Streamlining Insurance Compliance for Mental Health Practices.
fulcrum GT
fulcrum GT
Streamlining Insurance Compliance for Mental Health Practices.
Streamlining Insurance Compliance for Mental Health Practices.
At a Glance
At a Glance
Over the course of the summer, I worked on a new startup at Fulcrum GT's startup program. My team and I sought to solve the problem of therapists' lengthy and confusing administrative work that I uncovered in user interviews and other research. Armed with the research, my team and I landed on our solution: an AI-powered platform that simplifies insurance compliance for small and new mental health practices.
Over the course of the summer, I worked on a new startup at Fulcrum GT's startup program. My team and I sought to solve the problem of therapists' lengthy and confusing administrative work that I uncovered in user interviews and other research. Armed with the research, my team and I landed on our solution: an AI-powered platform that simplifies insurance compliance for small and new mental health practices.
4 months
4 months
My Role:
Product designer, researcher and strategist.
1 Product Designer (Me!)
1 Product Manager
1 Data Scientist
3 Developers
2 Business Strategists
My Role:
My Role:
My Role:
Product Designer
Founding Designer
Product Designer
1 Product Designer (Me!)
1 Product Designer (Me!)
1 Product Designer (Me!)
1 Product Manager
1 Product Manager
1 Product Manager
1 Data Scientist
1 Data Scientist
1 Data Scientist
3 Developers
3 Developers
3 Developers
2 Business Strategists
2 Business Strategists
2 Business Strategists
Results
Result:
Result:
Result
Our AI feature is expected to reduced documentation time by
Expected to reduce documentation time by
70%
based on user testing,
hours a month.
Presented at Iltacon 2025
12 Hour decrease in monthly clinical documentation time
70% projected decrease in documentation time leveraging our AI feature.
70% projected decrease in documentation time
PROBLEM
PROBLEM
PROBLEM
Therapists Face Insurance Denials and Tedious Documentation.
Therapists Face Insurance Denials and Tedious Documentation.
The Problem:
The Problem:
Confusing claims and rigorous documentation requirements force a choice: hire expensive coders or risk losing revenue to audits. This admin tax eats into client time and ultimately pushes providers to abandon insurance.
Confusing claims and rigorous documentation requirements force a choice: hire expensive coders or risk losing revenue to audits. This admin tax eats into client time and ultimately pushes providers to abandon insurance.
Solution Preview→
Sending claim to health insurance
Therapist session with client
Documenting the session (progress notes)
Click to enlarge
Click to enlarge
Completing an insurance claim document
Final Design Preview →
Completing a claim:
Documenting the session:
INITIAL PIVOT
INITIAL PIVOT
INITIAL PIVOT
Our Initial Patient-Focused Approach Met Negative Feedback.
Our Initial Patient-Focused Approach Met Negative Feedback.
This vibe-coded prototype prioritized function over aesthetics - link
This vibe-coded prototype prioritized function over aesthetics - link
Our Initial Problem Framing →
Our Initial Problem Framing →
At first, we didn’t set out to solve this problem for therapists; we began by creating a tool for patients to intelligently navigate their medical bill errors.
At first, we didn’t set out to solve this problem for therapists; we began by creating a tool for patients to intelligently navigate their medical bill errors.
The Problem with Our Approach →
The Problem with Our Approach →
User testing showed that fighting billing errors was unrealistic for patients, which led us to pivot to therapists' pain points.
User testing showed that fighting billing errors was unrealistic for patients, which led us to pivot to therapists' pain points.
RESEARCH
RESEARCH
RESEARCH
Therapists Face Excessive Time, Complexity, and Cost to Comply with Insurance.
Therapists Face Excessive Time, Complexity, and Cost to Comply with Insurance.
Small Practice Therapist
Female, 56 years old
Spends a long time on billing and payroll management
Wants more time to spend with clients
New Therapist
Age: 26-32
Small Practice Therapist
Age: 26-32
Spends a long time on billing and payroll management
Wants more time to spend with clients
Frequently makes coding and documentation mistakes
Wants a way to simplify complicated insurance bills
Small Practice Therapist
Age: 32-60+
Spends a long time on billing and payroll management
Wants more time to spend with clients
Small Practice Therapist
Age: 32-60+
Spends a long time on billing and payroll management
Wants more time to spend with clients
New Therapist
Age: 26-32
Frequently makes coding and documentation mistakes
Wants a way to simplify complicated insurance billing
New Therapist
Age: 26-32
Small Practice Therapist
Age: 26-32
Spends a long time on billing and payroll management
Wants more time to spend with clients
Frequently makes coding and documentation mistakes
Wants a way to simplify complicated insurance bills
User Personas→
Understanding Our Users→
Understanding Our Users→
“Seeing nearly a third of our hard-earned revenue vanish into clawbacks is beyond disheartening." - therapist interviewee
“Every time I think I’ve mastered the coding updates, the goals move and claims get denied." - therapist interviewee
“I’ve spent nine hours fighting Blue Cross Blue Shield on one denial, and it’s still unresolved." - therapist interviewee
“Seeing nearly a third of our hard-earned revenue vanish into clawbacks is beyond disheartening." - therapist interviewee
“Every time I think I’ve mastered the coding updates, the goals move and claims get denied." - therapist interviewee
“I’ve spent nine hours fighting Blue Cross Blue Shield on one denial, and it’s still unresolved." - therapist interviewee
User interviews (11) and secondary research →
User interviews (11) and secondary research →
Admin work stole an average of 8 hours a week with clients.
Admin work stole an average of 8 hours a week with clients.
Medical coding rules felt confusing and, therefore, led to denied insurance claims.
Medical coding rules felt confusing and, therefore, led to denied insurance claims.
>34% of claims were denied, rejected, and clawbacked.
>34% of claims were denied, rejected, and clawbacked.
Understanding Our Users →
Small Practice Therapist
Age: 32-60+
Spends a long time on billing and payroll management.
Wants more time to spend with clients.
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Interviewees
*Simplified persona
*Simplified persona
New Therapist
Age: 26-32
Frequently makes coding and documentation mistakes.
Wants a way to simplify complicated insurance billing.
How might we make administrative processes easier for therapists without sacrificing billing/documenting accuracy?
Our Direction →
Our Direction →
How might we make administrative processes easier for therapists without sacrificing billing/documenting accuracy?
Competitor Analysis →
Accurate insurance form filing
Often prohibitively expensive
Can't write up documentation
Medical Coders
Affordable
No automatic CPT coding
Slow documenting*
EHR Systems
*Or privacy violating transcriptions
Most Accurate Form Filing
Most Expensive
Not Flexible with Demand
RCM vendors
Finding the Gaps in the Market →
Accurate insurance form filing
Often prohibitively expensive
Can't write up documentation
Medical Coders
Affordable
No automatic CPT coding
Slow documenting*
Other EHR Systems
*Or privacy violating transcriptions
Most Accurate Form Filing
Most Expensive
Not Flexible with Demand
RCM vendors
Our Direction →
How might we…
make insurance billing easier for therapists?
How might we…
make documentation more efficient for therapists?
Competitor Analysis →
Competitors fell into three camps: medical coders (accurate but prohibitively expensive), EHR add-ons (integrated but clunky and designed for hospitals), and RCM vendors (comprehensive but inaccessible to small practices). None combined affordability, ease of use, and transparency. This gap shaped our opportunity: deliver coder-level accuracy through therapist-first, AI-powered workflows.
DEVELOPMENT
DEVELOPMENT
DEVELOPMENT
Streamlining Billing Complexity to Design Therapist Friendly Solutions.
Streamlining Billing Complexity to Design Therapist Friendly Solutions.
efficiency
learnability
Trading learnability for efficiency →
Trading learnability for efficiency →
Designing for therapists required a trade-off: should the tool be easy to learn or built for speed? I chose to prioritize efficiency, knowing that therapists would frequently do tasks like progress notes writing.
Designing for therapists required a trade-off: should the tool be easy to learn or built for speed? I chose to prioritize efficiency, knowing that therapists would frequently do tasks like progress notes writing.
learnability
efficiency
Mapping out a comprehensive practice management platform →
Mapping a comprehensive management platform →
I designed the user flow to include the complexity needed by therapists.
Ideating more efficient claims features →
Ideating more efficient claims features →
I began wire-framing solutions for how the process of filing insurance claims could be simpler and less time consuming with a mix of auto-populating fields and LLM technology.
I began wire-framing solutions for how the process of filing insurance claims could be simpler and less time consuming with a mix of auto-populating fields and LLM technology.
Progress Notes
Claims Submission
Hypothesis: making users review their claim form before submitting will reduce errors
Hypothesis: clicking preselected options (fed into an LLM) will speed up documentation time.
Progress Notes
Hypothesis: clicking preselected options (fed into an LLM) will speed up documentation time.
Progress Notes
Claims Submission
Claims page makes users review claim form to reduce errors
Hypothesis: clicking preselected options (fed into an LLM) will speed up documentation time.
Progress bar for the claims submission process
Progress Notes
Claims Submission
Hypothesis: making users review their claim form before submitting will reduce errors
Claim Progress indicator to remind users of claims
Progress Notes
Hypothesis: clicking preselected options (fed into an LLM) will speed up documentation time.
Exploring and refining progress notes solutions →
How might we increase documentation efficiency for therapists?→
I iterated on my initial idea for LLM assisted documentation to ensure my design met insurance standards, fit within therapists' mental models, and was technically achievable.
I iterated on my initial idea for LLM assisted documentation to ensure my design met insurance standards, fit within therapists' mental models, and was technically achievable.
Added structure to tag past selection on sidebar.
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03
Replaced the preview notes feature with helpful links to past client documentation.
V1 Progress Notes Feature
Improvements
The selection feature saves practitioner time
Left bar felt disorganized
Sections of tags weren't based on existing frameworks
Preview progress notes button didn't consider technical limitations
Little consideration for requirements and error prevention
02
Used the existing BIRP framework to structure the flow.
04
Added error messages and required sections to prevent errors.
v1 Progress notes
The selection feature saves practitioner time
Left bar felt disorganized
doesn't meet requirements and no error prevention
02
Added error messages and required sections for error prevention
Replaced the preview notes feature with helpful links to past client documentation
Added structure to tag past selection on sidebar
Improvements:
01
The selection feature saves practitioner time
Left bar felt disorganized
Little consideration for requirements and error prevention
V1 Progress Notes:
Added error messages and required sections for error prevention
Replaced the preview notes feature with helpful links to past client documentation.
Improvements:
V1 Progress Notes
The selection feature saves practitioner time
Left bar felt disorganized
Preview progress notes button didn't consider technical limitations
Little consideration for requirements and error prevention
02
Added error messages and required sections for error prevention
Replaced the preview notes feature with helpful links to past client documentation
Added structure to tag past selection on sidebar
Improvements:
01
The selection feature saves practitioner time
Left bar felt disorganized
doesn't meet requirements and no error prevention
V1 Progress Notes:
Design System →
I developed a comprehensive design system with over 50 components for 60+ unique screens. The system features a clean, medical aesthetic, using green and blue as primary colors to build a unique brand identity associated with healing and calm.
USER TESTING
USER TESTING
USER TESTING
Testing Our Progress Notes Feature.
Testing Our Progress Notes Feature.
I tested different ways to adjust our predefined options' extremity in progress notes.
I experimented with different ways to change option extremity
Adjustments to Progress Notes →
Adjustments to Progress Notes →
Based on 8 user tests, I found my earlier method of showing the extremity of the components with color was not intuitive for users. Additionally, I defined 1,000+ adjustable, predefined options to populate the tags based on card sorting with therapists.
Based on 8 user tests, I found my earlier method of showing the extremity of the components with color was not intuitive for users. Additionally, I defined 1,000+ adjustable, predefined options to populate the tags based on card sorting with therapists.
Testing LLM Behavior With Real Users →
User testing revealed a preference for real-time text streaming, which helped manage the wait time during generation. To safeguard against AI inconsistencies users expressed issues with, my team and I integrated a regeneration feature.
Testing LLM Behavior With Users →
User testing revealed a preference for real-time text streaming, which helped manage the wait time during generation. To safeguard against AI inconsistencies users expressed issues with, my team and I integrated a regeneration feature.
Testing LLM Behavior With Real Users →
User testing revealed a preference for real-time text streaming, which helped manage the wait time during generation. To safeguard against AI inconsistencies users expressed issues with, my team and I integrated a regeneration feature.
Testing LLM Behavior With Real Users →
User testing revealed a preference for real-time text streaming, which helped manage the wait time during generation. To safeguard against AI inconsistencies users expressed issues with, my team and I integrated a regeneration feature.
A More Comprehensive Platform →
Through getting feedback from target users, I learned therapists would only adopt our platform if it functioned like a full practice-management platform like our competitors. This meant I needed to add more features like treatment plans, intake assessments, and other essential workflows.
SOLUTION
A comprehensive insurance claim and document management platform for therapists.
Clear Claim management→
Clear Claim management→
A centralized dashboard for ease of access to documentation and claims-filing. Reminders to file claims & complete documentation.
A centralized dashboard for ease of access to documentation and claims-filing. Reminders to file claims & complete documentation.
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More Comprehensive and Quicker Documentation→
More Comprehensive and Quicker Documentation→
Our patented "Practinotes" feature guides users through writing documentation based on a database of over 1,000 options personalized to their particular client. Instead of manually writing out documentation, therapists just have to click, and our AI model fills in the rest.
Our patented "Practinotes" feature guides users through writing documentation based on a database of over 1,000 options personalized to their particular client. Instead of manually writing out documentation, therapists just have to click, and our AI model fills in the rest.
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Cleaner and Quicker Claim Filing→
Cleaner and Quicker Claim Filing→
Our system auto-populates confusing and lengthy insurance forms from our database and therapist documentation. Instead of selecting from over 11,000 CPT code options, therapists can just accept or deny CPT code suggestions.
Our system auto-populates confusing and lengthy insurance forms from our database and therapist documentation. Instead of selecting from over 11,000 CPT code options, therapists can just accept or deny CPT code suggestions.
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SOLUTION
A comprehensive insurance claim and document management platform for therapists.
SOLUTION
A comprehensive insurance claim and document management platform for therapists.
SOLUTION
A comprehensive insurance claim and document management platform for therapists.
The Results →
The Results →
Following a successful pitch, we secured continued funding from Fulcrum GT investors.
We have secured a provisional patent for our documentation feature called "practinotes".
We expect to reduce clinical documentation time by 70% based on initial user testing*.
*In user tests, our progress notes feature had an average task completion time of 3 minutes. This is more than 3 times faster than the 10-minute national average for writing manual progress notes, according to the American Psychological Association (APA). For the average therapist, this translates to approximately 12 hours of time savings per month.
12
hours saved each month with our progress notes feature, based on user testing
Following a successful pitch, we secured continued funding from Fulcrum GT investors.
12
hours saved each month with our progress notes feature, based on user testing
Expected to reduce clinical documentation time by 70% based on initial user testing.
SOLUTION
A comprehensive insurance claim and document management platform for therapists.
We even got our logo on "stress brains"!
Here is me presenting & getting feedback at Iltacon 2025
Me presenting Practility at Iltacon 2025
We even got our logo on "stress brains"!
Here is me presenting Practility at Iltacon 2025
Here is me presenting Practility at Iltacon 2025
We even got our logo on "stress brains"!
FINAL THOUGHTS
FINAL THOUGHTS
Key Takeaways and Next Steps.
Key Takeaways and Next Steps.
Designing for healthcare billing is about trust as much as speed.
Pivoting early concepts through research was critical to finding the right way to solve problems.
Sometimes it's a sign of strength to say "I don't know" when answering questions about complicated topics like healthcare insurance processes.
Next Steps →
Next Steps →
Progress Notes Testing: This involves insurance audits and gathering more feedback for the over 1000 predefined options.
CPT Code Generation: This focuses on testing the accuracy of the human-AI teaming flow.
Adding More Features: This includes finalizing the treatment plan and adding new billing and payroll management tools.
Progress Notes Testing: This involves insurance audits and gathering more feedback for the over 1000 predefined options.
CPT Code Generation: This focuses on testing the accuracy of the human-AI teaming flow.
Adding More Features: This includes finalizing the treatment plan and adding new billing and payroll management tools.
Progress Notes Testing: This involves insurance audits and gathering more feedback for the over 1000 predefined options.
CPT Code Generation: This focuses on testing the accuracy of the human-AI teaming flow.
Adding More Features: This includes finalizing the treatment plan and adding new billing and payroll management tools.
Adding more practice management features.
Getting HIPAA audited to ensure compliance.
Finishing up development and launching!
Thanks for visiting! I go into more detail on my work over calls/interviews. Feel free to reach me here.
Thanks for visiting! I go into more detail on my work over calls/interviews. Feel free to reach me here.
But Wait, There's More!
But wait, there's more!
But wait, there's more!
Final Design →
Sending claim to health insurance
Therapist session with client
Our Core User Flow
Documenting the session (progress notes)
Click to enlarge
Click to enlarge
Completing an insurance claim document
Final Design →
Documenting the session:
Completing a claim:
