Project Details
COMPANY: Cigna
DURATION: 8 Weeks
PRODUCT TEAM: (1) Product Owner, (1) Product Designer, (10+) Dev Team, (5) Data Team
About
We needed a system that can collect data from various claim platforms, that data then has to be researched, validated or reconciled to produce a single source of truth that can explain why Cigna couldn’t pay a claim or why the deductible might be more/less than expected.
Problem Definition



“As a user I need to be able to find, review, and validate payment data from various claim platforms so that we can build trust with our members by accurately identifying member balances and who is responsible for payment, but the information I need is spread out across many platforms and documents that might not share info with each other.”
“Build trust with Cigna members by providing a source of truth on their deductible balance, so that it is up to date, accurate and we can identify who is responsible for payments.”
“How might we design a central location to collect, reconcile and validate data between a given claim platform (i.e. Facets, Power, Proclaim, etc)
Design

The first prototype was a dashboard that let the user know how many claims discrepancies they needed to adjust. Allowing the user to quicky drill down to find the information that they need about those claims.



*I know what you’re thinking, why not just design it so the claims adjustment can happen from a button or some interaction that removes the data table from the equation all together. We designed a prototype for this but there were certain data limitations and part of the claims adjustment teams job was to reconcile the data itself. For example perhaps someone had the wrong group ID or there was other info that wasn’t correct. However the team is going to work towards this solution in the future.


User Testing



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