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Regence Explanation of Benefits

Communication Engineering

Regence Explanation of Benefits


(This video was made after I left the group so my role is played by another designer. I created all the sketches and designs featured in the video.)

The Regence Blue Cross Blue Shield Explanation of Benefits is a customer-facing document that explains what medical treatments and services have been paid by the insurance company on their behalf. It is an important touch point as it is often the only communication that customers regularly receive from their insurance providers.

Problem

The existing Explanation of Benefits provided a lot of transactional information and used jargon that was not easily understood by its members. It looked like it had been designed on a mainframe computer with many sections in all capital letters. It was so confusing to members that they often needed to call Regence customer service to get a better understanding of what was paid and why.

Solution

Our team took Regence through the Xerox Communication Engineering process. After first gathering requirements from Regence internal stakeholders, I led focus groups with members to understand their issues with the current document. Once we had defined the project requirements; I led the team through an iterative design process that culminated in an initial color prototype. I further refined the design with feedback and direction from both Regence internal stakeholders and members.

Results

The new Explanation of Benefits presented payment information clearly in a way that was easily digestible for members. It included educational information to show how members could get more out of their health insurance in the future, as well as status of deductibles and out-of pocket costs. The document was easier for Regence to produce. It also reduced the number of claims payment questions fielded by customer service representatives, allowing them to spend more time educating members about wellness. This document is still in use today, helping to build long-term loyalty and differentiate the Regence brand.

Prototypes

Regence Prototype SampleI created a total of three print prototypes in Adobe InDesign during the Regence engagement; refining each one with a round of feedback that culminated in the delivery of a final document. Each prototype book was printed and bound, containing 6 different Explanation of Benefits statements that captured all known permutations (multiple patients on one document, multiple page documents, documents with checks, etc.) along with a complete list of all the requirements and how they were addressed.
Prototype Excerpt

Design Specifications

Regence Design SpecificationsAlthough the final prototype and original design files in the requested format are delivered to the client at the end of an engagement, there is always a chance that they will change their print process in the future. To ensure that the Explanation of Benefits document could be reproduced on any system, I created accompanying design specifications. The specifications include a description of every unique element in the design: location, size, font details, color, graphic file name, associated business rule and specific requirement it meets.
Design Specifications: Pages 1-19

Core competencies: Requirements Definition, Sketching, Graphic Design, Focus Groups, Print Prototyping, Corporate Style Guide, Technical Specifications, Adobe InDesign, Adobe Illustrator