IHX Case Study B2B SaaS Android App Health InsurTech

Putting Doctors in the Loop on Every Cashless Claim

Only a hospital's insurance desk could see where a cashless claim stood. Families asked doctors and nurses anyway, and insurers sent medical questions the desk could not answer. IHX Nucleus Mobile put the claim in the hands of the people being asked.

Hero imageimages/nucleus-mobile-hero.webp IHX Nucleus Mobile app screens

RoleProduct Design · UX · UI · Prototyping

Team1 PM · 1 PD (me) · 1 Lead Engineer

PlatformAndroid · Live on Play Store

Timeframe3 weeks · design in 2 days

Daily users

9,500+

Hospital staff outside the insurance desk

Growth

↑33%

Client acquisition, led by enterprise hospitals

Speed

2 days

To design, 3 weeks to ship

TL;DR

The whole story, in five cards.

Problem

Families chased claim status across the hospital, and insurer queries needed medical answers the insurance desk could not give.

Users

Doctors, head nurses, counsellors and floor staff. They never submit a claim, but they are the ones being asked.

Solution

An Android app to see any cashless claim and answer insurer queries from the ward, with access set by role.

Numbers

9,500+ daily active users. 33% more client acquisition. Designed in 2 days, shipped in 3 weeks.

Takeaway

Claim status was a patient experience problem. The fix was giving the answer to whoever the family asks.

01 · Context

The patient journey inside a hospital for a cashless claim.

With cashless insurance, the hospital claims the cost from the insurer directly, so the patient does not pay up front. That claim passes through several hands, and the patient's family is watching every step.

1 · DoctorAdvises inpatient treatment

The patient needs to be admitted

→

2 · CounsellorExplains the treatment

What it involves, and how much insurance can cover

→

3 · Insurance deskRequests pre-authorization

Asks the insurer to approve the treatment cost

→

4 · AdmissionPatient is admitted

While the insurer reviews, and may raise queries

→

5 · DischargeDischarge approval

The final bill goes to the insurer, and the patient waits again

Journey map of a cashless claim across admission, waiting on pre-auth, treatment, a payer query and discharge: what the family asks, who they ask, why they are redirected, and what Nucleus gives staff

Terms used here

Insurance desk (TPA desk): the hospital team that files claims with insurers. Pre-authorization: the insurer's approval of treatment before or during a stay. Query: a question from the insurer that must be answered before a claim moves. TAT: turnaround time, how long an approval takes.

02 · Problem

Everyone was asked about the claim. Only the insurance desk could see it.

Families ask the doctor, the head nurse, the desk

“Is the pre-authorization approved?”
“How much has been approved?”
“What will we pay out of pocket?”

The insurer asks the insurance desk for

Clarity on the patient's ailment
Doctor notes and medical reports
Documents that are missing

PROBLEM 01

Families ask whoever is nearest

Once a patient is admitted, relatives and bystanders take these questions to the doctor, the head nurse and the insurance desk, which is busy filing claims for other patients. Only the desk can see the answer.

What staff tell a family about the claim status and the approved amount has to be right, and how the hospital handles these conversations shapes its patient experience.

PROBLEM 02

Insurer queries need clinical answers

Insurance desk staff are not medically trained, so every clinical query means tracking down a doctor or nurse who can answer it.

Every hour spent chasing raises the turnaround time for approval, and it happens twice: at pre-authorization, and again at discharge.

Why hospitals asked for it

Enterprise hospitals asked IHX for an app that would put their doctors in the loop: able to tell families where a claim stands, and able to answer insurer queries without walking to the insurance desk.

Competitor ParityUser Need

03 · Users & Constraints

Designed for any staff member, on any phone, on any signal.

The people who never file a claim but are asked about every one: the four moments the app had to handle, and the three constraints that shaped every screen.

Four moments it had to handle

Head nurse · at the bedside “Is it approved? How much? What will we have to pay?”

The nurse opens the claim and answers with its real status and approved amount, instead of sending the family down to the desk.

View Claim

Counsellor · during the stay A family is unsure what insurance will cover.

The counsellor checks approvals and co-pays on the claim and helps them plan for any out-of-pocket cost.

View Claim

Doctor or head nurse · a query arrives The insurer needs doctor notes, reports or clarity on the diagnosis.

The clinician sees the query on the claim and replies with documents and remarks from the ward.

Query Reply

Treating doctor · at discharge The final bill is with the insurer, and it wants one more report.

The doctor responds from the app, so the patient is not kept waiting to go home.

Query Reply

Three constraints that shaped every screen

CONSTRAINT 01

No training needed: a home screen of tiles that answer at a glance

Hospital staff vary widely in tech literacy and language fluency, and no hospital can train every nurse and doctor. So the home screen is a set of tiles that each answer a question directly: active claims, approvals pending, open queries, and discharges due today and tomorrow. No menus to learn.

CONSTRAINT 02

Low signal, low-end phones: a UI light enough to load fast

Many hospitals have low-network zones inside the building and patchy mobile coverage, and in tier 2 and tier 3 cities connectivity is a real problem. Most staff use low-end smartphones. The UI had to be simple enough to load quickly on all of them. The MVP launched on Android.

CONSTRAINT 03

Always current: answers that are precise and empathetic

Families ask about the claim and the bill, and anything said about insurance has to be exact. Up-to-date claim details, a last updated time on the dashboard, and visibility of every open query let doctors and nurses answer families precisely, and with empathy.

04 · Scope

Two jobs, three weeks.

The MVP had to do two jobs well: show a claim, and answer its queries. Everything else stayed on the desktop platform or waited for the next version.

In the MVP

Role-based access
Some staff can only read a claim, others can also answer its queries. Patient data stays with the people who need it.
Dashboard of tiles
What needs attention, one number per question.
Claim list
All active claims in one list.
Multi-parameter search
Search a claim by multiple parameters at once, powered by Elasticsearch.

Left out of the MVP

In-app notifications
Deferred; the insurance desk tells staff when a query needs them.
Internal team chat
Planned for the next version. It was built on desktop first, as the in-platform chat in QueryLens.AI, and comes to the app next.
Global search
Planned for the next version.

05 · Design

Every screen answers a family's question or an insurer's.

Three tabs in the bottom bar, Dashboard, Search and Claims List, and every path ends at a claim.

Step 1Log in

Username and password

→

Step 2Dashboard

Tiles that answer at a glance

→

Step 3Claim list

The claims behind the tile tapped

→

Step 4Claim

Details, documents, timeline and queries

Information architecture: login and forgot password, a dashboard of four tiles with a Dashboard, Search and Claims List bottom bar, three routes to a claim (claims list, structured search, open queries), and claim detail with details, documents and timeline tabs, split into read-only and read-and-respond access, with in-app notifications, internal team chat and global search out of MVP scope

Decision 01

A home screen of tiles, not menus

Each tile answers one question with one number: Active Claims, Approvals Pending, Open Queries and Discharges Due, split into today and tomorrow. Open Queries and Discharges Due put both of the app's jobs on the first screen, and a last updated time under the tiles tells staff how fresh the numbers are before they answer a family. Tapping a tile opens those claims.

Dashboard tiles: active claims, approvals pending, open queries, and discharges due today and tomorrow, with a last updated time

Decision 02

Claim cards built around a family's questions

Each card leads with what a relative asks: the approved amount, set large, and a colour-coded status, green for approved, orange for a query, red for denied. Patient name, admission date, payer and last updated sit alongside, so staff can find the right patient and answer without opening the claim.

Claim list cards with approved amount and colour-coded status

Decision 03

One claim, grouped the way staff are asked about it

Claim Details groups the facts into three cards: the patient and policy, the stay (doctor, admission, discharge, room type), and the money (claim number, claimed and approved amounts). Below them, Latest Update shows the current status with the insurer's remarks, such as a hospital discount that should not be collected from the patient: exactly what staff need to tell a family. Documents lists every attached file with its upload time, to view or download. Timeline shows the whole stay, from pre-authorization to discharge, each step with its remarks and time. Queries stand out in orange and approvals in green, and an approval letter can be viewed or downloaded right at the step where it was approved, so staff can see a query at discharge as easily as one at admission, and tell a family what happened and when.

Claim details grouped into patient, stay and amount cards, with the latest update and insurer remarks — **Claim Details**

Decision 04

Open queries, urgent first, answered in one screen

Open Queries lists every claim waiting on the hospital, tagged Pre-Auth Query or Claims Query, with filters for Discharge Due Today and Approvals Pending so the most urgent come first. The response screen keeps the claim summary on top, shows the insurer's query, and asks for only two things: a document (pdf, jpg or png, within the payer's size limit) and remarks. Only staff with respond access can submit.

Open queries list with urgency filters — **Open queries**

Responding to an insurer query with a document and remarks — **Respond to a query**

Decision 05

Structured search for the MVP

Search is a short form: patient name, mobile number, member ID, employee ID, IP number and doctor name, whichever details a family can give. Each field clears on its own, or all at once, and the results show how many claims matched, each with the patient, doctor, admission date, approved amount and status.

A single global search bar was the goal, and it is planned for the next version. Restrictions on our end at the time meant the MVP shipped this structured search instead.

Structured search form with results showing approved amount and status

Supporting screens

Log in and password reset

A plain username and password login. Forgot password does not send staff to another page: the login screen itself confirms that a reset link is on its way to the email registered to their login ID, with an option to resend.

Forgot password screen — **Forgot password**

06 · Outcome

What changed once the answer left the insurance desk.

Daily active users

9,500+every day

Doctors, head nurses, counsellors, floor staff and hospital management: the people families ask, now able to answer.

BeforeOnly the insurance desk could see a claim

Client acquisition

↑33%more clients

The app is live on the Play Store and comes to hospitals as part of the IHX Nucleus Pro contract. Enterprise hospitals specifically want an app that keeps their doctors in the loop, so it helps win new clients and keep existing ones.

Driven byEnterprise hospital demand

Also moved: adoption improved on an Android launch, insurer queries get faster answers from the clinicians who hold them, discharge approvals turn around faster, and conversations with patients and their families are calmer.

Claim status was never only an insurance desk problem. It was a patient experience problem, and the fix was giving the answer to whoever the family asks.

IHX Nucleus Mobile · Android MVP, designed in 2 days, shipped in 3 weeks

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