Regence Blue Shield’s Design Undermines Its Patient Relationships

The Affordable Care Act has a huge swath of problems but we don’t often talk about the challenge of dealing with our own insurance companies. They are bureaucracies focused on maintaining a profit margin on our health. One even less talked about component of working with them is the interactive design or user interface of their member websites. Today, I’ll walk you through the bad design of the Regence Blue Shield member dashboard. It’s so awful that it appears to be designed in part to make communicating with the company more difficult for members.

Problems with the Regence Message Center

No Scrollbars

Rather than scrollbars or standard paging controls, Regence used a non-standard scroll button:

Regence’s non-standard scroll button wrecks usability

In these videos, you can see that each time you press the scroll button, it takes you back to the top requiring you to scroll back down the page and press it again ad infinatum:

Link to watch the video on YouTube

The scrolling problem is even worse when you’re browsing claims (I added the vertical bars to the video to protect my privacy):

Link to watch scrolling claims on YouTube

If you’re looking for a claim from February, you better have time to scroll. And, notice how the total amounts for the year are inaccurate and incomplete on every page until you’ve reached the end.

Additionally, Regence’s absurdly large fixed header limits the visual information area:

Regence Blue Shield Dashboard

Regence’s Large Fixed Header Limits View Area

For pages with many rows of data, even more taps of the scrolling button is needed because the display area for data is smaller.

No Email Subject Allowed

Regence allows you to pick from selected topics but not specify any subject. So, if you’re writing a message about problems with a specific claim e.g. “International hospitalization reimbursement” or “Claim # xxx”, there’s no way to specify it:

regence dashboard message center

Email messages have no subject

Soon, as Regence replies to your messages, your inbox is a jumble of unidentifiable threads:

regence message center

Regence Inbox with only generic subjects

Other times, the inbox is just a repetitive list of claim announcements without provider names:

Regence message center inbox

Inbox subjects without provider names

It’s hard to imagine that no one involved in the process of designing the inbox thought, “shouldn’t we display the provider name?”

Problems with Out of Network Claims

If the provider is out of network, Regence says “NO TAX ID OWNER” even though the invoice provided both their name and tax ID number:

Regence claim problems

Regence won’t show out of network provider names

Problems with  Missing Claims

The messages don’t link the reader to the claim and in this case, there’s no claim available to view for Lions Gate Hospital:

regence health claims

Claim announcements aren’t linked and sometimes don’t exist

Problems Reading Replies to Messages

The view area of replies to member initiated messages doesn’t include line breaks and wraps the original message, quickly becoming incomprehensible. Here are a few examples (imagine having vision or cognitive impairment):

Regence message center problems

Regence wraps threaded message with line breaks

regence member dashboard message center

Regence message center has no line breaks

Regence customer service often respond quickly without reading message threads or considering the patient’s difficulties, so the threads of multiple replies are common.

Here’s the customer service agent below suggesting I call customer service myself:

email regence insurance

Regence reply to simple email message with thread wrapping

Locating Explanation of Benefits (EOB) Forms

Although the EOBs have provider names e.g. doctors, physical therapists and lab companies associated with them, they aren’t displayed:

Regence Explanation of Benefits

Explanation of Benefits (EOB) Forms Don’t Show Provider Names

And, at least as of today, Regence only shows the past three months of EOB’s unless you intuit that by opening the filter button, it will allow you to choose older dates (I just happened to discover that today).

While you can filter by date, you cannot filter by provider name:

Regence blue shield EOBs

No way to Filter EOB’s by provider name

Blocking Access to Data

As 2018 began, I still had to work with Regence to cover some remaining 2017 medical visits and approximately $10,000 of bills from a December international ER visit, ambulance trip and multi-day hospitalization.

But Regence turns off your medical coverage status on the website on January 1st of each year:

regence blue shield benefits

Regence Blocks Access to Last Year’s Data on January 1st

This makes it difficult to determine whether their payments are accurate in relation to your policy status.

Unnecessary Envelopes and Letters

The bad interface extends into the real world as well. I received these yesterday … eight letters from Regence’s pharmacy partner issuing denials of largely identical claims even after I told them I was still preparing the information for the appeal:

regence blue shield

Bundles of letters from Regence Pharmacy Provider

Each letter contained blank pages to protect my privacy because of what appears to be poor envelope design with huge plastic windows:

regence blue shield

Seaweed eating cat ponders the bureaucracy of humanity (two blank pages not shown)

Here’s another paper bill for out of network provider claims where the actual provider name isn’t shown:

Regence billing problems

Regence won’t show out of network provider names

Even if you can figure out which providers you had appointments for on those dates, you have to translate nine columns with footnotes to determine if your claim was handled properly.

In Closing

If you’re healthy, you’ve probably not noticed or cared too much about the interface design of your insurance company. The Regence dashboard in particular may work well for common scenarios … a patient with less than ten claims in a calendar year and no disputes.

But for those that have health challenges like me, I was diagnosed with a brain tumor in 2015, these systems make communicating with insurance companies unbelievably difficult.

Obviously, the sicker you are, the more you confront these design issues.

And of course, you might argue people can just choose different insurance companies but you don’t get a chance to preview your company’s website during the ACA sign up period. Additionally, people on ACA plans have fewer and fewer insurers available to choose from.

Recently I’ve been saying that it won’t be my tumor that will kill me, but the stress of dealing with health insurance companies will.

Postscript

After I filed a complaint with Washington State’s Office of Insurance Commission about how this website seems designed to make member coverage inaccessible, a company representative called me and committed to share my feedback with their team. She seemed to know about the problems with the scroll button.

Posted by Jeff Reifman

Jeff is a technology consultant based in the Pacific Northwest. Check out Portland Wild, a visual map-driven guide to Portland's public art, its Heritage Trees and its Little Free Libraries.