When their doctor prescribes a new drug, test, or treatment, it is routine practice for US patients to call their insurance.
They’d need to know whether their insurance would cover it. It can take days to get that response, but it’s one of the data-heavy procedures that some healthcare organizations are now attempting to speed up with artificial intelligence.
Customer-service agents at the insurance company Humana have been using an AI-driven tool called Automation Co-Pilot by the tech platform Automation Anywhere to help with these types of questions, according to Yan Chow, the global healthcare leader at Automation Anywhere and a pediatrician at Kaiser Permanente for decades.
According to Chow, the agents interface with the technology via a dashboard with buttons that they may press to receive insurance and other information on the customer they’re chatting with.
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Data-Diving Customer Service
Customer service personnel at insurance companies often search databases for information such as how the patient is covered and if they need to undergo any further testing before the insurer will authorize funding a surgery, according to Chow.
He claims that the Automation Co-Pilot tool may assist agents in determining if a certain operation is covered for a patient in minutes. “The beauty of having automation do that is that there isn’t a lot of human decision-making,” Chow added. “It’s just fetching information.”
“Otherwise, the customer will probably get something like, ‘We’ll call you back; we’ll give you an answer within three days,'” he continued, “and that’s not what most people want to hear.”
Humana calculated that automating parts of its administrative operations saved 684,000 hours per year in time personnel spent dealing with documentation in a case study released in February.
Humana also stated that it pushed the automation process within the corporation as a digital worker named “Allie,” as previously reported by Forbes. Humana did not respond to this report.
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Source: Business Insider
