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The Challenge
Submitting Medicare and Medicaid claims to the government requires absolute precision. In order for health insurance companies to be properly reimbursed for these claims, the complex and sensitive data that comprise them must be error-free. If the data are incorrect, companies must resubmit – which further delays their getting paid for services already rendered.
Larger health insurance companies usually have a staff with the deep institutional knowledge required to navigate the federal claims submission process. This knowledge includes the ability to recognize procedure codes and diagnose errors in practitioners’ entries. As well as having the technical expertise to recognize errors in formatting across hundreds of lines of data. The staff that manage this task are often highly specialized and usually overburdened.
The staff that manage this task are often highly specialized and usually overburdened.
In this landscape, smaller health insurance companies may not have the staff or the time to spend on such a data-intensive process – so they have more difficulty competing with the big players in the health insurance industry.
The Solution
Pouring through lengthy insurance forms and data-heavy documents is a time- consuming and error prone task. With an innovative approach to data evaluation, Babel's interface provides an enhanced and streamlined user experience through which insurance companies can evaluate, edit, and submit their critical data. By allowing them full transparency, analytical control, in a time saving interface, insurance companies can make better business decisions with their limited resources.
The Babel interface provides an enhanced and streamlined user experience for what is typically a tedious and time consuming task.
We worked closely with Babel’s cofounder, Mark Tobias, and their development team to architect and design a user-friendly product by:
Envisioning a one-stop shop for following a claim from submission to reimbursement, clearly presenting the impact of each claim to the company in dollars.
Working closely with subject matter experts and end users to design a user-focused solution from scratch.
Building increasingly complex prototype iterations, starting with minimum viable products and increasing functionality as features were added based on customer feedback.
Rethinking the display of complex data to allow a wide range of users with varying skill sets to easily access and perform critical functions, so smaller health insurance companies are able to easily submit claims without detailed specialized knowledge.
Implementing a custom dashboard solution that lets the user see trends, outliers and an overall snapshot of the health of their programs.
Creating and implementing a consistent visual design language throughout the application by creating and implementing a repeatable UI kit and design process.
Our unique approach to prototyping made the development handoff more streamlined in a way that caught the attention of our prototyping software company, UXPin, such that we were invited to host a webinar to present our process to other UX professionals.
Employing an agile UX process in congress with sprint-based development, which allowed Babel’s remote development team to have a vision of the future in mind while staying focused on the current iteration of the product.
The Results
Before Babel, submitting claims was a highly specialized process requiring both technical capabilities and vast knowledge of industry-specific terms. With Babel, submitting claims is a simple task requiring only basic knowledge of the industry as the barrier of entry. Additionally, Babel provides the means for mid-sized health insurance companies to access the kind of resources larger companies have, without adding overhead and personnel.
Babel’s custom mapping tool cleans data to ensure that the claims data from providers matches the Medicare/Medicaid requirements. In this way, Babel can identify repeated errors and correct providers’ future submissions, continually improving Babel’s return on investment by ending continuous frustrating rejections of valuable submission reimbursements.
As a result, Babel allows health insurance companies to quickly identify errors and focus on maximizing reimbursement dollars, saving hundreds of hours of admin time. Staff have the time to focus on identifying and correcting high-dollar claims, increasing savings to the company.
Babel is a standalone product, available for health insurance companies to start using – and is scalable for any size.
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