Depending on the type of insurance used, the claim for the payment can sometimes take a long time. Recognizing that this is an issue that plagues many people, Prudential has announced a collaboration with Google Cloud to introduce an AI technology that improves the accuracy and efficiency of medical insurance claims decisions.
Prudential is one of the first insurance providers in the world to use MedLM – one of Google's family of AI models optimized for use by the healthcare industry and healthcare organizations to develop solutions for doctors, hospitals, and other medical providers in an effort to improve the experience of healthcare workers and patients.
Starting in Malaysia and Singapore, Prudential will use MedLM to analyze documents accompanying health insurance claims such as diagnostic reports, prescriptions, and even invoices. This is because for Prudential, these two markets are the markets with the best customer scale for them to test the effectiveness of using AI technology in this insurance claims automation process.
MedLM supports the human decision-making process with its ability to extract relevant information from issued reports, and code them accurately for insurance claims purposes, helping to reduce the potential for errors due to manual data entry, so that claims can be processed more quickly and accurately.
This announcement follows several proof-of-concept tests by Prudential that showed that the use of MedLM has accelerated the claims review and evaluation process, as well as improved the accuracy of claims decisions. This allows insurance companies to deal with large claims volumes quickly and accurately, and this is seen to have improved the overall customer experience.
Prudential will implement MedLM for selected medical insurance claims in Singapore and Malaysia in the next 3-4 months. They will then compare the AI's analysis and recommendations with actual results using the current approval process.
This move will help Prudential identify the areas where MedLM can provide the greatest productivity gains and the most useful recommendations to claims assessors, while maintaining the “human element” at critical levels of the decision-making process.