Strategy for Pre-Claim Workflows

I worked with a cross-functional team to map out a strategy for pre-claim workflows in our ambulatory Collector product. In the process, I introduced teams to new frameworks for conducting, synthesizing and visualizing research.


As part of the Claim Readiness zone’s transition from a Hospital to Ambulatory focus, I worked with partners from Product Management and Analytics to deep dive into ambulatory billing workflows. By mapping the current state, conducting research to identify core problems, and providing regular updates across the business, we arrived at a strategy that helped set the stage for product enhancements through 2019 and beyond.


In late 2018, the Claim Readiness zone shifted priorities from focusing exclusively on the Hospital product to working on our Ambulatory product (for clinics and doctors’ offices). As billing workflows vary significantly between Hospital and Ambulatory, it was essential to give teams a grounding in the problem space and form a strategy for where to focus our efforts.


To kick off the project, we identified a set of shared goals among product, UX and analytics. We wanted to learn how a variety of practices engaged in charge entry and other pre-claim management work, and the impact of those methods on the ultimate financial performance of the practice. To facilitate this, I started by combing through whatever existing research I could find from previous site visits and interview studies, and by mapping the current state of the system using Mural.

The service map that we created at the beginning of the project formed a basis for the research questions and final artifacts we created. It was updated continuously as the project progressed.

Once that was done, I created a structured research template to ensure consistency in the way site visits were planned and reported. This allowed us to engage teams across Collector to conduct 8 site visits over the course of two months.

Product, UX and Analytics came together to define a set of goals for the discovery work we were going to do together.

As we started to get a clearer picture of the problem space and how we could make an impact, we did regular readouts on what we were finding, both in designated meetings and during all-product ceremonies. This gave stakeholders and people around the organization visibility into the work we were doing and why it was important.

One of our key findings from the research.
I wanted to let Dani know that she gave a very engaging presentation at the Collector R&D all hands (on March 21, 2019). The presentation was super informative and the audience was rapt (heads up & very few laptops open!). The way she framed her stories made me feel like I was there in the billing office or at the front desk with the people she had observed. I'm not sure how the work split went into building the presentation, but that was also very easy to follow along with. - feedback from one of the developers in Collector

The final stage of the project was to create an artifact that clearly laid out the problem space, the principles and final vision we wanted to move towards, and a canonical scenario that made that final vision visible.

A clear breakdown of user jobs, and how the person doing the jobs changes depending on the practice, helped set the stage for a clear user journey.
A workflow making clear the gaps in helping users accomplish those jobs framed the ultimate vision scenario.

The final stage of this project was delivering the presentation to a cross-functional team within Collector as part of their release planning ritual. While I had transitioned to Clinicals design leadership by this point, I stopped by to present the artifact and provide subject matter expertise, which helped the team inform the next several releases' work.

Dani's pre-charge visioning work captured a complex set of problems; distilled the problems into understandable, actionable chunks; and presented the material in a clear, concise manner that has really structured our backlog. It's a real living, breathing reference. - Product Management lead

Key Contributions

  • Organized and analyzed foundational research to guide our understanding of the problem space, including client site visits and analysis of previous research.
  • Worked with Product Management to align on a handful of key user problems to prioritize, with corresponding outcomes.
  • Engaged senior leadership and the broader product/development org through frequent readouts of research activities and progress against the strategy work
  • Created a North Star presentation and Service Blueprint to outline a vision for the outcomes we wanted to go after.