6 Ways AI Can Streamline Your Medicare Insurance Business

AI automation can save insurance agents time and resources, allowing you to focus on the most pressing concerns of your clients.
1 Jun 2023

6 Ways AI Can Streamline Your Medicare Insurance Business

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Artificial intelligence (AI) has been increasingly present in the news cycle latelyfrom ChatGPT to the Hollywood writers’ strike. We’re seeing new developments in technology and concern about new applications in a wide variety of industries. 

AI has applications for just about any business, and selling insurance is no exception. Automating processes saves time, reduces human error, and streamlines the customer experience. But because Medicare directly relates to your clients’ access to health care, staying conscientious and ethical while incorporating AI into your business is essential. 

We’ll walk you through some of the most effective ways you can use AI to improve your insurance sales workflow. 

What is AI automation? 

Before diving into the applications of AI automation in the insurance industrywhat exactly is AI automation? AI is software with problem-solving capabilities and the capacity to learn new information to improve its processes over time. Facial recognition software can sometimes be considered AI (because it uses its library of faces to become better at recognizing them), while a basic number-processing program is not AI (because it is not improving over time).

The three primary components of AI automation are

  • Analyzing data. AI can analyze large amounts of structured and unstructured data, letting you form a knowledge base about your clients and their needs. 
  • Workflow automation. AI streamlines workflows and improves interactions between employees and customers.
  • Automating back-office tasks. AI can complete data extraction and similar routine tasks.

With an understanding of these basic elements of AI automation, we can now dive into how you can use AI for your insurance business.

Automating routine tasks 

Many tasks agents must complete to run a successful insurance business are expert-level. But there is also a fair amount of repetitive, clear-cut work. Data entry is a crucial part of the insurance process but often takes more time than skill. 

When these tasks are outsourced to AI, your time and attention become more available for the parts of your job where a human touch is necessary. AI programs can complete data entry tasks faster than humans and are even able to read and compare data across incompatible systems. Since insurance agents often have to track data across systems that won’t communicate with each other, this saves you incredible amounts of time. 

Also consider automating other routine tasks, like sending out reminders for upcoming events, policy creations, and organizing lists of new leads. 

Customer service 

Face time with your clients is essential. But as anyone who has manned a phone line knows, not every question needs an expert to answer. Think of AI not as a replacement for direct communication, but as a first line of defense. AI screens out the easy, standard questions, leaving you with more time to address the more complex or nuanced cases. 

AI-powered chatbots are used more and more by businesses to give website visitors an interface to ask questions and get answers. Often, a chatbot will be offered in a pop-up window on the website’s home screen. Visitors then ask questions directly without having to navigate through your website. This immediate engagement sparks your leads’ curiosity and ensures they get the answers they’re looking for. 

Finding new leads

All businesses need to expand by bringing in new clients. Identifying leads and pursuing them is a skill in itself. Finding time to expand your client roster can be nearly impossible amid the mountain of other tasks you need to finish.

AI sorts through large amounts of abstract data from a variety of sources, it is a great tool for lead generation. Use this technology to find groups and individuals who might be potential clients based on their online behavior and social media presence. From there, an AI chatbot on your website can assist in qualifying your new leads. Just be sure to follow up with a personal touch!

Fraud detection 

Insurance fraud is a very serious issue. When dealing with claims, you constantly work to ensure you’re not processing fraudulent information. 

AI combats fraud by finding patterns across huge amounts of data that humans simply can’t process. Many fraudulent claims use similar imagery or are submitted multiple times. So AI is naturally able to identify these trends based on its previous exposure.

Of course, it’s possible scammers will learn what AI is picking up on and shift their strategy to be more evasive. More types of fraud will arise over time, further increasing the tension between potential scammers and the insurance industry. But with AI on your side, you’ll be more prepared to spot these scams. 

AI for the insurance industry

Assisting with claims

While not affecting you directly, staying informed on how AI is being applied to other steps in the insurance process can benefit you and your clients.

AI is already being used in some cases to assist with insurance claims. AI cuts down claim processing time by scanning messages, creating metadata indexes, and directing each claim into the correct queue. This automated workflow is intended to address the highest-priority claims right away. 

AI also excels at tracking errors, verifying information, and collecting data across sources. This technology can also be used to automate the scheduling process for claims, as well as disbursements. 

Risk assessment 

Insurance is all about managing risk. The policies you sell are in place to provide coverage when something goes wrong. So, knowing how likely it is for that “something” to occur is fundamental. 

Right now, AI is primarily an aid for liability insurance, when an insurer may want to use past reviews to assess the likelihood of an eventual lawsuit. However, there may be future applications for health insurance, including Medicare. Compiling qualitative data and texts can shed new light on a client’s situation.

That’s because risk assessment is usually based on factors provided by the client. But clients may give inaccurate reports (hopefully, accidentally), which is why digging deeper into additional sources of information creates more reliable risk assessments. 

With the aid of machine learning, insurers have access to a wider variety of information. Rather than just plugging quantitative variables into a database, machine learning also pulls data out of qualitative texts. Social media posts, reviews, and online commentary can now be part of the risk assessment process. 

Potential benefits of AI automation

We’ve now seen the myriad of ways AI automation saves time so you can focus on the tasks you can’t automate. By offloading some of the more routine tasks to an AI system, you’ll have more time for the issues truly requiring your expertise. 

Your increased availability is also a benefit for your clients. While beneficiaries may have initial contact with a chatbot to answer any of their basic questions, in the long run, they do end up with more attentive agents for their complex questions. 

Moving forward with AI 

Are you wondering how other agents are working with AI, or how you might incorporate AI into your insurance business? Contact Financial Grade to stay up-to-date on key issues affecting the insurance industry.


image credit: shutterstock/Tero Vesalainen