Rightway Healthcare
Medical Concierge / PBM
Company
Rightway Healthcare
Product
Benefit CMS
Approach
Desktop
Framework
React/JS
Platform
Web
Smarter Plan Creation: One Flow, Digital Review, and Locked Approval
Pain Points
- Health Guides had to toggle between multiple tabs while creating plans, often missing mandatory fields.
- Members only reviewed plans over long phone calls, creating back-and-forth confusion and delays.
- If a member wanted changes, the Health Guide had to manually track edits and re-explain the plan.
- Finalizing plans was error-prone; missed fields or unapproved edits delayed sign-off and implementation.
Key Features
- Step-based workflow with 50% data requirement before advancing.
- Member portal integration: members can make edits, submit feedback, and review changes online.
- Change indicators highlight exactly what’s been updated.
- Digital sign-off & lock: once approved, the plan is locked and ready for implementation.
- Exportable plans with attached compliance and cost documents.
- Built on Ant Design system with consistent 8-point grid alignment.
New Design
- Introduced a guided step flow: Health Guides complete one section at a time, with mandatory fields enforced before moving forward.
- Redesigned Advocate platform with a cleaner UI: top bar, side menu, 8-point grid, and clear proximity grouping.
- Enabled client portal review: members receive draft plans digitally instead of only over calls.
- Automated change tracking with visual indicators for edits.
- Added plan lock on approval to ensure compliance and prevent accidental edits.
1. Plan Setup
Health Guides enter plan details step by step (instead of toggling across tabs).
Mandatory fields must be completed before advancing, reducing the chance of missing critical data.
2. Plan Preview
The full plan is generated and displayed for review.
Includes cost-share options, preventive lists, and care plan rules.
Health Guides and admins can check accuracy before pushing forward.
3. Client Review
Draft plan is sent for client/member review via portal.
Members can make edits directly (e.g., coverage preferences, preventive drug list).
Any changes are flagged with indicators for Health Guide review.
4. Sign-Off
Once both sides are aligned, Health Guide or client signs off on the plan.
Sign-off confirms agreement on costs, coverage, and care components.
5. Approval & Lock
Final approval locks the plan in the system.
Prevents further edits unless explicitly unlocked by admins.
Plan is now ready for implementation across pharmacy and care platforms.
6. Export & Documentation
Complete plan can be exported with all documents attached (compliance, pharmacy rules, cost-sharing breakdowns).
Stored securely with plan security settings.
The Impact
- Reduced missed fields and incomplete plans by enforcing required steps.
- Eliminated repeated, time-consuming phone explanations—members now self-review and send changes asynchronously.
- Streamlined Health Guide workflow, minimizing errors and toggling across tabs.
- Improved collaboration between Health Guides, clients, and members with digital-first review and approval.
- Faster plan activation with automated lock and compliance-ready exports.
This is how it looked
