Superbill

What is Superbill?

A billing feature in Practice Fusion's electronic health record (EHR) to help physicians and small clinics streamline their billing process to payers (health insurance companies).

My role

As the lead designer at the Seattle office, I was responsible for the redesign of the Superbill during the billing code transition from ICD-9 to ICD-10. I partnered with the program manager in Seattle and different teams on the requirements, collaborated with the visual designer on the visual styles and worked intimately with the developers in Seattle.

Company

Practice Fusion

Role in project

Lead designer

Project included

Product design, strategy and user research

Problem

The Superbill for small clinical practices needed to be redesigned when the healthcare industry transitioned diagnostic billing codes from ICD-9 to ICD-10. I needed to ensure that the transition was as seamless as possible and aligned with the clinicians' workflow.

The existing Superbill was a modal and was not easy to use, could not adapt to the additional 68,000 billing codes, and did not receive any data entered elsewhere in the EHR.

Product

We had to design a feature that would work for both larger and smaller practices. Larger practices often have a billing specialist on staff that handles all the billing reports for the payers while in a small practice the clinician often does the work themselves. Our goal was to align the Superbill with how clinicians actually provide care instead of requiring them to remember the codes and naming conventions the payers (health insurance companies)use for the data.

In the previous iteration of the product, the Superbill modal appeared next to the clinician’s notes in a patient’s electronic chart. Through our research, we noticed that this meant clinicians and staff were constantly stuck in a repetitive, inefficient note-taking and billing process throughout the Practice Fusion EHR. For instance, a clinician would record procedures and diagnoses in a chart, but would need to enter the same information in the Superbill again later on.

Original Superbill

We found analogies to this experience in other products such as Amazon’s online shopping. We transitioned the Superbill feature to a full page to allow sub items like the procedures and diagnoses to expand into a modal.

Add procedure(s) modal

Ver. 1 of diagnosis modal (search)

Ver. 1 of diagnosis modal (historical)

Several iterations went into the diagnosis modal to continually try to streamline the process by connecting the existing data in the health record. . Usability testing with actual staff and clinicians pushed us to iterate further on the modal since everyone dreaded the transition from ICD-9 to ICD-10 codes. Eventually, our goal was to ensure that the Superbill could be pre-filled from the entire EHR features to include scheduling, registration, and encounter notes. Here is the final flow for adding a patient's diagnosis codes.

Final version (encounter diagnoses)

Final version (selected diagnosis)

Final version (search)

Approach

We -- the user researcher, developer and myself -- talked with many different users during the phases of this product to understand the complete lifecycle of the billing process and how to integrate it into the electronic health record. We built several versions based upon the flow derived from interviews and customer forums.


Understanding the upstream workflow proved to be valuable, as features that were key in the Superbill became important for other teams as well, such as the scheduling and clinical notes team.


I worked closely with all the teams to streamline the different interactions and design factors. It was also extremely important to understand how the payers (insurance companies) handle the Superbill data once they receive it in order to help manage the needs of both payers and providers. Using data about how insurance companies and clinicians think about patient encounters and diagnostic and billing procedures allowed us to redesign a Superbill that could be used effectively and efficiently by both parties.

Flow of the diagonsis codes

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