CASE TRACKER
Increasing insurance fraud response times and money recouped
Increasing insurance fraud response times and money recouped
Increasing insurance fraud response times and money recouped
I redesigned the UI and UX of an existing app to reduce complexities making it easier for investigators and managers to stay on top of their deadlines, reducing the room for errors, increasing response times, and a third thing
I redesigned the UI and UX of an existing app to reduce complexities making it easier for investigators and managers to stay on top of their deadlines, reducing the room for errors, increasing response times, and a third thing
My role
My role
My role
My role
Lead designer
Lead designer
Lead designer
Lead designer
Created for
Created for
Created for
Created for
Aetna
Aetna
Aetna
Aetna
Fraudulent actions are committed by providers, practices, and patients alike
Fraudulent actions are committed by providers, practices, and patients alike
Fraudulent actions are committed by providers, practices, and patients alike
Fraudulent actions are committed by providers, practices, and patients alike
Bad actors try to exploit the healthcare system, thinking they can hide in the complexities. The Special Investigation Unit (SIU) is responsible for finding and rectifying suspected fraud, waste, and abuse. As one of the United State's largest insurance providers, this is no small task.
Bad actors try to exploit the healthcare system, thinking they can hide in the complexities. The Special Investigation Unit (SIU) is responsible for finding and rectifying suspected fraud, waste, and abuse. As one of the United State's largest insurance providers, this is no small task.
Bad actors try to exploit the healthcare system, thinking they can hide in the complexities. The Special Investigation Unit (SIU) is responsible for finding and rectifying suspected fraud, waste, and abuse. As one of the United State's largest insurance providers, this is no small task.
Bad actors try to exploit the healthcare system, thinking they can hide in the complexities. The Special Investigation Unit (SIU) is responsible for finding and rectifying suspected fraud, waste, and abuse. As one of the United State's largest insurance providers, this is no small task.
Cases
Cases
Cases
Cases
With a high volume of cases in active litigation and recovery, it can be difficult to keep on top of important actions and deadlines, potentially resulting in accidental loss of recovered funds.
With a high volume of cases in active litigation and recovery, it can be difficult to keep on top of important actions and deadlines, potentially resulting in accidental loss of recovered funds.
With a high volume of cases in active litigation and recovery, it can be difficult to keep on top of important actions and deadlines, potentially resulting in accidental loss of recovered funds.
With a high volume of cases in active litigation and recovery, it can be difficult to keep on top of important actions and deadlines, potentially resulting in accidental loss of recovered funds.
Supervisors
Supervisors
Supervisors
Supervisors
Managers oversee teams of investigators and their cases that total from thousands to millions in damages. There isn't a way currently to easily keep track of a team on investigator and all the cases.
Managers oversee teams of investigators and their cases that total from thousands to millions in damages. There isn't a way currently to easily keep track of a team on investigator and all the cases.
Managers oversee teams of investigators and their cases that total from thousands to millions in damages. There isn't a way currently to easily keep track of a team on investigator and all the cases.
Managers oversee teams of investigators and their cases that total from thousands to millions in damages. There isn't a way currently to easily keep track of a team on investigator and all the cases.
Investigators
Investigators
Investigators
Investigators
Investigators juggle multiple cases at once all at various levels of severity and stages of completeness.
Investigators juggle multiple cases at once all at various levels of severity and stages of completeness.
Investigators juggle multiple cases at once all at various levels of severity and stages of completeness.
Investigators juggle multiple cases at once all at various levels of severity and stages of completeness.
Investigation nation
Investigation nation
Investigation nation
Investigation nation
Investigators have a dedicated space all of their own. The dashboard is a personalized view of all their current cases, tasks, and flags. It's a great place to come back to during your day to make sure everything is on track.
Investigators have a dedicated space all of their own. The dashboard is a personalized view of all their current cases, tasks, and flags. It's a great place to come back to during your day to make sure everything is on track.
Investigators have a dedicated space all of their own. The dashboard is a personalized view of all their current cases, tasks, and flags. It's a great place to come back to during your day to make sure everything is on track.
Investigators have a dedicated space all of their own. The dashboard is a personalized view of all their current cases, tasks, and flags. It's a great place to come back to during your day to make sure everything is on track.
Case by case basis
Case by case basis
Case by case basis
Case by case basis
Keep track of all the cases you're currently working on. Get notified about followups and new tasks so you never miss a deadline.
Keep track of all the cases you're currently working on. Get notified about followups and new tasks so you never miss a deadline.
Keep track of all the cases you're currently working on. Get notified about followups and new tasks so you never miss a deadline.
Keep track of all the cases you're currently working on. Get notified about followups and new tasks so you never miss a deadline.
Send up a flag
Send up a flag
Send up a flag
Send up a flag
When a supervisor or investigator sees something they need your help with they can assign it to you for your attention or approval.
When a supervisor or investigator sees something they need your help with they can assign it to you for your attention or approval.
When a supervisor or investigator sees something they need your help with they can assign it to you for your attention or approval.
When a supervisor or investigator sees something they need your help with they can assign it to you for your attention or approval.
Taking the work out of research
Taking the work out of research
Taking the work out of research
Taking the work out of research
When Case Tracker believes a claim is potentially fraudulent, it automatically generates a lead. Investigators sift through the details of the lead to determine if it is a true lead or not. If true, they pick up the case weighing current workload and team initiatives.
When Case Tracker believes a claim is potentially fraudulent, it automatically generates a lead. Investigators sift through the details of the lead to determine if it is a true lead or not. If true, they pick up the case weighing current workload and team initiatives.
When Case Tracker believes a claim is potentially fraudulent, it automatically generates a lead. Investigators sift through the details of the lead to determine if it is a true lead or not. If true, they pick up the case weighing current workload and team initiatives.
When Case Tracker believes a claim is potentially fraudulent, it automatically generates a lead. Investigators sift through the details of the lead to determine if it is a true lead or not. If true, they pick up the case weighing current workload and team initiatives.
The proof is in the pudding
The proof is in the pudding
The proof is in the pudding
The proof is in the pudding
Don't get lost in the details as you sort through a lead. Important information and actions are fixed to the right side of the screen, making it easy to save your edits, assign the lead to yourself, or send the referral to another investigator.
Don't get lost in the details as you sort through a lead. Important information and actions are fixed to the right side of the screen, making it easy to save your edits, assign the lead to yourself, or send the referral to another investigator.
Don't get lost in the details as you sort through a lead. Important information and actions are fixed to the right side of the screen, making it easy to save your edits, assign the lead to yourself, or send the referral to another investigator.
Don't get lost in the details as you sort through a lead. Important information and actions are fixed to the right side of the screen, making it easy to save your edits, assign the lead to yourself, or send the referral to another investigator.
Keep it moving
Keep it moving
Keep it moving
Keep it moving
Think of referrals like an active investigation. Here, you keep record of the neccesary people involved, financials, milestones and more.
Think of referrals like an active investigation. Here, you keep record of the neccesary people involved, financials, milestones and more.
Think of referrals like an active investigation. Here, you keep record of the neccesary people involved, financials, milestones and more.
Think of referrals like an active investigation. Here, you keep record of the neccesary people involved, financials, milestones and more.
Show me the money
Show me the money
Show me the money
Show me the money
Verify amounts recovered, see transaction history, log payments, post checks, and more.
Verify amounts recovered, see transaction history, log payments, post checks, and more.
Verify amounts recovered, see transaction history, log payments, post checks, and more.
Verify amounts recovered, see transaction history, log payments, post checks, and more.
Subject says
Subject says
Subject says
Subject says
Compile a rolodex of vital contact information and codes pertaining to the investigation for history and future reference
Compile a rolodex of vital contact information and codes pertaining to the investigation for history and future reference
Compile a rolodex of vital contact information and codes pertaining to the investigation for history and future reference
Compile a rolodex of vital contact information and codes pertaining to the investigation for history and future reference
Go the extra milestone
Go the extra milestone
Go the extra milestone
Go the extra milestone
Timestamps are automatically generated. Important actions are highlighted when additional attention is required.
Timestamps are automatically generated. Important actions are highlighted when additional attention is required.
Timestamps are automatically generated. Important actions are highlighted when additional attention is required.
Timestamps are automatically generated. Important actions are highlighted when additional attention is required.
Case closed
Case closed
Case closed
Case closed
The final step to closing a case is going through the closure checklist to confirm all possible work was done and affirm due diligence in the investigation.
The final step to closing a case is going through the closure checklist to confirm all possible work was done and affirm due diligence in the investigation.
The final step to closing a case is going through the closure checklist to confirm all possible work was done and affirm due diligence in the investigation.
The final step to closing a case is going through the closure checklist to confirm all possible work was done and affirm due diligence in the investigation.
Supervisor
Supervisor
Supervisor
Supervisor
Managers now have their own space to help them keep track of their team. An interactive graph shows investigator's open cases. Easily track open referrals, cases in recovery, tasks and more.
Managers now have their own space to help them keep track of their team. An interactive graph shows investigator's open cases. Easily track open referrals, cases in recovery, tasks and more.
Managers now have their own space to help them keep track of their team. An interactive graph shows investigator's open cases. Easily track open referrals, cases in recovery, tasks and more.
Managers now have their own space to help them keep track of their team. An interactive graph shows investigator's open cases. Easily track open referrals, cases in recovery, tasks and more.
Dashboard
Dashboard
Dashboard
Dashboard
The supervisor's dashboard is packed with helpful visualizations and information. Quickly and easily view the status of investigations and follow up with your team on progress.
The supervisor's dashboard is packed with helpful visualizations and information. Quickly and easily view the status of investigations and follow up with your team on progress.
The supervisor's dashboard is packed with helpful visualizations and information. Quickly and easily view the status of investigations and follow up with your team on progress.
The supervisor's dashboard is packed with helpful visualizations and information. Quickly and easily view the status of investigations and follow up with your team on progress.
Reporting for duty
Reporting for duty
Reporting for duty
Reporting for duty
Quickly export statistics, progress, and metrics. Generate reports of entire teams, individual investigators, payouts, and more.
Quickly export statistics, progress, and metrics. Generate reports of entire teams, individual investigators, payouts, and more.
Quickly export statistics, progress, and metrics. Generate reports of entire teams, individual investigators, payouts, and more.
Quickly export statistics, progress, and metrics. Generate reports of entire teams, individual investigators, payouts, and more.
Manager reports
Manager reports
Manager reports
Manager reports
Use major milestones of the investigation process to create summaries.
Use major milestones of the investigation process to create summaries.
Use major milestones of the investigation process to create summaries.
Use major milestones of the investigation process to create summaries.
Would you like a reciept?
Would you like a reciept?
Would you like a reciept?
Would you like a reciept?
Historical revenue reports created in a snap. Case Tracker pulls from a large database of cases to create a timeline of payments.
Historical revenue reports created in a snap. Case Tracker pulls from a large database of cases to create a timeline of payments.
Historical revenue reports created in a snap. Case Tracker pulls from a large database of cases to create a timeline of payments.
Historical revenue reports created in a snap. Case Tracker pulls from a large database of cases to create a timeline of payments.
