Garner Health Innovation, Technology & Agility

What project are you most excited to work on in 2025, and what is particularly compelling about this work for you?

We’re working on a project to show our members a full view of their medical claims in our app, both those that are approved for payment and those that aren’t. It’s one of the top-requested features from our members, and I’ve definitely felt the need for it myself as a Garner member.

What does the roadmap for this project look like? Who will you collaborate with, and what challenges will you need to overcome in the process?

This is a multi-quarter project that’s going to span a couple of different teams, but the real challenge is going to come from the medical claims data. When you interact with the American medical system, it generates a digital trail that loosely approximates what happened in reality. I say it “loosely approximates reality” because the purpose of a medical claim is to determine the flow of money that happens after the medical service, and piecing together the story of that visit isn’t always straightforward. 

For example, let’s say you visit your doctor for a checkup, and they prescribe you a blood pressure medication. Their office sends that script to your pharmacy, which will fill it and bill your insurance. Your life gets busy, and you forget to pick up your medication, so the pharmacy re-stocks it. From your perspective, nothing really happened beyond that initial visit, but there’s a flurry of claims activity behind the scenes: claims, adjustments and reversals. Representing all that activity in a way that makes sense to the patient is a hard problem to solve. We’re going to spend a lot of time with our product managers to figure this out.

What in your past projects, education or work history best prepares you to tackle this project? What do you hope to learn from this work to apply in the future?

My background is in fintech and e-commerce, where the digital paper trails are equally as complex. I once worked on a project in e-commerce where we crawled the web for product data but needed to preserve data provenance to prove to regulators that we weren’t violating European Union copyright laws: very much a case of reality from data that loosely approximates it.

Mostly, I want to learn more about how normal people understand medical claims and how to help them understand it better. It’s an opaque industry that obfuscates a lot of information in jargon, but at the end of the day, there are only two questions anyone cares about: “How much does this cost?” and “Who pays for it?” I hope we can meaningfully teach our members how to navigate both of these questions and make it easy for them to get answers.