Users Don’t Read? They Don’t Listen, Either!

The company I work for, Availity, LLC, provides (among other things) a web application that allows healthcare providers to submit transactions to insurance companies and get responses, all in real time. Users learn just one user interface (ours), submit the transaction to us, and we do the dirty work of routing the transaction to the insurance company, receiving the response, validating it according to HIPAA guidelines, and displaying the response back to the user.

One of the transactions that providers can submit through us is called an Eligibility and Benefits Inquiry, which determines whether the patient is indeed covered by insurance, what their copay is, what their deductible is and how close they are to meeting it, and what other benefits they have. Traditionally, providers have called the insurance companies to gather this information, but through our portal they get this information faster, more accurately, and more completely. When a patient walks up, providers can type the patients’ information into our screen or swipe their insurance card through a card reader, and presto! The Eligibility and Benefits information appears, and the providers know how much money to collect up front from the patients.

I told you all that to tell you this. Last Saturday, we were releasing new software (“we” meaning Availity — I wasn’t involved with this release). We haven’t yet moved to an active-active datacenter scenario, so when we release software we typically notify the users that we’ll be performing system maintenance, we take down the systems, upgrade them, run our tests, and bring the systems back up. While the systems are down, any attempts to hit our login page show a generic, “Sorry, we’re performing system maintenance” screen. Our release for last Saturday was scheduled to run 9:00 AM – noon (we usually perform upgrades on Saturday nights — I’m not sure why this one happened Saturday morning), so the notice that went out to users said we’d be down on Saturday from 9:00 AM – noon. On Friday, though, I saw an email that they decided to start the upgrade at 7:00 AM so they could have the web application up by 8:00 AM (the upgrade involved other systems as well).

Saturday morning, I went to a clinic to get my elbow X-rayed — I’ve had intermittent pain since I banged it against the floor in a basketball game a month ago, and it’s very sensitive to the touch. When I went to the reception desk to settle up, they said Availity was down. It was about 9:00 AM, so I was surprised that the web portion was still unavailable. I tried bringing up the Availity application on my iPhone, and the login screen appeared. This meant that the web application was up and running, so I tried logging in, and that worked, too. I explained to the person at the front desk that Availity wasn’t down and showed her my iPhone as proof. The eavesdropper working next to her said Availity was down from 9:00 AM to noon for system maintenance. I explained that I worked for Availity, and that the maintenance (as far as they were concerned) was complete, and they could use the Availity services to pull my Eligibility and Benefits information. The person helping me tried to log in, and the system told her that the password she’d entered was incorrect. She said, “See? Availity is down!”

I was part of the project that replaced the security system that went to Production about a month ago (two days before I hurt my elbow, in fact), so I’m particularly sensitive to login issues. I explained that Availity wasn’t down, that the fact that it could tell her that her password was wrong was evidence that Availity was running, and that she obviously had mistyped her password. She tried again, got the same error message, and said, “See? It’s down!”

During this exchange, the eavesdropper kept bleating, “Availity is down today from 9:00 to noon!” I’m shocked and a little grateful that she’d read and memorized the notice, but here I was not only superseding the message, but also promising to make her morning less difficult. I tried again to tell the person helping me that she evidently had the wrong password, and that she should use the sleek, wonderful “I forgot my password” function to reset her password and get into the system. She kept insisting that her password was right and that Availity was down.

My need to win arguments has fallen dramatically over my life (whether from age, marriage, or parenthood), so I smiled, told them my deductible was met (which it is — one of the benefits of having five children) and I have no copay (which I don’t) and they let me go. I’m not sure how well they coped with the rest of their morning without running any Eligibility and Benefits Inquiries, and I wonder if the one woman ever got her password reset or if she’ll keep typing in the wrong one until the system locks her out. Most of all, though, I wonder: Why don’t users listen?