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Das M11 Alfons Lernsoftware O5 Hit-Radio Antenne Sachsen-Anhalt E12 Macmillan Hong Kong I2 Navigo M12 Schulbuchverlag E. Dorner I1 Veranstaltungsforum der Verlagsgruppe | | | | | | Schaubild zeigt alle derzeit verfügbaren Websites, die wichtigsten Inhalte sowie P8 Antenne Mecklenburg-Vorpommern M3 Fachverlag Verlagsgruppe Handelsblatt G11 Macmillan India G6 New Palgrave Dictionaries F4 Scientific American Georg von Holtzbrinck Returns & Exchanges System Alignment Today Holtzbrinck Web Map P5 Antenne Thüringen D1 Farrar, Straus & Giroux. J4 Infoseek D12 Macmillan Language House M9 Nicolai Verlag F1 Scientific American Explorations K1 Vereinigte Wirtschaftsdienste deren Verknüpfungen untereinander. Die aufgeführten Websites repräsentieren GEORG VON HOLTZBRINCK Firmen, Tochtergesellschaften, Unternehmensteile oder Produkte. 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B6 Bedford/St. Martin's N12 Graphik International H2 Learn Technologies Interactive O12 manus presse L6 Prognos B4 Stonewall Inn O2 Wetter und Reise TV Windows pa ge M10 Bildung Online E8 Grove Dictionary of Art Online J2 Lebensmittelpraxis K7 MegaLex L12 Spectra Lehrmittel-Verlag C7 W.H. Freeman and Company ni de S E6 M4 pa ve 2 m C F7 Grove's Dictionaries Le Scienze A4 Monica's Story P6 Radio 7 K8 Spektrum Akademischer Verlag Wirtschaft-online ge au nd all oll (4) (1) (2) (3) N11 Clausen & Bosse E7 Grove's Dictionaries of Music A6 Let's Go P7 Radio Gong 2000 G4 Spektrum der Wissenschaft K3 Wirtschaft und Wettbewerb n d Se ec This diagram was created by Dynamic Diagrams and ACTIV-CONSULT during q p iv e rv ti F6 K11 E9 O7 O1 K5 u a e 2 q ic n o New Grove Dictionary of Opera Online Logo Lern-Spiel-Verlag Nature Radio Regenbogen Spektrum TV Wirtschaftswoche (WiWo) d a g a nd u e o n is n e u d a n April and May of 1999. 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Employer & Harvard University Brown University Ingenta plc Kahn+Associates Mad*Pow Director of Publications | Publications Institute for Research in Information Chief Technology Officer Founder and Managing Director Experience Design Director Title Editor and Research Associate | and Scholarship (IRIS), Senior Systems Analyst Project Coordinator | Project Manager & Research Scientist | Director Cadmus Patient Medical Billing Journey Map Insured Adult, Urban Setting Problem: Skin growth; Diagnosis: Skin cancer; Treatment: Outpatient Surgery

Problem Awareness PCP Exam Specialist Exam Pre-Procedure Procedure Post-Procedure Bill Resolution Communications 12/15/15

Diagnostic Biopsy Assisting Pre-procedure Post-procedure Diagnostic Biopsy Biopsy Biopsy Who Does The Work

PCP Specialist Specialist Hospital MD Hospital MD $25 $50 $0 $0 $0 Hospital MD Team Is it over now or are there more Medical 8/15/15 10/29/15 12/8/15 12/23/15 1/7/16 1/26/16 2/5/16 2/18/16 surprises? Should I expect another Director of Electronic Publishing Awareness of a problem, feeling PCP Physical, referral to Specialist Specialist examines Specialist tells Patient about Surgeon repeats biopsy, examines Surgeon performs procedure with Surgeon examines patient, Events bill for that last unwell, unable to return to good for the problem. problem, orders biopsy. biopsy results, refers Patient patient, explains procedure. assistance from 2 Anaesthsialogists, procedure is successful. 5/1/16 visit? health. Schedule appointment for to Surgeon at Hospital and post-procedure biopsy. exam with PCP. for procedure.

Patient This problem is not I can’t get an Now I’m really I need surgery as The surgeon was That went well. I I received great Experience going away. I have appointment with nervous. I have soon as possible! very reassuring. don’t have to stay care but I still to see my doctor. a specialist for a to wait for the What’s the best I think this is overnight. don’t know what it month! I hope biopsy results. hospital? What going to be okay. will cost me. this problem’s are they going not serious. to do to me? 2/10/16 This is not what I was Now I have to told to expect. What’s figure out how to I survived surgery. 2/15/16 3/3/16 3/22/16 going on now? 4/22/16 pay this bill! Let’s find out how 1/26/16 much this is going Insurance didn’t The hospital charges $20,000 but to cost me. call me back. I they are only allowed to charge Here comes the already have one $3,190. You will have to pay this bills. I don’t bill from the amount. Along with other 2/10/16 understand hospital that's charges this will take you over the description. Can’t tell you now, due in 2 days. I your $4,000 deductible. we’ll call you back better pay it now. in a few days.

Who is this bill from? Why did it take 3 I’ve never heard of this months to get this Okay, I’ll just pay it 12/18/15 My co-pay covers place or this doctor! bill? with my FSA card. 3/10/16 most things when I 1/15/16 2/15/16 see my PCP.

Patient Facing

Billing PCP Exam EOB Process

Billing Stream 1 10/29/15 11/25/15 12/15/15 PCP Claim is approved, No bill is sent to the PCP is paid the Patient

Specialist Exam Why was the claim I called the doctor’s billing I still haven’t seen a bill yet. I denied? Will I have office. I called the FSA manager. need to pay before 3/15 to use to pay it later? I haven’t see a bill yet. money from my 2015 FSA. EOB EOB This journey map traces a patient’s experience of a single healthcare event over a nine-month $284.82

period. Most of the actors and institutions Billing Stream 2 12/8/15 12/18/15 1/2/15 2/12/16 2/15/16 3/5/16 3/10/16 Specialist Specialist Lab Claim denied, Claim is then Claim is Claim appears to be Specialist and Billed: $284.82 represented in the Ecosystem Diagram play a send Claim to Provider ID resubmitted approved, the approved Lab send Bill to Paid with with credit card, sent Insurer was missing to Insurer Specialist and Lab Patient in FSA form for reimbusement. role in this Patient Experience. are paid

The experience follows a common path Yikes, I can’t use the card to pay The money’s been removed Lab for an expense that occurred from my 2015 FSA so I guess Atex, Inc. through the US healthcare system: patient during the previous year. I did it right. sees her Primary Care Provider (PCP) for a problem, PCP refers her to a Specialist, the $72.30 $72.30 Specialist orders diagnostic tests, the Patient is Billing Stream 3 Lab 12/15/15 12/20/15 1/12/16 1/15/16 2/15/16 2/25/16 3/2/16 referred for surgery after a positive diagnosis, Outside Lab send Claim is approved, Outside Lab Billed: $72.30 2nd Notice: $72.30 Payment on FSA Resend FSA claim Claim to Insurer the Lab is paid sends Bill to Not paid Paid over the phone card is denied form, uploaded to the diagnostic test is repeated by the Hospital, Patient with FSA card Third Party Portal the Patient meets with the Surgeon, the pro- cedure is performed by a Hospital Team, and the Patient has a post-procedure exam with Hospital Surgery the Surgeon. There are no significant errors and no medical complications represented in this journey. $253.56 $253.56 Applications Specialist Billing Stream 4a 1/26/16 1/2/16 1/22/16 1/24/16 2/15/16 This healthcare experience triggers six Lab Hospital Lab Claim is Hospital sends 1st Bill: 1st Bill: $253.56 diƒerent billing streams involving claims and send Claim approved, the monthly Bill to $253.56 Paid on Hospital to Insurer Hospital Lab Patient Pre-proc portal payments and bills between the Insurer, the is paid biopsy Patient, PCP, Specialist Practice, Labs, Hospital system and a Third Party administering the Patient’s FSA/HRA accounts. $667.95 Billing Stream 4b 1/7/16 1/8/16 1/10/16 1/22/16 2/5/16 2/7/16 2/15/16 3/18/16 3/20/15 3/22/16 This journey map is provided as an example. Services Hopital send Claim denied, Claim is then Claim is Hopital sends Some service Claim is then All Claim are Hospital sends 2nd Bill: $667.95 There are a multitude of variations that a Previsit claim lacking resubmitted approved, the Procedure claims are resubmitted finally approved, monthly Bill to for pre-proc visit to Insurer referral letter to Insurer Hospital is paid Services Claim denied for to Insurer the Hospital is Patient and proc services patient could experience in their medical code to Insurer coding errors paid billing journey and all of the possible variations

are not represented here. Where did this money come from? What’s it for? EOB

Billing Streama 4c $3,858.32 Facilities 2/5/16 3/21/16 3/21/15 3/21/15 4/20/15 4/22/16 Deductable is Check: $1,642.88 Hospital sends Hopital sends Claim is 3rd Bill: $3,858.32 for Maxed out. Check appears from monthly Bill Procedure Services approved, the pre-proc visit, proc is issued from Third Party to Patient Claim to Insurer Hospital is paid services & facilities HRA Account

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Université Paris 1 Panthéon-Sorbonne: Master Multimédia interactif Paul Kahn ENSBA, INA, ParisTech: Création et Production Multimédia Rhode Island School of Design [email protected] m. 978-933-1422 @pauldavidkahn linkedin.com/in/paulkahn