SUMMARY

BUSINESS PROBLEMS

HealthRules Payor product has a huge content library. Much of it contains Procedure codes like HCPCS, Diagnoses Codes such as ICD-9, ICD-10, Pharmacy codes such as NDC as well codes custom to Payor. These codes are needed for routine workflows when doing data entry around insurance claims. Besides their number being in hundreds, the code sets need to be refreshed every few releases due to updates, changes from 3rd parties and so on. The problem existed in having command line based tool to do these updates which worked like a black box to the business user. Errors were not reported, performance of uploads could not judged and so on. Moreover, there was no intuitive way of keeping a record of history of uploads for different hosted customers which for HealthEdge are tenants. We had no way of doing any accounting on how the code were being loaded.

OVERALL APPROACH

SOLUTION

The solution was a to build a tool with microservices based architecture to support multi tenancy and intuitive UI. The tool is internal but can be used by technical analysts at the Health Plan IT departments. The tool needed to show live code updates and version the loads. Various files types needed to be handled.

MY ROLE

I worked with the UI engineers and Product Owner to provide design and usability direction as well as a design system to support Internal Support catalogue apps, starting with this one. I conducted Usability Tests with internal Professional Services staff and guided main changes before the go-live.