Eligibility & Benefits

Delta Dental Strategic Realignment

Project Overview

Client: Delta Dental
‍
‍Duration: 2 Years
‍
‍Team: 4 UX Designers, 2 UX Researchers, 5 Developers, 3 Project Managers, and myself
‍
‍Objective: Integrate and optimize the multiple Dentist and Patient portals Benefits Experience in mobile through desktop breakpoints into one voice and vision to provide a cohesive, scalable, and legally compliant user experience.

The Challenge

Delta Dental had a massive problem with the way benefits information was being given to providers, subscribers, and others. The data was not always accurate, components were confusing, and the overall IA was a mess and hard to navigate.

I identified this issue when I was asked to create a Grievance and Appeals feature. During the discovery I noted that 80% of the calls coming in were specifically about Benefits and Claims based on benefits.

The Approach

Integrating two user portals—one for Dentists and one for Patients—while accommodating the needs of three distinct lines of business and varied state laws was a complex challenge.

We now had to sit down and figure out how we were going to connect the Benefits experience across both portals. We also had to understand the users need, and what the major pain points are.

We decided to conduct a design sprint to kickstart the discovery phase. We also launched several user surveys to gather more information. Then from those outputs we could create a roadmap.

Discovery

We launched a survey that we sent to 1000 patients and 500 Dental Care Providers. We knew going in that e had issues getting responses to any surveys, usually we had a .5% response from patients, and a 1% response from Dental Care Providers.

We organized a design sprint to quickly gather insights, define the problem, brainstorm solutions, create prototypes, and test them within a week.

This accelerated our understanding of user needs and pain points. we end up identifying the following main issues.

001

Confusing interfaces for both users and the product team, that may have conflicting data

002

Inconsistent legal requirements, and data was causing confusion and misrepresentation

003

Need for a seamless, scalable, and compliant user experience that connects the Benefits and claims experiences for the Dentists and patients alike.

We discovered that users were not happy about the way the interfaces provided information and looked. That the two systems didn't have away of talking to each other. Interactions weren't clear, and benefits information was missing critical information on both sides.

We also had various needs across various lines of business across state lines. Due to regulatory issues Delta Dental has differences in usability, information sharing, and actions that are dictated by state and local ordinances.

So there wasn't an easy way to create a consensus around need, but we were able to identify overlaps in requests and feedback.

Define

We created detailed user personas and journey maps to identify specific pain points and confluences of requests. This helped us understand the systemic issues and prioritize our approach.

We had to work closely with content and legal to map out what we could achieve based on location.

We had to be meticulous in identifying and approaching requirements through design sprints. Then verifying them with legal and then assigning them to specific areas for localization.

This was the hardest part as we realized during the process that there are some significant dependencies on both portals that needed to be addressed before we could implement critical parts of the sequences.

Sequence of process

001

Phase 1: Eligibility & Benefits, Patient Profiles, and Spend Overviews

002

Phase 2: Claims, Payments, and Communications

003

Phase 3: Medicaid, State Exchange, and other Specialty Builds

004

Phase 4: Support Features & Noncritical Systems

Ideation / Design

When we were brainstorming solutions we prioritized a few key features and built out wirese used high-fidelity wireframes to communicate our ideas effectively. Within those frames we had three major prioritie

Key Features

001

Intuitive UI System: Introduced color-coded taxonomy for easier understanding, as well as a simplification of patterns

002

Refined IA: The overhauled architecture centered the whole platform around Eligibility & Benefits and ho it connects betwen platforms and to other features on the platforms

003

Simplified components: We consolidated many of the complicated and confusing components to simplify the experience and condense relevant information in contextual spaces.

Testing /Validation

We conducted a diary study over 15 days with Dentists and Subscribers, gathering raw feedback. The revised system was then beta-tested with a select group of clients.

We ran an A/B test as well with the new expereince being fired off to a limited number of participants to gage feedback.

81%

Approval Rating
Patiens

78%

Approval Rating
Dentists

43%

Decrease in calls to the call center

22%

Increase in
return users

Conclusion & Next Steps

By addressing underlying issues and focusing on user-centric solutions, we enhanced platform usability and set the stage for future improvements. The positive feedback confirmed the effectiveness of our approach.

Future plan

001

Data & Tracking Overhaul: Implement a comprehensive tagging and data tracking system to capture user activities and feedback.

002

Benefits & Claims Refinements: Refine our claims system to create a direct line from benefits for both dentists and subscribers.

003

Better Feedback Loops: Create and facilitate seamless feedback loops between dentists, subscribers and Delta Dental, promoting transparency and responsiveness.

Let's see how I
can help you

I was able to help Delta Dental

I helped to integrate the various Delta Dental Platforms into a singular experience for our Dental Providers and Patients to connect and share critical information. What can I do for you?

001

Design