Industry: HealthcareRole: Conversation Designer
Skills: Conversation mapping, transcript analysis
A quick note: almost all of the projects I work on are under an NDA and are authenticated experiences, so I can’t share particulars here when it comes to names and detailed designs.
The Project
The main objective of this chatbot is to help providers find information about members on topics such as claims, prior authorizations, and commissions. While I didn’t design the original bot, I was tasked with consulting on best practices for conversation design and worked with the client team to help them improve their designs. Eventually, I began designing for them from scratch.
The Challenge
Providers had to navigate through several different chatbots to get the information they needed. This fragmentation led to inefficiencies and a disjointed user experience. Additionally, the manual data collection process placed a heavy burden on support agents, reducing their capacity to handle more complex tasks.
The Solution
Consolidation of Chatbots I took multiple bots and simplified the architecture to create one main bot. This not only streamlined the process for Providers but also reduced redundancy and confusion.
Data Gathering Flow Design I also designed a complex data gathering flow to automate the data collection process. This included integrating simple Regex validation to ensure data accuracy. By automating these flows, the system could pass accurate information directly from the chatbot to the agents, freeing them up for more critical tasks.
API-Driven Flows Finally, I designed two new comprehensive flows specifically for checking the requirements and status of prior authorizations. These flows collect data from the Provider and interface with an API to retrieve relevant information. The design had to strike a balance between user expectations and the business's capabilities with the new API. This careful design led to a 3% increase in containment, indicating a higher success rate in addressing provider queries without human intervention.
The Results
I lead an initiative to create a new analytics dashboard for the chatbot which gives insights into the full funnel journey of Providers, allowing for rapid optimizations. For instance, the dashboard revealed that Providers were frequently getting stuck at a particular point in the flow. This insight enabled a quick redesign of that section, significantly improving the user journey.
The consolidation and optimization of chatbots, combined with the implementation of automated data gathering flows and strategic use of analytics, significantly improved the efficiency and effectiveness of the Provider information access system. These improvements not only enhanced user satisfaction but also allowed support agents to focus on more complex tasks, ultimately benefiting the overall business operations.