figma
InVision
Notion
Code
Kendo UI
HTML
CSS
React
Context

What happens if there is a discrepancy in a check amount?

Let's examine a scenario where a dentist is paid the wrong amount by the insurance company.

In this case, the dentist needs to send their check back along with a form asking for an adjustment to that check. Business users from the insurance company will receive the form along with the check and take the necessary steps to resolve the issue and send a check with the corrected amount.

This is just one scenario where an adjustment to a check needs to happen in order to resolve an issue.

A process that relies on business users from Accounting & Claims departments working hand in hand to identify, resolve and close an event.

Adjustment Tracking System was a product initiative that aimed at simplifying this process and allowing people involved to keep track of such events.

THE Problem

This process is done manually, therefore it's unorganized and inefficient.

The existing process relied on people using offline methods (paperwork, Excel spreadsheet) to coordinate.

This process involves a number of different personnel in Accounting and Claims departments, performing specific steps to advance a claim adjustment from the first time it is identified to a final resolution.

Goal

How might we create an intuitive workflow management capability to advance sensitive claim adjustments while giving visibility to key business users?

Our goal is to incorporate a simple workflow management capability to eliminate the need for offline methods. The system needs to help simplify activities between the Accounting and Claims departments related to three key scenarios:

A) An issue occurred with a check sent to a provider and they have returned the check. This is an insurance check since it was originally sent by the insurance company.

B) An issue is discovered when the insurance company receives payment from a provider, this is a provider check.

C) An issue is discovered when an insurance check is already printed, this issue is dealt with differently depending on whether it was mailed or not.

KEY RESEARCH INSIGHT

There is a lack of a step-by-step process to complete an adjustment. A time-consuming process that is vulnerable to human error.

I conducted user interviews with key business users from Accounting and Claims departments to understand the current process, their pain points and documented key observations.

Human Error

Enterprise is accountable for potential human error which could cause millions of dollars in liability and time wasted.

Enterprise is accountable for potential human error which could cause millions of dollars in liability and time wasted.

Process Time

This is a time-consuming manual process which could take take as long as 8 hours to be completed.

Back and forth exchange of sensitive documents.
Long email threads.
Long, exhausting meetings.

Visibility

Key business users are unable to observe the process from start to finish

Minimum visibility on who advanced the event to the next step. Key business users had to dig through emails and excel files to pinpoint an issue.

INFORMATION ARCHITECTURE

Workflow Diagram

The data had to be extracted from email messages and excel files to visualize the system and provide the necessary structure to process information. This exercise helped identify key steps to resolve an event.

How should we create and resolve issues using a workflow management system?

In order to keep track of an ATS event, we assign a status to them.

Upon discovery, each event will be created with an open status. They will go through a series of steps until resolved.
Key statuses are open, ready and complete.

The business users will be able to discover or locate an events with their current status and advance it to the next status upon completing a task.

Open

Ready

Complete

DEFINING THE NEW EXPERIENCE

Multiple Step Process to Complete an Event

The concept was sketched and discussed with business users and a series of wireframes were presented to capture various aspects of the system.

I relied on the interaction design pattern library, design system library, and reusable components to deliver the final prototype.

THE SOLUTION

Locate, Adjust and Resolve

The solution allowed business users from claims and accounting departments to easily locate an event, perform necessary actions to adjust it, notify key business users to review and resolve that event.

LOCATE

Design for Finding

Business users were able to quickly locate events that required their attention. The solution accounted for exploratory seeking, known-item seeking, and a berry-picking model that allowed them to search and browse before triggering an action.

Exploratory Seeking

A pre-set filter was designed for business users with different roles, so upon landing on the screen, they could quickly scan the list. Business users were able to create custom filters so they quickly find desired results.
Known-item Seeking

Business users were given the option to narrow their search down to locate a known event. They were also given an option to save their search so they could access it faster in the future.
Berry-picking Model

Business users were able to examine additional information such as claim details, provider information and modify their search if necessary. This is useful for those overseeing the overall process.
ADJUST

Batch Functionality

The system allowed batch action for certain steps that were considered low risk and high value which saved valuable time for business users. Business users were given the option to select a pre-set filter that would only show events ready to be resolved and by enabling batch functionality, they could quickly select all those records and advance them to the next step.

Multi-select
‍‍

Users can quickly identify unresolved events, select all, change the status to complete with one click.
Resolve

Design for Visibility

The system captured key information when a step is completed, data such as timestamp, user-id, and status of an event were captured and stored in the history tab.

History

Historical data presented to key business users so they can keep track of key activities.
Notifications

Notify Key Business Users

After a status was changed successfully, notifications were sent to key business users to execute the next step until the event was resolved. Each notification allowed users to quickly navigate to the event and advance it if necessary.

Notify

Key business users are notified that an event is completed, they can see the exact status, user-id and date of completion. They also have the option to quickly view that event if they choose to.

One System, Two Departments

The accounting and claims departments expected the system to tailor in coordination with their assigned workflow, they also required the system to hide privileged data from the other group.  Therefore the system was designed slightly differently for each department.

IMPACT

Results + Next Steps

Adjustment Tracking System served as a benchmark for tackling complex internal workflows, it relied on productive collaboration between different departments within the organization and justified the need for applying human-centered design. I worked closely with the development team to build the solution and experience firsthand what it means to save valuable time for busy users.

-25%

Reduced Error

Measured by analyzing historical data and compare it to the new system's flexibility to highlight potential issues.

+170%

Task Completion

Measured by capturing the average time it takes to resolve an event.

+80%

Increased Visibility

Measured by analyzing the key business user navigating to the history tab at least once after an event is resolved.

THANK YOU

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