How Artificial Intelligence is Helping UnitedHealthcare Enhance Member Experience

MACo’s Gold Corporate Partner UnitedHealthcare is utilizing Artificial Intelligence to improve member experience.


From UnitedHealthcare’s Website:

When Reymond Acosta answers the phone in a UnitedHealthcare call center, he’s ready to be a supportive resource. As an Advocate4Me representative, he works to answer members’ questions and clear up any confusion related to their health care.

In order to do this, advocates must gather and research personal information to verify the caller. This important step can add time to the call, which can delay how quickly advocates are able to answer questions for the member. But a new capability using artificial intelligence (AI) is working to streamline this process — for both the advocate and the member.

“Behind the scenes, AVA is pulling data in for each specific member that calls in,” said Stephen Packen, senior product analyst for digital marketing capability at UnitedHealthcare. “What’s excellent is that the agent is not having to navigate through multiple systems to pull the data, AVA is doing that for them.”

AVA supplies the advocates with answers to basic questions through a chat interface, which gives them what they need in seconds. The ease of finding information has allowed advocates to focus more on the member and less on digging through information – making the experience more conversational rather than transactional.

The transparent nature of software allows agents to go one step further, offering clear data that helps guide consumers to the care that’s right for them. If a member called to ask about where to go for care, AVA would bring up the different member specific benefits for that provider or site of service. In the future AVA will even make suggestions based on what we know about that member. The ease of finding this information gives Rey the time to ask additional questions, so he can help that member choose the best place for care, which may lead to cost savings.

“We want to help reach that member at significant points in their journey to make an impact both on the cost and the outcome of their healthcare.” said David Wietecki, director of digital capability at UnitedHealthcare. “In order to do so, we need the proper foundation innovation pieces in place to make that contact possible.”

For the full article, visit UnitedHealthcare’s website.

Thank you to Gold Corporate Partner UnitedHealthcare for co-sponsoring the Inaugural Banquet at MACo’s Winter Conference!

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