Medical Revenue Cycle Management
The Opportunity
Our SaaS Practice Management software suffered from a low NPS score despite delivering client requested features at a fast pace throughout the prior two years. One of the key aspects of a practice management software is Revenue Cycle Management (RCM). As an organization we knew our focus would be on improving the Revenue Cycle Management in our platform, but didn't have a clear definition of where to begin.
The Team
Our UX team consisted of myself as design director, 6 designers, and 1 researcher. The team had different skill levels in user experience research, and little to no knowledge of RCM. In order to understand where our software could be improved we needed to:
- Increase the UX team's understanding of revenue cycle management and UX processes.
- Understand where the current pain points are both spoken and unspoken.
- Find out if our expectations of client use, match how clients actually use the software.
- Guide the roadmap for future improvement and iterations in the RCM.
Our Plan
Foundational Work
Help the team better understand the problem space and prepare for interviews.
Interview & Observe
Use the foundational work to frame the interactions - learn through surveys, interviews, and in-person observation.
Assimilate & Deliver
Perform qualitative analysis on the data obtained from interviews and observations - provide knowledge share tools.
Brainstorm & Solution
Discover new ways to please the client, validate with customers, and solve their challenges.
Learn & Revise
Continue the feedback loop after implementation and development for continuous improvement.
Foundational Work
Medical Revenue Cycle Management is a complicated 7 phase process.
We needed to develop a team of designers who were equipped to create complex UI workflows that supported real life work patterns.
To do this we enlisted our business partners from Support, Implementation, and Consulting Services. They walked us through the process step-by-step.
As we interviewed our internal stakeholders - we also worked together in LucidChart to diagram the process flow. While doing this, we documented known pain points, interesting facts, and unanswered questions using different colors of sticky notes.
Interviews
We interviewed people who dealt with all areas of the RCM. This included:
- Physicians
- Office administrators
- Front desk associates
- Insurance billers
- Patient liaisons
- Injectable drug specialists
- Anyone in a practice who touches any part of the RCM
Observations
We conducted in-practice side by side days where we observed and asked questions about the processes in the office. This was often conducted as though we were new employees training to do the job. We sat with the same people we interviewed, or in some cases others with the same role.
Assimilation & Delivery
We worked together to assimilate our interviews and observations into key deliverables.
- Documentation of how our platform processes different areas of the RCM
- Persona kit to allow Stakeholders such as Product Owners to use assets in Jira stories to keep the user at the heart of the story.
- An RCM Journey map of our customers experience in the platform
Key Takeaways
There were a few key places we found we could provide a better, more comprehensive services for the practices who use our software. We had a number actionable design improvements gleaned from our work, some of which were:
RCM Begins at First Contact
We had often thought of revenue cycle management as beginning with the billing cycle, perhaps when someone is walking out the door. The RCM begins with the first phone call, and typically the people with the least experience field this call. We found our software could do a better job of walking customers through the steps of identification and verification of insurance.
Complexity and Overhead
We did multiple side by sides with people who exported our reports into excel and spent their day doing and reviewing calculations that our reports could have provided automatically. There were entire departments that followed these processes. Getting feedback on these additional calculations and incorporating them into the report saved hundreds of hours.
Clear Foundation for the RCM
The impending No Surprises Act meant that our providers needed to be able to provide accurate estimate for care that included calculations which were often done towards the middle or end of the RCM in our software. This reinforced the need to provide accurate tools for collecting and pre-verifying insurance and billing amounts in the platform.
