UX research plan: How clinics handle insurer claims
Author: Kofi Mensah · Date: 5 November 2026
Background
Carewell's Billing squad will decide in January whether to build in-app insurer claim submission or deepen our integration with ClaimBridge, the clearing service 38% of clinics already use. Claims are the second largest source of billing tickets. We do not know who in a clinic files claims, how often claims are rejected, or what happens after a rejection. This study informs the build versus integrate decision.
Research questions
- Who files insurer claims in a clinic, and how much of their week does it take?
- At which steps do claims get rejected, and how do clinics find out?
- What would make a clinic switch away from the tool they use today?
- Do clinics that use ClaimBridge experience fewer rejections than those that file by hand?
Method (and why)
Remote contextual interviews of 60 minutes, with participants sharing their screen while filing or reviewing a real recent claim (with patient details hidden). Interviews over a survey because we do not yet know the right options to offer; contextual over plain interviews because people misremember how many steps a claim takes. A short follow-up survey to all clinics in January will size what we find.
Participants
| Criteria | Target N | Recruiting source |
|---|---|---|
| Files claims by hand, 1 to 3 practitioners | 4 | In-app banner to eligible clinics |
| Uses ClaimBridge | 4 | Customer success list |
| Clinic owner or manager who reviews rejections | 4 | Customer advisory board |
Consent and data
- Consent: written consent form sent with the invite; verbal confirmation at recording start.
- Storage: recordings in the research drive, access limited to the research team and the Billing PM.
- Retention: recordings deleted 90 days after readout; anonymised notes kept.
Discussion guide outline
- Warm-up: role and a normal week (5 min)
- Walkthrough of a recent claim, on screen (25 min)
- Rejections: the last one and what happened next (15 min)
- Tools and switching (10 min)
- Wrap-up (5 min)
Timeline
| Phase | Dates | Owner |
|---|---|---|
| Recruiting | 10 to 21 November | Kofi |
| Sessions | 24 November to 5 December | Kofi, Maya |
| Synthesis | 8 to 12 December | Kofi |
| Readout | 15 December | Kofi |
Deliverables
A synthesis doc in reph with findings tied to each research question, a 6 minute highlight reel, and a journey map of the claim lifecycle. Goes to the Billing squad and the VP of Product.
Stakeholders
Jonas Berg (Billing PM) owns the decision and observes at least four sessions. Priya Raman (engineering lead) observes two. Ana Lima (design lead) attends the readout.