UX Researcher, UX Lead, UX Manager
HYORIM PARK
The Problem
The “No Surprises Act” rules create new protections against out-of-network balance billing and establish a new process, called independent dispute resolution (IDR), which providers (including air ambulance providers), facilities, and health plans can use to resolve payment disputes for certain out-of-network charges.
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In the complex landscape of the Federal IDR process, the role of auto-generated emails is pivotal in serving as the primary mode of communication for parties to understand where they are in the IDR process, conveying critical information, updates, and next steps. Ensuring that these communications are clear, effective, and user-friendly is of paramount importance. The reliance on auto-generated emails has highlighted a need for an in-depth understanding of how these communications are received by users, their impact on the efficiency of the Federal IDR process, and their alignment with user expectations and needs.
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This research is developed in response to feedback suggesting that while auto-generated emails are beneficial for streamlining communications, there may be significant room for improvement in their design, content, and overall user experience. This research aims to bridge the gap between current practices and user expectations, identifying opportunities to enhance the effectiveness of auto-generated emails within the Federal IDR process. By focusing on user feedback, pain points, and preferences, this study seeks to propose actionable improvements that can lead to more efficient dispute resolutions, better user experiences, and ultimately, a more effective Federal IDR process.
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Enhance
Communication for IDR
# User Research, # User Interview, # Usability Testing, # Qualitative Research
The Approach
Identify User Pain Points: Understand the specific pain points and challenges users related to Federal IDR portal email communication.
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Content Clarity and Understanding: Assess the initial and current clarity and comprehensibility of the emails and communications provided to parties.
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Email Communication Evaluation: Evaluate the effectiveness of current email communications in meeting user needs and expectations, identifying any gaps in information, layout, content, and functionality.
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Communication Preference and Behavior: Understand user preferences for receiving updates and confirmations, explore the impact of email volume on user experience, and investigate user actions post-email reception.
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Support and Assistance: Assess how users seek help with queries related to received emails and their preferences for obtaining support.
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Methodology: Employ a combination of surveys (sent to interview participants, to quantitatively assess user preferences and pain points) and semi-structured user interviews (to qualitatively explore in-depth insights into user experiences and expectations).
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The Process
1. Planning and Preparation
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Define research objectives, goals, and key research questions.
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Develop research protocols and interview/questionnaire guides
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Create stimuli mockups ​
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Current communication emails​
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Mockups of potential emails based on needs identified in previous user research
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2. Recruitment and Scheduling
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Recruit participants and schedule interviews
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Participant Profiles
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Provider Profiles
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Health Care Provider
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Health Care Facility
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Revenue Cycle Management Contractor
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Practice Management Firm
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Plans/Issuers Profiles
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Group Health Plan
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Individual Health Insurance Issuer
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Third-Party Administrator
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Cost Containment Firm
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Prepare testing environments and tools
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Train the research team and coordinate logistics
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3. User Interviews + Usability Testing
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Conduct interview sessions with participants
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60-minute interview with Zoom​
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3 participants from Iniaiting Parties
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4 participants from Non-Initiating Parties
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Gather qualitative and quantitative data on user interactions
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Document observations, feedback, and pain points
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Regularly debrief with the IDR team to discuss initial finding
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4. Data Analysis and Synthesis + Findings Report + Readout (Presentation)
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Analyze all collected data from interview sessions and follow-up research.
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Identify common themes, pain points, and opportunities for improvement.
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Create findings presentation, journey maps, or other visualization tools to represent findings.
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Document research findings report and present to cross-functional teams and executive leadership
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Prioritize findings/recommendations and convert these findings into Jira Tickets.​
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5. Follow-Up Synthesis
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Perform additional analysis, dependent on the complexity of the research data collected.
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Work with workstream stakeholders to identify potential adjustments or refinements based on the initial findings.
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Collaborate with cross-functional teams to ensure the integration of research findings into ongoing project development.​​
The Outcomes
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User Journey Maps to identify pain points and opportunities for each communication email
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​Flow Visualization to analyze all email communication including volumes
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Recommend to launch a 'Payor Provider Portal' for entire communication, which is approved to be implemented in 2025.
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Recommendations for the Payor Provide Portal (+8 Functionalities and UX enhancements)​
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"Allow users to view and monitor all communications within the portal."​
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"Facilitate the viewing and downloading of all completed forms, notifications, and uploaded documents within the portal."
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"Implement team-level access to support multiple users assigned the same responsibilities, allowing them to view and manage shared items within the portal."
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Identify User Pain Points (+2 UX enhancements)
- "Notify users in advance about any changes to the subject lines of auto-generated emails so they can adjust their system settings accordingly for categorizing emails."​
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Recommendations for Help (+3 UX enhancements)​​
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"Adding FAQ link to emails can provide answers to commonly asked questions and reduce the number Help Desk tickets."
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"Provide live support through a chat bot or representatives to help users address problems more quickly and effectively."
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"Establish a separate, dedicated tech support Help Desk to alleviate issues associated with technical glitches."
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Recommendations for each email on each phase (+28 UX Enhancements)
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"Provide an email to notify a closed dispute due to ineligibility."​
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"Display selected IDRE at the top of the page, under IDR reference Number, for easier scanning."
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"Consider attaching the Notice of IDR Initiation and including the Non-IP’s name for documentation purposes."
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* Due to the NDA restrictions, the final outcomes of this project are confidential and cannot be posted on this website. Please contact me if you are interested in learning more about this project.