Project Three:Prior Authorizations
Problem
Prior authorization is process that requires approval from a health plan before a doctor can provide a medical service or prescription. It’s a notoriously challenging experience for providers (i.e. doctors) and for patients trying to get services authorized. How might we make it easier?
Process
Analytics: Reviewing prior authorization data and analytics to understand submission patterns, common issues, handle time, etc.
Generative Research: In-depth interviews to understand user (authorization coordinators that work for providers) workflows, existing needs, and pain points
Synthesis: Synthesis of findings to present recommendations for issues with the existing authorization process and opportunities for future investments
Results
Informed investment case for work to redesign authorization experience on the provider portal and product requirements. This was an area that previously had little to no research and design support
Process kicked off dedicated research support model for provider experience
Reflection:
Recruiting providers means having strong relationships with them so that they want to make time to help improve their experience.
This was an area that previously had little to no research and design support. 0 to 1 research is hard. Have patience as you build study recruitment from scratch and work diligently to include stakeholders in the research process to win hearts and minds.