Humana Medicare Claims Phone Number – Humana, a leading health insurance provider, has reduced costly pre-service calls and improved the provider experience with conversational AI.
One of the largest insurance providers in the United States, Humana offers Medicare Supplements, health insurance, dental insurance, vision insurance and pharmacy insurance to more than 13 million customers nationwide.
Table of Contents
- Humana Medicare Claims Phone Number
- Why Top Analysts Say Buy Stocks Like Qualcomm & Humana
- Humana’s Alleged Use Of Ai To Deny Claims Draws Class Action
- Humana Cuts Profit Projections As Medicare Advantage Costs Soar
- An Insurer’s Transformation: Humana’s Evolution Into Medicare Powerhouse Offers Strong Lure To Aetna
- Lessons From Vivek Garg, Chief Medical Officer Of Humana, On The Future Of Primary Care And Selling To Medicare Plans
Humana Medicare Claims Phone Number
To differentiate themselves in a complex and highly competitive space, healthcare and insurance companies must constantly innovate to improve customer service and retention. Customers expect quick and accurate answers to their questions wherever and whenever they want. Gradually, service providers are forced to rethink their service offerings to meet customer expectations.
Why Top Analysts Say Buy Stocks Like Qualcomm & Humana
Humana’s interactive voice response (IVR) system diverts too many calls to human agents, at a huge cost to the company and customer satisfaction numbers. Administrative staff members from health care providers contact Humana by phone to inquire about Humana member health plan benefits and eligibility. Humana receives more than one million provider calls each month, and most callers do not return to the IVR system to be directed to external call centers, which Humana pays per call. More than 60% of these calls involved typical, specific pre-service questions with concrete answers.
In order to keep up with ever-increasing customer expectations, Humana needed a way to completely rethink the way it approached customer questions. Humana’s Provider Services Innovation (PSI) team was tasked with finding a solution that could better address these costly pre-service calls and improve the provider experience.
This is not the kind of technology you install and go. It needs to be tracked, trained and monitored to benefit from the real insights that can be gained.
Conversational assistants weren’t as widespread or advanced as they are now when Humana began this journey in 2016, but the company recognized the great promise of AI in customer care. Humana chose to work with Watson®, an industry leader in artificial intelligence for businesses, and began a partnership.
Humana’s Alleged Use Of Ai To Deny Claims Draws Class Action
Data and AI Expert Labs & Learning (DAELL). After a three-month proof of concept (POC), Humana began developing what became Voice Chat Services with Watson. The solution runs multiple Watson applications in one chat assistant, on the Cloud®, and watsonx™ Voice Assistant runs inside Humana.
Humana Voice Agent with Watson provides a faster, friendlier and more consistent way for administrative staff in healthcare providers to access priority service, medical authorization, verification, authorization and referral information without having to speak to a live agent. The solution relies on artificial intelligence to understand the intent of the provider’s call, verify that they are authorized to access system and member information, and then determine how best to provide the requested information.
The voice assistant uses significant speech customization with seven language models and two acoustic models, each targeting a specific type of user input collected by Humana. During speech recognition training, the solution achieves an average error rate accuracy of 90%–95% on significant data input. The implementation handles a number of sub-intents within the main groups of Entitlements, Benefits, Claims, Permits and Travel, enabling Humana to quickly answer questions that otherwise could not be answered. In the previous IVR system, a request for “benefits” could result in a seven-page fax. Now, Watson’s solution can respond with a specific “points” benefit, for example, “$100 off chiropractor visits.”
Blind: We didn’t tell the presenters that they were going to be in a new environment, because I wanted to understand their reactions, so that we could change and continue to develop Watson and observe.
Humana Cuts Profit Projections As Medicare Advantage Costs Soar
The live healthcare provider calling solution launched in April 2019, with several updates throughout the year to expand functionality and user base. It could process inquiries at about a third of the cost of the current system, and it had a higher overall response rate—almost double that of the previous automated IVR system.
During development, the Watson Expert Services team enhanced Watson services with customized training and models that can better understand healthcare terminology in a low-bandwidth call center environment. This has led to the filing of numerous patents pending, and the team has published tools, instructions, and methods for building, testing, and configuring a large Watson Voice Assistant solution. The Humana Voice Assistant solution was recently officially prototyped by offering Watsonx Voice Communication solutions.
“Humana’s voice agent has greatly improved self-service capabilities for Humana healthcare providers, enabling them to quickly obtain patient insurance information across a variety of different data points. Providers can now call the Watson-based solution and complete an inquiry within two minutes without waiting for a representative to call” We have a level of insight into these conversations that we’ve never seen before,” says Sara Hines, director of customer experience and engagement at Humana.
The solution receives more than 7,000 voice calls from 120 service providers every working day, and user feedback is overwhelmingly positive. “The Humana with Watson initiative has been three years in development and is still growing after implementation,” says Hines. “This is exactly how Humana is enhancing our provider experience, and I’m excited to explore the endless possibilities of artificial intelligence.”
An Insurer’s Transformation: Humana’s Evolution Into Medicare Powerhouse Offers Strong Lure To Aetna
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Lessons From Vivek Garg, Chief Medical Officer Of Humana, On The Future Of Primary Care And Selling To Medicare Plans
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