The Client
The client is an esteemed entity within the healthcare insurance industry. They wanted a comprehensive solution that would address historical challenges related to the needs of health plan holders, employers, brokers, and third-party administrators. The client also wanted to improve customer experience when trying to claim health insurance benefits. To meet these needs, the client had an app idea for a platform that would transform the health benefits experience.
The Challenge
The client needed the app to allow users secure access to their insurance information. They saw dissatisfaction among insurance holders because of several obstacles that did not let them make proper use of their insurance when the need arose. These included the following.
- Health plan members have to rely extensively on traditional customer service call centers. Their experiences can be frustrating, often due to long wait times.
- The interpretations of each plan vary according to its provider. As a result, understanding it becomes difficult and confusing for patients.
- Many health benefits systems are too complicated, causing problems for members when they try to access or utilize their benefits.
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The Solution
Our team researched ways to reduce dependence on call centers and misinterpretation of provider coverage. We then created the design with an understanding of the user's point of view.
- The AppsChopper team designed Tres with an outstanding customer experience to address the dependence on call centers and past consistencies related to customer care.
- Our team integrated user-friendly elements, such as a Quick Access section, to present health plan-related information in an organized manner.
- We added a separate section that shows a list of all the claims and their status from newest to oldest. Each entry can be expanded to show a detailed cost breakdown summary, benefits, and member responsibility.
The Outcome
Through Tres, the client has enabled health plan users to access information and assistance conveniently through their smartphones and computers. The proposed solution is available on iOS and Android.
- Our solution provides straightforward tools to help insurers with efficient claims processing and timely reimbursements to healthcare providers.
- The app makes it easier for users to find healthcare providers based on their specialty and location. It simplifies the process of connecting to different telehealth providers as well.
- It also sheds light on the expenses patients will have to bear out-of-pocket, providing a much-needed answer to the question, "What will this medical procedure cost when using my insurance?"
Value Added for the Client
The Tres application built by the AppsChopper team adds substantial value for the client in multiple ways.Exceptional Customer Experience Tres has uplifted customer experience, fulfilling user demands, and expectations in this regard.
Streamlined Access Tres clarifies plan benefits and presents information in a way that is easy to understand, eliminating misinterpretations.
Better Communication Patients can supply the right information by understanding the claims submission process. Insurers can provide timely reimbursements to providers and communicate clearly with policyholders.