Cigna Operations: Data Capture 2.0
Design Case Study | CIGNA 2020
Cigna ingested claims information inefficiently as claims data was ingested after claims were paid off. At the time, complete, accurate, and timely data capture was a casualty of tradeoffs; if too much data was captured, it took too long, and cost too much. A technological solution was bought in to reduce such tradeoffs that would ingest claims data faster to more effectively progress claims that would reduce high costs. The goal as a UI/UX designer was to assist international markets with automizing Cigna’s claims ingestion process by creating an auto-populating form interface where users would validate claims data to cut down on ingestion time and accurately ingest the claims data. | Desktop Design
Discovery
PROBLEM STATEMENT
In the past, complete, accurate, and timely data capture was a casualty of tradeoffs; if too much data was captured, it took too long, and cost too much. Technology can reduce such tradeoffs. Cigna needs such a technological solution that would ingest claims data faster to more effectively progress claims that would save Cigna high costs.
INTENDED SOLUTION
Capturing more data accurately will allow Cigna Global Health Benefits (CGHB) to improve affordability, demonstrate value to clients, become a whole health partner to customers, and win against emerging competitors. There is significant business value in capturing more data. My UI/UX role is to assist international markets with automizing Cigna’s claims ingestion process by creating an auto-populating form interface where users would validate claims data to cut down on ingestion time.
UI/UX GOAL
Create a UI that captures claims data at the front of claims processing in a user-friendly, quick & efficient way.
INTENDED USERS
An offshore team in India dedicated to processing claims
TECHNOLOGIES
Salesforce Velocity, Figma, Zeplin
UPFRONT USER RESEARCH
The user research was conducted with caution as users were not aware that the majority of their job is going to be automized. To avoid causing fear of job loss, I conducted interviews with extensive prep with the UX research team. I was cautious of terminology and word phrasings.
The six user interviews were conducted with 45-minute sessions. As users were from India and not confident in their English response, their manager was also present.
Results concluded that the most crucial pain point was that the users currently have to transfer claims information from a non-readable PDF to an electric form manually. This manual process is prone to errors.
RESULTS
Current User Flow: Users had an inconvenient work process where they first need to pull up an excel sheet that contains the currency format for every country. They referred to this excel sheet throughout the day to confirm the correct currency format. Then, they open the current data capture to transfer data manually from a non-readable PDF. If there are any issues during the data entry, they go and email the quality team for assistance.
Key Features that could make Data Capture 2.0 Successful:
Translations:
Non-transalated data / content is copy and pasted into google translate
Action options:
Complete, Hold, Pending, Auto-fill
Metric tracking of users:
Sign in, sign out, breaks: looking to capture time / productivity metrics
User specialization:
Users are grouped by region to specialize in understanding regional data
(currency format, adress format, etc.)
Potential need for a guide:
They have guidebooks for tools; may need to make one for data capture 2.0
Improvement Suggestions:
Some improvement suggestions from users that they would like to see in data capture 2.0:
Auto-populated fields:
As users need to manually type out data, auto-populated fields would be ideal
More drop down selection fields:
Users wish to see more drop downs to avoid error & faster entry process
Remove description field character limit:
Description field currently has a limit of 250 characters. Often claims in Chinese are longer. This process can elongate data input time.
Error Handling:
Data Capture 1.0 has features in preventing data input that may be off (for example: billed amount). Ensure that it is installed in data capture 2.0 as well with more fields with error handling features
Incorporate Alt Code feature:
Users currently need to google alt code options to use special characters / symbols. They would appreciate a feature that allows users to directly pick such characters / symbols
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