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Virtually Speaking

Intelligent Virtual Assistants for Payers

Posted by Leslie Shamion on Nov 10, 2017 12:57:46 PM


Top Five Questions From Health Plans Answered

Artificial intelligence (AI) is transforming businesses across industries and continents, allowing those who invest in the technology to leverage data, automate processes and gain or sustain a highly-coveted competitive advantage. The health insurance industry is no exception and payers who utilize AI technology like intelligent virtual assistants to engage consumers will continue to widen the gap between those who have and haven’t.

If you’re interested in getting started with a conversational AI solution but don’t know where to begin, we’ve got you covered. Here are answers to the top five questions we receive from healthcare payer organizations.

1) What is an intelligent virtual assistant?

An intelligent virtual assistant is an automated self-service solution that emulates human interaction to perform particular tasks like answering questions, providing instructions, website navigation or making recommendations based on customer account information. Intelligent virtual assistants encompass aspects of artificial intelligence like machine learning, natural language understanding and logistic regression which enables the technology to learn, reason, improve and understand – much like a human.

2) How are payers using intelligent virtual assistants?

As competition among health plans heats up and advancements in digital technologies raise customer expectations, payers are looking to AI-powered intelligent virtual assistant technology to compete and differentiate themselves as a leader in member care and retention. By utilizing intelligent virtual assistants on their digital channels, payers offer a concierge-like experience to each and every consumer.

Here are a few ways payers are using intelligent virtual assistants to personalize the digital experience for their members:

  • Referencing member account information like plan type, benefits, claims, etc., the IVA can provide personalized responses, specific to each member’s account, rather than a one-size-fits-all response
  • Providing a warm welcome message to potential or new members
  • Guiding new members through enrollment processes
  • Providing member education
  • Encouraging health assessments
  • Informing members about eligibility and coverage
  • Simplifying form and procedure interactions
  • Helping members navigate benefits and claims
  • Collection and payment assistance
  • Detecting member mood and service satisfaction
  • Providing cost-of-service estimates and comparisons
  • Pharmacy assistance and shipment tracking
  • Alerting members of account specific activities that require action
  • Locating in-network providers and more

In addition to consumer-facing intelligent virtual assistants, payers are also using the technology within their organization to help educate staff, improve the speed of service as well as increase accuracy and efficiency.

3) Due to strict security protocols, can the IVA solution be hosted on my company’s premises?

Yes, Next IT offers hosted, cloud and on-premises solutions to accommodate client requirements.  With over 15 years of proven experience working with a number of Global 5000 organizations, here are some other highlights of our member service solution:

The world’s largest industry-focused data library

  • 160,000 unique member service vocabulary terms
  • More than 1,600 concepts
  • Over 400 business intents
  • 56 plugins and counting
  • Reporting and analytics suite

4) What are some of the business results IVAs have achieved?

  • Over 60% reduction in average handle time with claims processing
  • 83% decrease in live-chat volume
  • 50% less time spent completing a task with IVA (vs. live chat agent)
  • 44% cost reduction in the first year
  • Saved over $1 million with reduction of internal “how to” calls
  • Averages over 46,000 questions per day
  • Saves consumers as much as $170 in out-of-pocket costs on more than 30 commonly selected healthcare services

Just to mention a few.

5) How do I get started?

Instead of trying to boil the ocean with AI, we recommend taking a simple, iterative approach.

Start by downloading, Intelligent Virtual Assistants for Payers, for the full guide.



Topics: Conversational AI, Artificial Intelligence (AI), Business, User Experience, Technology