Artificial intelligence in supplementary healthcare can become your health plan operator's biggest competitive differentiator. Do you want to know what it is, what the real benefits are and how to implement it in your health plan provider? Check out this complete article on the subject:

Artificial intelligence (AI) has gained space in the management of companies in the healthcare sector and can have a positive impact on several departments in the area.

More and more digital tools are being developed to help organizations have a clear view of their operations, optimize processes, reduce operational costs, and even increase productivity and consequently improve results.

This is because technology continues to play new roles in our daily lives in different ways.

From robots that clean equipment and perform surgeries to applications that identify compatibility based on genes and/or interests, virtual solutions are everywhere – and the healthcare sector has been evolving more and more by implementing the new technologies available.

In today's article, we will see what artificial intelligence is, what its role is in business health management and what are the advantages of applying it to supplementary health.

Interesting, right? Continue reading to update yourself on this topic right now:

After all, what is Artificial Intelligence?

Artificial intelligence is a field of computing that aims to reproduce human tasks through algorithms.

The idea is that software can make decisions that mimic human intelligence through intelligent learning from data that is stored, processed and analyzed.

In practice, this means that a complete platform can encode and analyze large amounts of data quickly and efficiently.

In recent years, the use of intelligent systems became a major differentiator for the company.

New operating systems appear every day and point to different strategies to improve efficiency and productivity in the corporate world.

This is an excellent conclusion due to the construction of a large database and machines capable of processing complex analyzes with ever greater agility.

Therefore, artificial intelligence is currently used in different market areas.

In the health field, technology can help optimize the process from the simplest (such as administrative tasks) to the most complex (such as carrying out research, diagnoses and even precise surgeries).

How healthcare companies are adopting artificial intelligence

Investment in corporate health increases every day. Therefore, the need to adapt to the new era and therefore adopt digital solutions to improve health maintenance is also growing.

The Health On Demand study initiated by Mercer Marsh Benefits (MMB) demonstrates a strong business case for digital health.

In the survey, three-quarters of senior decision makers believe that promoting or sponsoring “e-health” solutions helps retain the most qualified employees.

For 63% of those interviewed, this will become increasingly important for employee engagement and motivation.

At the same time, 50% of people said that increased productivity will be a direct consequence and 46% of people believe that artificial intelligence will bring more security to the workplace.

Of the more than 210 million Brazilians, only 25% have access to private health services, which are generally financed mainly by companies.

When the company is unable to control the value provided by the operator when negotiating facilities and adjustments, this percentage tends to fall even further.

Therefore, the biggest difficulty in managing this situation is estimating these numbers and understanding whether the amount to be paid is fair, and assessing whether your employees are satisfied and the service is good.

The answer to this question seems simple: use a data culture to visualize all company indicators and employee health to ensure the company's continuous improvement.

What benefits does AI bring to health plan operators?

The application of artificial intelligence in the management of health plan operators is conducive to mapping and monitoring procedures, costs, service providers, materials, etc., mainly in the following aspects:

• Prevention;
• Providers’ work routine;
• The use of medical plans;
• Reduction of undue charges due to error, misuse or fraud;
• Optimization of Prior Authorizations with automated regulation rules;
• Reduction of OPME costs, with online requests and acquisitions;
• Reduces time and expenses with materials and medicines for hospitalizations, with on-site audit records, via tablet, online or offline;
• Reduction of structural costs and optimization of operational processes;
• 100% Paperless;
• Reduction of Operational Cost of Processing and Auditing Medical and Hospital Bills and Disallowance Resources;
• Among many others.

By obtaining information about these behaviors, in addition to mapping and monitoring the evolution of all these indicators, an internal health plan can also be created to guide and care for the health of the N lives present in the health operators' client portfolio.

The use of artificial intelligence in measures to ensure customer well-being also helps identify areas for improvement in overall health.

With this, the health plan operator begins to improve people's quality of life, reaping very significant results in the future, in the medium to long term.

The impact of AI is directly related to the growth and profitability of your health plan operator, especially when we consider other advantages provided by healthier and happier customers, such as:

• Reduces the risk of delays in responding to authorization requests, avoiding complaints from beneficiaries, through better control of the workflow, through the possibility of determining a response deadline for granting authorization or denial based on the TISS standard
• Reduces response time to requests, through online digital communication, supported by accurate information supporting real-time decisions
• Reduces operational costs of the Authorization Request process, completely or largely replacing call centers, paper, and emails, which make the process more bureaucratic and time-consuming.
• In addition to many other advantages!

How to implement Artificial Intelligence in supplementary health management

The first step to using artificial intelligence in the company's corporate health management plan is to determine the strategy's objectives.

In other words, for example, determine whether your organization's core pursuit is related to reducing absenteeism or reducing costs through employee furloughs.

So, your company must research which alternatives best meet these needs.

You can start this process step by step by choosing just one artificial intelligence technology solution and measuring its results before adding other solutions.

However, for this initiative to be effective, all employees in the organization must be involved so that leaders can accurately communicate this recommendation and encourage their teams to adopt the changes it entails.

It is also important to align with the right technology to manage population health.

The important thing is to choose a system that provides an effective way to gather all relevant data for analysis in one place. In this process, the SAUDI it has excellent modules that can be integrated or optimized to implement the objectives outlined in the best AI strategy to improve the results of your health plan operator.

Used by the largest operators such as insurance companies, cooperatives, self-management, group medicine and benefit administrators, which serve more than 6 million lives with more than 4.5 million transactions per month throughout Brazil, the software automates the process of audit of medical bills, enabling a clear vision for both sides (operators X service providers) and a significant reduction in unnecessary costs thanks to all the resources it has to control and manage care costs.

Only SAUDI offers intelligent elements and tools to formulate short, medium and long-term improvement interventions, depending on the objectives set, so that its directors and managers can learn more about the behavior of their lives! And the best part: ZERO implementation cost with noticeable overall results in the first 3 months of use!

Get in touch with our experts and find out why SAUDI is the most awarded medical bill audit system in Brazil and how our personalized solutions can make a BIG difference in your health plan provider! ; )