It's Just Not Working: Delta Dental Edition
I've been writing for a long time. I've been complaining about tech for even longer.
I always thought it might be interesting to create a series of posts that discussed things that "just don't work" and why that might be as it relates to the complexities of technology and software integration (my old field of work).
It's the complexity of the business process coupled with the complexity of the technology, particularly as it pertains to moving information between systems that drives most of these failures.
I remember when I broke Geico's systems after Hurricane Sandy destroyed my car (this was a claim notification flow bug).
I just tried buying something online on my iPad this morning and ended up having to go to my laptop to make the purchase because it just wasn't working on the iPad version of Safari (this is an e-commerce checkout flow bug).
I also tried to login to the kids' pediatrician's portal to schedule a visit. It was down. (A database connection bug, but more likely a problem with a lack of monitoring to know when the site is available).
And, if you've been anywhere within 5 miles of me over the last school year you've certainly heard me screaming about Google Classroom* (this, as I'll mention below too, is a lack of family persona systems design bug).
Today, I'm compelled to tell this story about Delta Dental. For those of you outside of America, Delta Dental is a dental insurance company.
Before anything happens the login-flow is broken
It starts with logging into their site. The login flow is:
- Get a message that thanks me for logging out
- Login a second time
So, that always puts me in a good mood when dealing with them.
But, then I see that I can't access my information (it's greyed out).
The concept of a "family persona" is beyond their ken
You see, my wife is the primary person on the insurance policy. And Delta Dental says that because I'm an adult, HIPPA prevents them from showing my health information to my wife.
Right by my greyed out information there's a help pop-up that explains what's going on, and says I need to sign a piece of paper to give my wife access to my information.
I humored them (technically it was a "transfer of humor" because I was annoyed to do it) and sent it in. In fact, I got a letter in the mail dated October 5th saying that my wife has access to my claim information.
What's with all the paper? But, I digress. (TLDR; The friction is a feature not a bug. The more they prevent you from using your insurance, the better off they are.)
Notice today's date. It's 11/3, almost a month after that letter, and I finally made the time to call support because my information still wasn't available.
My name was still greyed out on the landing page I reach right after logging in.
30 mintues later (25 minutes of that was being on hold!) it turns out that the information was available it was just poor web design / implementation.
Broken information architecture
From the landing page where it appears to summarize all of our information and gives me direct links to things like "claims and visits" (where my information was NOT showing up)... that's not the "claims and visits" page I needed to visit.
Talking to support, I'm apparently supposed to click on the top of the page where it says "my account".
Of course, it can't be that easy. When I click "my account" it logs me out.
After logging back in, and then again clicking "my account" it takes me to a new page that looks completely different from the landing page. In fact, this looks more like the terrible enterprise software I'm used to... so I suspect I'm getting closer.
From that (ugly) page there's now another set of menus where I can click on "claims" or "benefits". Both of these now correctly show my information.
But wait, there's more!
There's no way to get back from here to the langing page, except to logout and log back in.
Which I do while I'm on the phone with support.
Once I've accessed my information on the ugly part of the site, when I logout and log back in... the landing page properly displays my information!
I've spent the last month checking every few days, when all I needed to do was find the ugly part of the site, access my information, then logout and log back in to get to the landing page to see my stuff.
The real cost of complexity
I certainly didn't need to spend 30 minutes on the phone with the recording telling me how they were experienceing unusually high call volume. There's a real cost to Delta Dental for this mistake represented by my time on hold, their time holding me, the unnecessary support call, all the people that couldn't get through because I was trying to resolve this dumb issue, and my wife's HR department who I had to get involved because I was trying to avoid calling.
One last point
I went to the dentist for a regular cleaning about a month ago.
When I got there, they "confirmed" my address and email. Both were wrong.
When I gave them the correct info, they said they couldn't update it. Turns out, I couldn't update it either.
Only my wife's HR department could have it updated! (WHAT?! You mean, my busy working wife and her HR department dealing with covid and return to office are the only ones who could change an email address from 5 years ago – how did they even get that email address?!?)
So, I refused to have the appointment. If they have the wrong info for me, I was afraid insurance wouldn't cover the visit and I didn't want to be responsible for the cost when it's supposed to be free (it was just a cleaning/checkup).
Instead, I had to disrupt my wife's workday. Ask her to bother HR. And I had to do it twice because it was only partially fixed the first time they reached out to Delta Dental.
Summary and final questions
So, I have a new dentist.
After bugging my wife and her HR department, I have correct information (11 months into the year, when in another month, things can change again!)
I've figured out their silly** website and can see my information.
And, it's all because of the complexity of integration and the tightly controlled back-end insurance management systems. Improving the patient experience is going to be really challenging until the companies that control those systems (I doubt a company as small as Delta Dental would write their own) enable proper APIs and open those systems up to innovation. But that scares them, because vendors with "old school business models" lose power over their customers when they give up control.
Delta Dental put a modern looking front end web page in front of the ugly stuff so they can feel good about being up to date (look, it's responsive!) and probably to solve the problem of the main back-end being closed when they want to do more.
In reality the end-user complexity is frustrating and I don't see how anyone likes these companies as a result. Digital transformation is about improving people's experience with technology, yet companies still release shit software like Delta Dental's customer portal.
A few final questions:
Why is it only Delta Dental that does this with sharing family information? Neither Cigna, Aetna, Blue Cross, nor any of my prior dental or eye insurance companies have ever done this.
Why can't they figure out how to create a family persona? (that link is from a post I wrote seven years ago asking for this!)
Don't they use these systems themselves? Could I really be the only person who has to login twice each time I want to login? Could I really be the only spouse that's not also the primary insured that does the paperwork in a family?
Does the team that's build the nice looking landing page work with the back-end team? Fidelity has done this same thing. Their 401K system is clearly not modern, and not being modernized. It's probably very difficult to get information into- and out-of. There's a front end that's pretty (and that implements some of their newer features nicely)... but as soon as you go deeper than the main landing page to manage your 401K you're back at an ugly web interface to (what appears to be) a mainframe backend.
On that last point, interestingly, Fidelity have the same "thank you for logging out after logging in the first time" problem. And have had for years.
Am I really the only one?
* The kids' new school uses the Altitude Learning platform and it understands that kids are part of a family with multiple parents.
** 'Silly' is a euphamism for 'dumb'.