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Health Claims Exchange
Health Claims Exchange
August 2022-24 | Finarkein Analytics
August 2022-24 | Finarkein Analytics
August 2022-24 | Finarkein Analytics
August 2022-24 | Finarkein Analytics
August 2022-24 | Finarkein Analytics
Sr. UX Designer
Sr. UX Designer
Sr. UX Designer
Sr. UX Designer
Sr. UX Designer
Sr. UX Designer
Skills
Skills
Skills
Information Architecture
Information Architecture
Information Architecture
B2B Dashboard Design
B2B Dashboard Design
B2B Dashboard Design
Ecosystem Architecture
Ecosystem Architecture
Ecosystem Architecture
Trust Design
Trust Design
Trust Design
Conversation Design
Conversation Design
Conversation Design
B2C Dashboard Design
B2C Dashboard Design
B2C Dashboard Design
UX Writing
UX Writing
UX Writing
Design for Digital Public Infrastructure
Design for Digital Public Infrastructure
Design for Digital Public Infrastructure
Methods
Methods
Methods
Conversational Design
Conversational Design
Conversational Design
Prototyping
Prototyping
Prototyping
Logic Mapping
Logic Mapping
Logic Mapping
Wireframing
Wireframing
Wireframing
Information Architecture
Information Architecture
Information Architecture
Design System Governance
Design System Governance
Design System Governance
Regulatory Design
Regulatory Design
Regulatory Design
Overview
Overview
Overview
Overview
The Ayushman Bharat Digital Mission (ABDM) is a national initiative to digitize health records for over a billion citizens. I designed the end-to-end service: a Citizen Onboarding journey for digital ID creation (ABHA) and a Provider Dashboard (HCX) for instant hospital insurance verification.
The Ayushman Bharat Digital Mission (ABDM) is a national initiative to digitize health records for over a billion citizens. I designed the end-to-end service: a Citizen Onboarding journey for digital ID creation (ABHA) and a Provider Dashboard (HCX) for instant hospital insurance verification.
The Ayushman Bharat Digital Mission (ABDM) is a national initiative to digitize health records for over a billion citizens. I designed the end-to-end service: a Citizen Onboarding journey for digital ID creation (ABHA) and a Provider Dashboard (HCX) for instant hospital insurance verification.
Challenge
Challenge
Challenge
Challenge
Indian healthcare suffers from paper-heavy fragmentation, causing high patient friction and delayed insurance claims at hospital intake.
Indian healthcare suffers from paper-heavy fragmentation, causing high patient friction and delayed insurance claims at hospital intake.
Indian healthcare suffers from paper-heavy fragmentation, causing high patient friction and delayed insurance claims at hospital intake.
Approach
Approach
Approach
Approach
I implemented a "Mobile-as-Identity" logic, fetching longitudinal health history and policy coverage via a single digital handshake (ABHA).
I implemented a "Mobile-as-Identity" logic, fetching longitudinal health history and policy coverage via a single digital handshake (ABHA).
I implemented a "Mobile-as-Identity" logic, fetching longitudinal health history and policy coverage via a single digital handshake (ABHA).
Result
Result
Result
Result
Collapsed a multi-step manual intake into a 30-minute digital process, saving 2.5 crore man-hours and linking 800M+ citizens to the national grid.
Collapsed a multi-step manual intake into a 30-minute digital process, saving 2.5 crore man-hours and linking 800M+ citizens to the national grid.
Collapsed a multi-step manual intake into a 30-minute digital process, saving 2.5 crore man-hours and linking 800M+ citizens to the national grid.
Defining the Ecosystem
Defining the Ecosystem
Defining the Ecosystem
ABDM
ABDM
The national framework (the "Digital Backbone") that enables secure data flow between patients, doctors, and insurers.
The national framework (the "Digital Backbone") that enables secure data flow between patients, doctors, and insurers.
ABHA
ABHA
(Ayushman Bharat Health Account) is a unique 14-digit ID, linked to a mobile number and Aadhaar, that stores a citizen's digital health records.
(Ayushman Bharat Health Account) is a unique 14-digit ID, linked to a mobile number and Aadhaar, that stores a citizen's digital health records.
HCX
HCX
The exchange protocol that allows hospitals and insurance companies to settle claims in real-time, replacing traditional manual paperwork.
The exchange protocol that allows hospitals and insurance companies to settle claims in real-time, replacing traditional manual paperwork.
Defining the Ecosystem
ABDM
The national framework (the "Digital Backbone") that enables secure data flow between patients, doctors, and insurers.
ABHA
(Ayushman Bharat Health Account) is a unique 14-digit ID, linked to a mobile number and Aadhaar, that stores a citizen's digital health records.
HCX
The exchange protocol that allows hospitals and insurance companies to settle claims in real-time, replacing traditional manual paperwork.
Defining the Ecosystem
ABDM
The national framework (the "Digital Backbone") that enables secure data flow between patients, doctors, and insurers.
ABHA
(Ayushman Bharat Health Account) is a unique 14-digit ID, linked to a mobile number and Aadhaar, that stores a citizen's digital health records.
HCX
The exchange protocol that allows hospitals and insurance companies to settle claims in real-time, replacing traditional manual paperwork.
Defining the Ecosystem
ABDM
The national framework (the "Digital Backbone") that enables secure data flow between patients, doctors, and insurers.
ABHA
(Ayushman Bharat Health Account) is a unique 14-digit ID, linked to a mobile number and Aadhaar, that stores a citizen's digital health records.
HCX
The exchange protocol that allows hospitals and insurance companies to settle claims in real-time, replacing traditional manual paperwork.
The Front-Stage: Citizen Onboarding (ABDM)
The Front-Stage: Citizen Onboarding (ABDM)
The Front-Stage: Citizen Onboarding (ABDM)
The Front-Stage: Citizen Onboarding (ABDM)
The first half of the service focuses on how a user establishes their digital identity to access national benefits.
The first half of the service focuses on how a user establishes their digital identity to access national benefits.
The first half of the service focuses on how a user establishes their digital identity to access national benefits.
Informed Consent
Informed Consent
Informed Consent
The journey begins with educational onboarding, emphasizing that data access is purely consent-based and users retain the ability to revoke it at any time.
The journey begins with educational onboarding, emphasizing that data access is purely consent-based and users retain the ability to revoke it at any time.
The journey begins with educational onboarding, emphasizing that data access is purely consent-based and users retain the ability to revoke it at any time.
Aadhaar-Linked Verification
Aadhaar-Linked Verification
Aadhaar-Linked Verification
The journey begins with educational onboarding, emphasizing that data access is purely consent-based and users retain the ability to revoke it at any time.
The journey begins with educational onboarding, emphasizing that data access is purely consent-based and users retain the ability to revoke it at any time.
The journey begins with educational onboarding, emphasizing that data access is purely consent-based and users retain the ability to revoke it at any time.
Identity Fulfillment
Upon successful registration, the user receives their ABHA Card, featuring a QR code for instant hospital check-ins and a unique ABHA address (e.g., shalvidesh@abdm).
Identity Fulfillment
Upon successful registration, the user receives their ABHA Card, featuring a QR code for instant hospital check-ins and a unique ABHA address (e.g., shalvidesh@abdm).
Identity Fulfillment
Identity Fulfillment
Upon successful registration, the user receives their ABHA Card, featuring a QR code for instant hospital check-ins and a unique ABHA address (e.g., shalvidesh@abdm).
Upon successful registration, the user receives their ABHA Card, featuring a QR code for instant hospital check-ins and a unique ABHA address (e.g., shalvidesh@abdm).
The Back-Stage: Provider Operations (HCX)
The Back-Stage: Provider Operations (HCX)
The Back-Stage: Provider Operations (HCX)
Step 1: Mobile-Based Discovery
Step 1: Mobile-Based Discovery
Step 1: Mobile-Based Discovery
Instead of filling out physical forms, the hospital staff enters the patient’s mobile number. The system acts as a "Discovery Layer," fetching all insurance policies linked to that number.
Instead of filling out physical forms, the hospital staff enters the patient’s mobile number. The system acts as a "Discovery Layer," fetching all insurance policies linked to that number.
Instead of filling out physical forms, the hospital staff enters the patient’s mobile number. The system acts as a "Discovery Layer," fetching all insurance policies linked to that number.
Step 2: Instant Policy Intelligence
Step 2: Instant Policy Intelligence
Step 2: Instant Policy Intelligence
The dashboard provides a "Quick Glance" at the patient's coverage:
The dashboard provides a "Quick Glance" at the patient's coverage:
The dashboard provides a "Quick Glance" at the patient's coverage:
Visual Benefits: High-impact icons instantly communicate covered services like Ambulance Charges, Maternity, or Critical Illness.
Visual Benefits: High-impact icons instantly communicate covered services like Ambulance Charges, Maternity, or Critical Illness.
Visual Benefits: High-impact icons instantly communicate covered services like Ambulance Charges, Maternity, or Critical Illness.
Financial Visibility: Staff can view policy types, coverage amounts (e.g., Rs. 10,00,000), and waiting periods without digging through fine-print documents.
Financial Visibility: Staff can view policy types, coverage amounts (e.g., Rs. 10,00,000), and waiting periods without digging through fine-print documents.
Financial Visibility: Staff can view policy types, coverage amounts (e.g., Rs. 10,00,000), and waiting periods without digging through fine-print documents.
Step 3: Historical Traceability (Claim Management)
Step 3: Historical Traceability (Claim Management)
Step 3: Historical Traceability (Claim Management)
Upon proceeding, the Health History Module provides total transparency into the patient's medical past:
Upon proceeding, the Health History Module provides total transparency into the patient's medical past:
Upon proceeding, the Health History Module provides total transparency into the patient's medical past:
Audit Trail: Staff can track past Claim IDs, diagnoses (e.g., Acute Appendicitis), and approved amounts to make informed decisions for current treatment.
Audit Trail: Staff can track past Claim IDs, diagnoses (e.g., Acute Appendicitis), and approved amounts to make informed decisions for current treatment.
Audit Trail: Staff can track past Claim IDs, diagnoses (e.g., Acute Appendicitis), and approved amounts to make informed decisions for current treatment.
Real-Time Status: The interface tracks live statuses for Pre-authorizations and Payment Status, ensuring the hospital's financial operations stay in sync with patient care.
Real-Time Status: The interface tracks live statuses for Pre-authorizations and Payment Status, ensuring the hospital's financial operations stay in sync with patient care.
Real-Time Status: The interface tracks live statuses for Pre-authorizations and Payment Status, ensuring the hospital's financial operations stay in sync with patient care.
Learnings & Reflection
Learnings & Reflection
Learnings & Reflection
Learnings & Reflection
Designing for High-Density Utility
Designing for High-Density Utility
Designing for High-Density Utility
In a hospital environment, time is critical. I used Iconographic Grids and Traceable Tables to reduce cognitive load, allowing staff to move from "paperwork" to "patient" in seconds.
In a hospital environment, time is critical. I used Iconographic Grids and Traceable Tables to reduce cognitive load, allowing staff to move from "paperwork" to "patient" in seconds.
In a hospital environment, time is critical. I used Iconographic Grids and Traceable Tables to reduce cognitive load, allowing staff to move from "paperwork" to "patient" in seconds.
Systemic Resilience
Systemic Resilience
Systemic Resilience
I realized that a front-end UI is only as strong as its back-stage integration. The value of this dashboard lies in its ability to fetch fragmented data from various insurers into one unified, trustworthy view.
I realized that a front-end UI is only as strong as its back-stage integration. The value of this dashboard lies in its ability to fetch fragmented data from various insurers into one unified, trustworthy view.
I realized that a front-end UI is only as strong as its back-stage integration. The value of this dashboard lies in its ability to fetch fragmented data from various insurers into one unified, trustworthy view.
Trust-Oriented Architecture
Trust-Oriented Architecture
Trust-Oriented Architecture
Working on a National Initiative taught me the importance of designing for security and consent, ensuring sensitive health data is handled with extreme care and verified at every step.
Working on a National Initiative taught me the importance of designing for security and consent, ensuring sensitive health data is handled with extreme care and verified at every step.
Working on a National Initiative taught me the importance of designing for security and consent, ensuring sensitive health data is handled with extreme care and verified at every step.
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PLVIxDesign
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