Authored by: Kevin Flanagan
As a healthcare payer, you’ve never been short on data; there’s plenty of it. But making that data usable and ready for artificial intelligence tools is an entirely different challenge.
At this year’s CommunityLIVE, where we explored new technologies and shared real stories about how payers are using them, one message stood out: progress isn’t always about adding more technology. Sometimes it’s about connecting the tools and data that already exist.
The event covered new innovation that helps payers modernize their technology without starting totally from scratch. We’ve pulled together a few common themes and how they can help you tackle the tricky challenges payers face every day.
Innovation That Makes Everyday Work Easier
While the larger keynote sessions offered plenty to learn, some of the most practical ideas came from side conversations and in breakout rooms. A number of those conversations focused on Jadu’s Agent-Ex. This technology is a conversational interface that helps users find and act on information using the natural language they’d use when asking a friend a question. For example, a member might ask, “What’s the process for appealing a denied claim?” or “How can I find my pending claims?”
When members can ask these types of questions, it keeps them out of your phone queues and strengthens self-service portals. They can ask questions and get clear, actionable answers without menu hopping or manually sorting through dozens of results to find what they actually need.
Reducing Time Spent on Routine Tasks
When we talked with payers, one technology that consistently sparked “lightbulb” moments was intelligent document processing (IDP) because of its incredible potential to save time.
Claims, provider documents, and member communications all depend on consistent classification and data extraction. Over time, these areas can pile up from small inefficiencies that slow teams down. It’s the classic death by a thousand paper cuts. When we talked with payers and explained exactly how IDP works, many were excited about it.
IDP automates much of the busywork that takes up your team’s time. It not only defines the fields on a form but also interprets the context. The technology goes beyond extracting keywords and metadata; it understands the actual details within a document to capture valuable context.
Making Answers Easy to Find for Everyone
Knowledge discovery was another big highlight at the event. On our team, we like to call it “full text search on steroids.” It takes the familiar idea of typing a phrase into a search box and makes it smarter. Instead of handing you a long list of documents to dig through, it gives you the answer right away and shows exactly where that information came from.
For payers managing thousands of records, this type of capability can save considerable research time. Whether the question involves content stored in a system like OnBase or information pulled through IDP, knowledge discovery helps users ask real questions and get clear, direct answers.
Agents Guiding Improved Workflows
Many payers are already starting to explore artificial intelligence, but during the event, we talked a lot about how the next wave of automation will come through agents. These digital assistants can help your team analyze, make recommendations, and sometimes even take action.
We saw how several agents can work together, almost like a mini workforce. One might interpret a records retention policy, while another applies that policy to existing content to suggest what should be archived or destroyed.
Agents also minimize errors in routine tasks and give your staff more time to focus on meaningful work that truly benefits members. And just to be clear, these teams aren’t replacing human experts. They’re here to support them, taking care of the repetitive work so your team can focus on the complicated cases that need their expertise and judgment.
Putting New Ideas to Work Back Home
As payers move into the future, the question often isn’t whether they should modernize their technologies but rather how to do it. During the event, we explored some of the most innovative and exciting ways other payers are doing that, as well as what’s coming next for the industry.
With many of the technologies we explored, the path forward became much clearer for payers who want to do more with what they already have, improve accuracy, and deliver a better experience for every member.
Do you want to learn how other payers are putting innovation into action? Check out our CommunityLIVE recap to hear how they’re making their work easier and more connected.