TL;DR
Providers were sending messy, incomplete documentation that slowed insurance approvals. I analyzed 600 provider messages, designed structured "Document Upload" tasks and "Documentation Gap Alerts," and changed task behaviors (removed snooze, added minimum submission set). Results: 60% respond to gap alerts within 7 days; 50% submit all required docs in a single response; fewer manual reviews and shorter PA timelines.
The Problem
Providers often responded to tasks in a messy, inconsistent way—uploading incomplete records, leaving insurance info in free-text fields, or requiring follow-up clarifications.
This led to:
- Delays in PA approvals
- Significant volume of tasks requiring manual review
- Frustration for providers and patients
Understanding our providers
I analyzed 600 messages from our providers, categorizing them into task types. I diagramed the flow of each of these task types in FigJam, identifying the tasks that took up the most amount of time and had the greatest potential for automation.
| Task Type | Total Tasks | % of total tasks | Manual time spent reviewing | % of day |
|---|---|---|---|---|
| Information Submission | 267 | 43.20% | 1-3 minutes | 44.74% |
| Acknowledgement | 211 | 34.14% | <1 min | 8.84% |
| Action request | 74 | 11.97% | ||
| FYI | 27 | 4.37% | 1-5 minutes | 6.79% |
| Request for Information | 21 | 3.40% | 1-2 minutes | 3.52% |
| Technical Complaint | 15 | 2.43% | 3-5 minutes | 5.03% |
| Misc. | 3 | 0.49% | 1 minute | 0.25% |
| Total | 618 | 100.00% |
Process
- Identified that information submissions took up 44% of our Provider operations capacity, and accounted for 43% of our daily message volume.
- Partnered with Ops to audit 600+ provider submissions and identify ideal intake solution
- Iterated task copy and UX flow to encourage complete submissions
- Collaborated closely with eng to balance automation and provider flexibility
I constructed a diagram of the ops process and identified the specific points where a document gap could be identified (Purple)
Feature 1: Structured Document Upload Tasks
Goal
Guide providers to submit complete, correctly formatted documentation the first time—minimizing rework and reducing processing delays.
What we designed
- Task Redesign – Clearer copy outlining required vs. optional documents
- Three Upload Sections – Insurance card, Visit notes, and Additional medical records
- Submission Requirements – Cannot submit without visit notes + insurance response
- Insurance Entry Options – Structured form, image upload, or self-pay
- Cancel Rx Button – Optional if provider no longer wants to proceed
- Status Logic – New RX status flows depending on insurance validity
UX in Action
"Please upload the following documentation: Insurance card or self-pay note, visit notes, and any relevant labs or med history."
This helped ensure the minimum viable submission was always received upfront.
📐 Figma linkFeature 2: Documentation Gap Alerts
Goal
Alert providers when documentation was incomplete or predicted to result in denial—and help them respond quickly.
Designing based on data
To make decisions on what paths we would offer our providers, I examined their current behavior that providers exhibited when they receive a document request.
| Provider response | % of tasks |
|---|---|
| Submission | 56.35% |
| Snooze / Provide Later | 23.81% |
| EHR Submission | 12.70% |
| Proceed Without Uploading | 3.97% |
| Cancel Script | 3.17% |
We then made decisions on what kind of behaviors to support in the task
- Provide required info led to a modal where providers could upload their documents or indicate that the documents were in the EHR
- Proceed without info allowed the provider to consent to submitting the PA without supporting documents
- We axed snoozing providers would leave the task incomplete until they were ready to submit
- Cancel Script let providers stop the process and try a different route.
UX in Action
📐 Figma link"If information is unavailable, please advise how to proceed. No action is needed while gathering info—we'll hold the submission until we hear back."
Impact
- 60% of providers responded to gap alerts within 7 days
- 50% submitted all required documents in one go
- Fewer manual insurance reviews → shorter PA timelines
- Reduced operational follow-ups and back-and-forth
Reflection
Designing for clinical workflows taught me the power of precision. Providers don't need more flexibility—they need clarity. By breaking down tasks into clean, guided flows, we empowered them to submit faster, with fewer errors.
This was a rewarding challenge in balancing automation, compliance, and UX in a high-stakes setting.