DENVER, CO – November 03, 2016
Welltok, the leading consumer health enterprise SaaS company, has created a way for members to more efficiently navigate benefits with a “Virtual Benefits Agent” during open enrollment season, and year-round. Leveraging cutting-edge artificial intelligence technologies, including machine learning and IBM Watson, Welltok’s Applied Cognitive Computing Practice has developed an innovative solution that addresses the majority of health coverage and preventative care questions before they reach a customer service representative, presenting health plans with the potential to save millions of dollars.
The Virtual Benefits Agent was created by Welltok’s Applied Cognitive Computing Practice, which applies proprietary technologies, IBM Watson and expertise to solve complex healthcare challenges. Recently, the team worked with a major national health plan, building on an existing framework and leveraging available content, to expedite development of the Virtual Benefits Agent capability. The plan, which handles upwards of 30 million member calls annually, sought to reduce the high-cost, high-touch model of service centers. By potentially reducing 5-10 percent of call volume, Welltok can deliver an estimated 10x return on investment.
The Virtual Benefits Agent feature responds to personalized questions such as “what is my current deductible?” or “what services are free to me?” in seconds, and also predicts future questions. The technology may be deployed on health plan portals and mobile applications, enabling 24/7 dialog with members and virtual conversations on more complex topics. By providing members with an intelligent, self-service solution, health plans now have the opportunity to improve consumer satisfaction by guiding them to appropriate and more cost-effective benefits.
Additional use cases of the Virtual Benefits Agent for health plans, as well as large self-insured employers, include:
• Prompting the individual to learn about anticipated costs or provide additional information
• Understanding an individual’s needs and providing the call representative with context for a more efficient conversation
• Predicting additional needs or interests for an individual, and guiding them towards cost-effective benefits usage
“We are just starting to discover the countless ways we can apply cognitive computing to healthcare,” said Ryan Pellet, senior vice president of consulting and services for Welltok. “We are excited to have addressed a costly and cumbersome issue with our proprietary technology and IBM Watson, and will continue to explore opportunities to simplify the consumer’s experience and drive new, more effective ways to engage with and satisfy them.”
For a demonstration of the Virtual Benefits Agent feature or to learn more about Welltok’s Applied Cognitive Computing Practice, please contact: optimizedhealth@Welltok.com
November 3, 2016