Product Users: Start With The Journey

Four years ago, I joined a young ambitious startup called Oscar that was tackling health insurance. Since then, I’ve built internal tools for our servicing team, UX for our provider network and our provider data platform. Plus, I’ve helped grow our team from 100 people to around 1,300. Let’s look at the Oscar universe then drill down into how we serve our diverse segments of product users.

Oscar is a health insurance company and a tech company, and we strongly believe in engaging with our members to help shape their healthcare experience. We now have about 240,000 members across nine states.   

A Typical Member Journey

As an Oscar member-to-be, you might start by shopping for a health plan, and you check out prices, benefits and plan design. Once you enroll in a plan, you can download our mobile app which manages your account, bills, claims history, labs and a bunch of other features. One fun part of the app is that you can sync your walking steps. When our product users meet their walking goal, they earn a dollar a day. 

Now, if you get injured or sick, instead of going to the ER, you can request a doctor on call visit on our app, and one of our doctors will call you. Meanwhile, our physicians have an entire suite of care management tools, and they can see a patient’s clinical history, medications and other information to be able to provide the best care. 

If you need to see a doctor in person, you log in to our app and search for a doctor. You can choose based on location and the doctor bio, and you can schedule an appointment. Behind the scenes, we have a huge network team. They build provider relationships and set up contracts with labs, hospitals, doctors, imaging centers and more. Much of this is accomplished using a suite of internal network management tools we’ve built for this segment of product users. 

More Internal Tools

Our doctors can also use our provider portal to view information about members, such as their plan and benefits. As a member, you might need labs or an x-ray, and a few weeks later you get a bill that explains what the cost of your service was. For that to happen, the doctor submitted a claim describing the services. Then, the claim system checks over 100 datapoints to calculate covered services, how much the doctor gets paid and how much the member owes. Plus, for questions about billing – we have a concierge team.

Each concierge team is set up with five different internal product user teams assigned to specific patients. This means the concierge team gets to know the patients and their journeys. They have the tools to look up member information, engage with you, generate documents and anything else you need to help you with your healthcare experience. 

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About the speaker
Neha Kumar Oscar Health, Director, Product Member

Neha Kumar is a Director of Product at Oscar Health. She currently oversees core platform teams that build the data models and internal tools for managing our networks, enrollments, plans & payments. Prior to joining Oscar, she worked in Strategy and Product roles at American Express where she worked on assessing the growing digital payments space and building out alternative banking products. Neha is a graduate of The University of Michigan and currently lives in New York City.

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