Ancillary Benefits Manager (ABM)
Ancillary Benefits Manager (ABM) is an Optum product for managing specialty health services like imaging, lab tests, and DME. Prior authorization (PA) is a critical workflow but historically fragmented and inefficient—providers juggle multiple portals, unclear requirements, and fax-based communication, causing delays and frustration.
Problem
Providers waste time determining if PA is needed and gathering documentation, leading to care delays and administrative burden.
Opportunity
Build a unified ABM Authorization Portal to streamline PA submissions, reduce complexity, and improve patient care.
Research Findings
User Stories
As a provider user, I want to know upfront if a prior authorization is required, so that I don’t waste time on unnecessary paperwork.
As a provider user, I want clear prompts for all the required information and documents, so that my request gets approved on the first try.
As a provider user, I want immediate confirmation and reference number, so that I can track & follow up easily.
— User story 3
User Person & Needs
It all begins with an idea. Maybe you want to launch a business. Maybe you want to turn a hobby into something more. Or maybe you have a creative project to share with the world.
The Authorization Process & Design Solutions
Eligibility Verification
Research Findings: Users waste time submitting PAs for ineligible patients; eligibility checks happen in separate systems. Design Solution: Integrated real-time eligibility check at start of workflow. Automatic validation with clear “Eligible/Ineligible” status before proceeding.
Plan Two
It all begins with an idea. Maybe you want to launch a business. Whatever it is, the way you tell your story online can make all the difference.
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Eligibility Verification
Research Findings: Users waste time submitting PAs for ineligible patients; eligibility checks happen in separate systems. Design Solution: Integrated real-time eligibility check at start of workflow. Automatic validation with clear “Eligible/Ineligible” status before proceeding.
Plan Two
It all begins with an idea. Maybe you want to launch a business. Whatever it is, the way you tell your story online can make all the difference.
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Listen Up
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