Anthem EDI Project


Electronic Data Interchange (EDI) with Anthem Health Insurance Provider

The current enrollment process needed to be improved and Word and Brown built an automated solution to submit enrollment data via EDI transaction.


Establish an entirely new process.

All transactions were collected and sent over to Anthem in PDF format. 8-pages paper forms (below) per each transaction were converted into PDF format manually.

The BRD document (below) illustrates the scope of the project.


System users

The primary system users are Word & Brown representatives serving operations with Anthem healthcare provider. We interviewed 4 users, documented their current working process, and discuss the opportunities to implement a new one. The goal was to optimize transaction delivery time and decrease amount the errors through the process.


We found that the most of the errors happened when the users search for the data in the different parts of the 8-pages paper form and then enter the data into the different parts of the electronic form. Pre-filled data based on the previous entries would simplify the process a lot.

We found very important for users to compare current data with any information they are entering. To set the experiment and get quantitative data, we exposed existing data on the left screen and allowed the users to use the right screen making the changes.

New system design


From the user perspective and workflow effectiveness, we worked on the errors handling and the reduction of the time needed to finish each transaction. But the most important part of our work was to implement business rules, reduce project scope, and collaborate productively with the development group.


We rearranged some part of the flow making them more convenient for the users. For instance, we put household information right after job information and coverage details (below). That contradicts with the data logic but reflects the way how the primary users read the paper form. During research stage, we found that inverted flow generates 30% fewer errors and keeps the overall workflow clear.


Below is the link to the front-end deliverable. The full-functional version is accessible for the internal Word & Brown users only.

My Role

  • Contextual inquiry

  • Prototyping

  • Interface design and implementation

  • Presentation to the client

© Egor Sovtsov