Procedure Code Search

Disclaimer: All PHI has been wiped from any visual representations below. Any data pictured is fake and for demonstrative purposes only.

The procedure code search allows users (providers and offices) to see estimated, granular benefit information at the procedure code level to get a better idea of their patients benefits.

Introduction

Background

Industry: Health Insurance Technology
Company: Cigna Insurance
- Title: Product Designer
Product line: Web app (no mobile support)

My Role

I am the sole Product designer dedicated to this team, and am responsible for UX and UI design throughout the project. I work in conjunction with a dedicated UX researcher on my team during parts of the project including discovery, ideation and user research.

Constraints

Handoff: I was hired after the project had already started and had to continue the work done by an outside contractor.
Research: There had been usability done on the project before I arrived so there was no further budget to do any further research.
Process: The proper agile product development process wasn’t being properly followed when I began and led to many compromises in the implemented product.

Project framing

Overview

This specific workflow started off as part of a larger workflow. When I was hired on they had already completed the initial parts of the project including mockups, user testing, and grooming with the development team. The starting point below is the work that our contractor handed over to me.

Problem Statement

How do we allow our users (healthcare providers and offices) to gain a better understanding of patient benefits and allow them to reference this information later on, while making it clear that this is not a cost estimate tool?

Process

Benefits preview after multiple procedure codes are added

Starting Point - Initial Mockups

This is a sample of the original mockups for this workflow. It was a part of a different overall workflow called the BRN or Benefit Reference Number workflow. This tool would allow users to search for a medical procedure code and add that to a “cart.” From there they could add more procedure codes or proceed to generate a BRN that would save benefit information based on the codes searched.

After I took over the project, additional project requirements were added and the summary of the user testing that was given to our team. Using these we identified that we needed to:

Add additional benefit information and networks to the preview
Improve search for/adding procedure codes, as there was confusion around the clipboard concept (cart-like functionality)

Benefit preview after the user has searched for and entered all required procedure code information

First Revision

After a few iterations, it became clear that in order to improve and simplify the original workflow (BRN or Benefit Reference Number) we need to take this part of the workflow and make it entirely separate. We made the following improvements:

Moved this workflow to a dedicated accordion on the page
Allowing users to enter the procedure code and other required information in the accordion instead of a search bar and light-boxed pop-up
Expanded the benefit preview to include multiple patient networks and multiple benefits

Further Additions

At this point in the process I though we had settled on this simple view, but there was a last minute decision made to incorporate significantly more information and accommodate a greater number of procedure codes in each search. For this iteration we added:

All networks
Further benefit messaging
Related services and coverage policy links
Making each procedure code line collapsible to preserve vertical space in an already crowded page

Current State

New items have been continually added to this workflow as it has been rolled out to users and further functionality has been added.

New items added:

All benefit categories (coinsurance, copayment, etc) displayed for all networks
All benefit messaging included for each benefit so users don’t have to leave this workflow to reference the general benefits information
Displaying multiple benefits within a category under a single network (not shown in the mockup on the right)
Tabs that allow users to toggle between type of provider
Rolling this tool out to all lines of business (Medical, Dental, Behavioral Health)

Finalized state showing all available information and structure under each procedure code

Outcomes and lessons

Initial feedback from users in the beta group and medical groups was good and criticisms focused on the small number of procedure codes supported in this tool. As further procedure codes were rolled out and additional lines of business were included, the feedback become more and more positive. Since November of 2020 the number of code searches performed has increased 10-fold, even as work continues on supporting more procedure codes.

This was quite a frustrating project to work on for a number of reasons.

The lack of effective user research throughout the project and the inability to get comprehensive feedback throughout the iterative process to ensure that we were delivering an effective solution.
There was a lack of understanding from the project team I worked regarding the full scope of what needed to be included from the beginning. This meant that time was wasted on iterations that didn’t include necessary information.
Constant scope creep meant reevaluating the design and feature many times but without the time to properly gain an understanding of each addition.
Restrictive design standards meant that we could only utilize existing implementations of components that had been designed for Cigna’s other website with a different user and focus.

Going into the future with this project we will likely have to push for a redesign of this tool since many changes were made without time given to properly reevaluate the design and workflow. We will also likely push for a greater evaluation of this tool in the context of the entire page because not enough time was spent on determining the problem being solved and why.