The integration of artificial intelligence (AI) tools and digital technology is driving changes in the healthcare industry including IPMI, according to Pacific Prime.
“These advancements have led to new opportunities to enhance the efficiency and effectiveness of health insurance processes,” Pacific Prime said in its report The State of Health Insurance 2023.
“By leveraging AI, including generative AI like ChatGPT, and related digital technologies, insurers can: streamline operations, enhance risk protection, improve disease identification, personalise coverage and deliver better solutions and services to customers,” Pacific Prime said.
That also applies to the IPMI industry.
Xavier Lestrade, CEO at Axa Global Healthcare, said: “We hear more and more every day how AI and machine learning are two parts of a booming tech industry.
“And although this technology isn’t new, we’re seeing more and more sectors using it.”
Lestrade continued: “In the IPMI industry, it’s possible for AI to decide whether some claims are valid within seconds, removing the need for an individual to read through each and every claim form and make a decision and giving the opportunity to both save costs.
“This leaves insurers with more time to focus on business growth and importantly, providing a more effective, tailored experience for customers.”
Pacific Prime noted that while ChatGPT is not designed for medical advice or examinations, it could be integrated into healthcare applications with user verification and could assist in drafting prior authorisation letters, insurance denial appeals, and other claims.
Meanwhile the use of AI in the healthcare market has been improving cost control as well.
David Myers, chief sales officer, health at Allianz Partners, said: “Over the past year, we’ve witnessed more use of both AI and technology internally to allow for more efficient servicing, claims assessment, and fraud detection – all resulting in better cost control.”
Neil Raymond, CEO and founder at Pacific Prime, added: “Although ChatGPT and AI tools have been around for a while now, the sheer power and potential of these tools have only recently come to light, and I’m eager to see how it will transform our industry.
“Technology not only has the potential to increase efficiency and streamline operations, but it can certainly be a force for social good such as through addressing health inequities that were worsened by the pandemic.
“Whether through telemedicine and other virtual health solutions, I firmly believe that technology in healthcare really is the solution in the post-pandemic world.”
