DaVita Healthcare

Automating Claims & Auditing to Replace Manual Processes



The Backstory

DaVita Healthcare sought to create a single, comprehensive tool that combined the functionality and business logic of multiple systems/manual processes. The goal was to create a new software solution, Circ, designed to streamline healthcare auditing processes, improve efficiency, and enhance user experience. Circ would allow users to easily search, modify claim data, and support role-based approval workflows. Additionally, it needed to include a robust reporting dashboard to generate daily, weekly, and monthly business insights.


The Challenge

The redesign of Circ came with several challenges:

  1. Complex Data Use Cases: The software had to handle data sent from various healthcare providers, which required a flexible and customizable grid system.

  2. Navigational Hierarchy: Ensuring auditors could seamlessly navigate and resume progress in intricate claim datasets was critical.

  3. Role-Based Approvals: Designing workflows that supported dynamic, role-based approval processes added complexity.


The Solution

The project involved a holistic design approach, combining user-centered design principles and modern interface aesthetics to meet the needs of both the business and end users.

Discovery & Research

  • User Role Definition: Collaborated with stakeholders to identify key user roles and personas, ensuring that the solution aligned with varying job functions and responsibilities.

  • Interviews and Validation: Conducted interviews with internal business users to validate requirements and understand pain points in their current workflows.

  • Journey Mapping and User Flows: Mapped out detailed user journeys and defined workflows for auditing, claims modification, and role-based approvals.

  • Discovery Exercises: Included card sorting, mind mapping, and existing software demonstrations to uncover usability issues and opportunities for improvement.


Design Process

  1. Design Principles Definition: Established guiding principles to ensure consistency, scalability, and alignment with organizational goals.

  2. Information Architecture and Wireframes: Created IA diagrams and low-fidelity mockups to define the software’s structure and core interactions.

  3. High-Fidelity Mockups: Delivered modern, visually engaging designs with full annotations for seamless handoff to development teams.

  4. Grid System: Designed a flexible, customizable grid system to handle complex data manipulation needs, allowing users to sort, filter, and adjust views with ease.

  5. Custom Workflows: Developed intuitive workflows that dynamically adjusted based on user roles, ensuring efficient approval processes.

  6. Reporting Dashboard: Created an interactive dashboard interface for generating real-time and scheduled reports, providing actionable insights at a glance.


The Solution

*Click samples to view full display.


Key Results

  • Improved Efficiency: The new Circ software significantly reduced the time needed to complete healthcare audits and manage claim data.

  • User Satisfaction: Feedback from user testing indicated a dramatic improvement in ease of use and workflow efficiency.

  • Scalability: The solution supported DaVita’s organizational goals by accommodating future growth and evolving requirements.

  • Enhanced Navigation: The new navigational hierarchy allowed auditors to resume progress effortlessly, improving overall productivity.