Who was the customer?
BlueCross Blue Shield is the only South Carolina-owned and operated health insurance carrier, we have been offering security to Palmetto State citizens for more than 70 years.
What were my Roles and Responsibilities
As the customer project lead I worked directly with the I/S team (developers, engineers, designers) with planning and managing the build out process. This was an agile project managed in Jira. Through weekly sprints I recommended which task would be worked on weekly.
As lead UX Designer I worked with the designing team designing the prototype for the application (mobile and full site) that was used in the first phase usability testing. As UX designer I also led a monitored usability study including developing the task and developing the summarization for our senior level staff.
Tools : Invision, Adobe XD, Adobe Photoshop, Adobe Illustrator, Validately
Skills : Wire-framing, High -Fidelity Design, User Test Planning, Prototyping
Problem
Prior authorization is the process to approve services before using your benefits. Through the process, there will be a review your benefits and the clinical information related to the services requested. Prior to developing the prior authorization tracker members were only able to track the status of their prior authorization by either calling in to customer service or awaiting their results by mail. This caused a problem for members because of the delayed notification of the status. Members must wait for the approval to have procedures done or be able to pick up medicine. This delay caused members to miss dates for procedures and lapse in getting their prescriptions filled.
Design Process
The project started with an ideation session which included meeting with over 30 members of staff including customer service, providers and various line of business members. This was a two-day session during which we created 4 different low fidelity prototypes using Poster boards and markers.
We then narrowed the prototypes down to 2 prototypes. As the project lead I worked with a team of designers in iterations to design and build out a function prototype via Adobe XD. This process was done utilizing the agile method and weekly sprints to keep watch over the process.
After meeting with senior staff and performing walk throughs of the prototypes and discussing how it works I took their feedback and readjusted the prototype and started the usability testing.
First Phase of design
Final Phase of Application
From the homepage members are able to access the prior authorization by selecting the hamburger menu and selecting prior authorization.
Once a member has accessed their list of prior authorizations they have the ability to filter to only show certain members under their plan or to only view prior authorizations based upon the status of the authorization. Members also have the ability to select and choose a particular authorization to view the details of the authorization.
Once a decision has been made on the prior authorization if its approved the member will be able to see any letters attached to the authorization and will also be able to view details about the doctor and service that was approved.
USABILITY STUDY RESULTS
