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This solution will net significant efficiencies, anticipated savings in the millions, and much happier users.
A healthcare organization approached us with a seemingly straightforward problem: reduce the number of insurance claims rejected due to missing pre-authorizations.
Their proposed solution was simple—add a link in the provider interface to access the existing pre-authorization requirements document. The assumption: providers couldn't find this information easily.
Instead of immediately implementing the requested solution, our team proposed a critical first step: observe and talk directly with end users to validate the actual need.
With support from delivery owner and his director , our team conducted on-site sessions with financial coordinators, administrative assistants, and managers.
The feedback was unanimous and unexpected: "We would never use that link."
Through careful observation and conversation, we uncovered the real issue. Providers knew where to find the pre-authorization document—they simply didn't trust its accuracy. Some had resorted to submitting pre-authorizations for every procedure, yet still experienced claim rejections even when told pre-authorizations weren't required.
Our design team developed multiple solution concepts, created workflows and mockups, then validated them with the actual users to identify the most effective approach. The winning solution had three components:
While this solution required more investment than simply adding a link, our approach delivered tremendous value:
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I know few more powerful forces for good design in the world than Jonathan. ... He's an empathetic, effective manager of people who brings out the best in them, and he brings a boundless spirit of optimism and affirmation to every task and team.
– Patrick E. Sharbaugh
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