North stars and Rethinking provider credentialing

Observing the paper-based credentialing process

Observing the paper-based credentialing process

 
 

How can we organize and make transparent the muddled credentialing world?

Credentialing is the process by which a provider becomes in-network with insurance companies, allowing them to treat patients and get paid. Current credentialing workflows are riddled with inefficiencies related to mixing paper and digital, unclear payer requirements, and lack of payer transparency on paperwork status.  

The goal of this project was to create a North Star vision and road-map for a credentialing service and product. A solution to the state of credentialing would allow the healthcare world to operate more efficiently as a whole, and provide entry for our company to a key touch-point in the healthcare management life cycle.  

This was the first time a full strategic and design thinking approach had been undertaken at the company. 

role

Supporting UX Researcher

approach

Design thinking activities were heavily used, with a focus on observation, interviews, concept testing, usability testing, persona creation, design workshops, collaborative sketching, story boarding, affinity mapping, and surveys.

Impact

  • A north star vision was created and accepted by the senior leadership and stakeholders moving the discussion forward on the need to fix credentialing for the company and healthcare industry

  • Stakeholder holders understood more fully the value of user experience and strategic design

  • A road map was developed for the credentialing space