At a Glance
Challenge: Complex, regulation-heavy EOBs were creating confusion rather than clarity, limiting their potential as valuable member touchpoints.
Solution: Engagys redesigned the EOB experience using member research, industry best practices, and rigorous testing to improve understanding and actionability.
Results: Final designs achieved 100% PEMAT scores for both Understandability and Actionability and drove a 30-percentage-point increase in positive user ratings.
The Client
Large, national plan with millions of members, delivering healthcare coverage to individuals and families across multiple commercial plans.
The Challenge
Dense, loaded with regulatory language, and disconnected from member experience, EOBs often raise more questions than they answer. EOB-related inbound calls can cost plans more than $10 per contact, making their simplification a business imperative.
The Opportunity
Recontextualize EOBs as key member touchpoints to not only document fulfilled payment obligations, but also to build literacy and brand confidence.
Engagys Approach
- Multi-stage design process balancing federal & state EOB rules, cross-industry best practices, and brand standards.
- Qualitative and quantitative research to develop, test, and refine design concepts.
- PEMAT evaluation to objectively compare original vs. redesigned EOB effectiveness.
Deliverables
- Key Insights Report covering client and industry knowledge on EOBs, financial literacy best practices from healthcare and beyond, and our research plan
- Research protocols and summaries
- Wireframe design concepts
- Future state visualization of the EOB experience
Selected Results
100% PEMAT scores in both Understandability and Actionability on final designs, compared with prior version scores as low as 0%
30pp Increase in positive user rating on final design
User assessments of the new designs were highly positive, specifically referring to:
- Brand sentiment
- Understanding of health insurance
- Personalized communications
