While most healthcare stakeholders are expecting AI to have a significant on the quality and efficiency of healthcare services, an increasing number are looking to the new technology to impact the health insurance market, too.

The big difference between providing healthcare and insuring healthcare, of course, is that while providers have an array of possible goals to achieve with AI, insurers largely focus on one: efficiency and the resulting cost savings.

To that end, a survey last year by Accenture “identified six areas where AI can make a difference in an insurer's operating model, and said the top three are in anticipating and resolving customer questions, improving the benefits loading and design process and accelerating prior authorization and clinical review of claims.”

In other words, operating more efficiently.

As another tech writer sees the possibilities, there are three primary benefits insurance companies can gain from AI. 

First up, he says, is greater data accuracy. “An AI platform that connects multiple healthcare databases can glean hidden insights, enabled by deep integrations between different interfaces. You could fetch data from public records, employer databases, and healthcare provider information and apply an intelligent algorithmic layer to process these streams. Using technologies like Natural Language Processing (NLP), the data can be analyzed in text formats to give meaningful insights. For healthcare insurance providers, this means more accurate patient profiles and seamless access across employer systems and clinics.”

A step further, in his eyes, is deeper customization. “In every sphere, AI engines are helping to customize recommendations in line with user patterns and preferences – think Google and Netflix. For health insurance as well, a recommendation engine could use machine learning to personalize the navigation process and suggest the right insurance options.”

Indeed, the Accenture survey found “that 37 percent of millennials decide to choose health plans simply because of the quality of service.”

Finally, there’s stringent fraud prevention. “AI can provide insurance companies a precise risk analysis, including predictions around possible losses. This would be based on patterns formed by correlating inaccurate billing trends, service under-utilization records, and anomalies in the database being leveraged.”

In short, as insurers look for new ways to ensure customer loyalty and save on costs, AI technology will likely be a primary driver for increasing visibility and predictability, resolving queries and disbursing claim amounts.