How I led an increase of the Claims Experience customer satisfaction by +25% in 2020
The Claims Experience
Claims are like a receipt of medical, vision, or dental services that a patient received from a provider. Blue Shield acts as an intermediary between the two parties to manage how the services are paid for.
I took Claims very seriously because, from a mission point of view, I felt the claim represented the relationship between insurance and the customer. To me, a good claims experience was about trust and corporate insurance following through on its promise to its customers.
There are two web pages (and similar iOS and Android pages which were also updated at the same time) that make up the core of the claim experience. The Claims Summary Page which was a chronological feed of claims for any family members the current user had permission to view. Then each Claim links to its own, individual Claim Detail Page.
The Goal
Each team in the Digital Org was tasked with increasing their customer satisfaction as measured by NPS (Net Promoter Score) system. It was clear to me there was room for improvement because the Claims score was in the average range but I needed to feel confident that our 2020 changes would be measurable. I turned to user feedback and research to uncover the opportunities and validate our plan.
The Problem
After analyzing +1,000 user comments sent in from both of the Claims pages over the course of 1 year, I pulled out the most prevalent themes. Then I created wireframes to validate the problem space using a quantitative user test sent to ~100 online BSCA members. The user’s pain points became more clear and I worked with Product to define the 2020 plan.
- Users didn’t know how to view and manage a family member’s claims
- Users couldn’t find what services a claim included
- Users didn’t understand how charges were calculated and how their deductible fit in the financial picture
- Users wasted a lot of time opening and closing claims looking for information
Hypothesis
Product and I developed a few specific hypothesis around data points, layout, and user behaviors all pointing to a general hypothesis:
If users could more efficiently distinguish one claim from another, they will experience less friction and have a positive experience.
- Add data specific to the Patient’s visit
- Add data specific to the Provider
- Use common financial layouts that fit user’s expectations
- Increase scanability, group like data with like data
- Ensure key data isn’t buried under a click
My Roll
Sole contributor for the Claims SCRUM team responsible for:
Responsive Web, iOS, Android
SKILLS
Direct User Research
Wireframes
Mobile1st Responsive Mockups
iOS and Android Mockups
Redlines & Annotations
Design QA
TOOLS
Sketch
Invision
PEOPLE
Collaborate with User Researchers
Collaborate with Product
Support Development
Claims Summary Page (before)
After the round of user research, I looked for clues in the existing experience that caused users to think, feel, and behave as they did. I noticed a number of things that could be causing the confusion. My task was to improve these areas, incorporate Product’s additional features (such as bringing in deductible context), and set the team up for measurable success.
Claims Summary Page (after)
The resulting design uses existing styleguide typography and components but brings in new data points and reorganizes the information for scanability.
Claims Detail Page (before)
When it came to the claim itself, there were alot of confusing things about the existing page that a better design could remedy. Generally speaking, the page had very little visual or informational hierarchy.
During my research, I heard that users found more value from the Explanation of Benefits pdf (EOB) than they did our claim. Many would just go and download the EOB and not bother with our online experience. However, when asked about the EOB, the majority of users didn’t enjoy using it. I saw an opportunity there.
Claims Detail Page (after)
The resulting design uses existing styleguide typography and components but brings in new data points and reorganizes the information for scanability.
Result
The changes the team made in 2020 were a success. Our NPS went up by +25% and the Digital Org really celebrated this win. I was proud because I knew we provided value to the users. I see things that I would like to change now, especially from a visual design point of view, but the fundamentals of the work are sound and ultimately, when you’re talking about something as important as a Medical, Dental and Vision claim, it’s all about how the user accesses the information.
Reflection
Even though the team exceeded our goal and the organization was pleased, I would like to have refined the visual design more and iterate the typography for a more refined look and feel. I think eventually I would have liked to rethink the expanding and collapsing cards and make the dates more readable.