BATON ROUGE – Somesh Nigam, Ph.D., Blue Cross senior vice president and chief analytics and data officer, and Gina Laird, Blue Cross senior vice president of Benefit Operations, presented the innovative ways Blue Cross is using artificial intelligence (AI) to provide outstanding service last week at the America’s Health Insurance Plans (AHIP) forum in Chicago.
AI allows Blue Cross to harness the massive amounts of claims and other data it has available from members, providers, caregivers and others to design interventions or confirm new ways of doing things. Using data to improve member programs and services and show what’s working well has helped Blue Cross deliver better care and experiences for members. Blue Cross is also using data insights to partner with network providers in boosting health outcomes for patients. Developing these targeted interventions allow Blue Cross staff to fulfill their mission to improve the health and lives of Louisianians.
Using integrated data with machine learning and natural language processing, for example, enables Blue Cross customer service advisers to proactively reach out to members. Members often see this as outstanding service compared to calling in and waiting to speak to someone.
In their talk, “Enhancing Customer Service with AI, Natural Language Processing,” Nigam and Laird describe how their teams pinpoint issues and reach out to members before they might have a complaint. Blue Cross identifies and connects those members with the information or resources they need to resolve issues.
“Members reach out to us often at the most vulnerable moments in their lives,” Nigam said. “This collaboration shows that providing AI-driven and timely interventions for members can enhance care coordination and enrich their experience, as well as decrease complaints.”
