High volumes of patient requests connected to healthcare coverage and insurance are straining provider systems, which negatively impacts overall patient care and wellness.
The Amelia Integrated Platform works with providers and payers to help deliver excellent service, while relieving overburdened staff from repetitive, high-volume tasks.
Conversational AI
Amelia Conversational AI can provide real-time, personalized answers to patients’ questions regarding benefits coverage, procedure costs and more.
AIOps
When dealing with patient care and insurance, providers should never be hindered by IT issues and backlogged support queues. Amelia AIOps can help by optimizing IT operations with Intelligent Automation.
Orchestration Services
Intelligent automation embedded with strategic orchestration, connecting front-end Conversational AI capabilities with back-end AIOps.
Amelia: A Skilled Healthcare Payments Expert
Call centers in the health insurance industry are seeing an increase in call volume, and healthcare providers overall are looking for ways to scale patient experiences. Amelia can address these challenges and more.
As a complement to medical professionals and provider networks, Amelia with her Conversational AI capabilities can be truly transformative. In fact, the trend of patients accessing general information and services via AI-powered agents like Amelia is accelerating as more providers and patients turn to digital channels.
Through the end-to-end automation of the healthcare payments ecosystem with Amelia AIOps, patients can concentrate on their overall care plans, and providers can deliver more personalized and efficient services. Read more by clicking the tabs.
Spiraling costs, not only the cost of healthcare but in the administration of services, presents ongoing technical and clinical challenges. In various countries and regions, there are shortfalls in nurses, doctors and staff, sometimes severe, which impacts overall patient care when providers need to spend inordinate amounts of time on administrative duties.
Amelia can be deployed by health insurance providers to answer patients' benefits questions, detail procedure costs, and locate doctors and hospitals. She also processes member payments, issues claim information, and she can even notify patients of insurance authorization.
As health insurance provider staff spend time reviewing authorizations, claims, and dealing with billing challenges and questions, other tasks accumulate, which slows down the overall efficiency of the health insurance ecosystem.
Amelia is able to handle questions and tasks related to provider administration. She can serve as an intermediary between providers and insurance companies, and she can work with administrators to ensure that patients receive relevant and regular communications.
People need clear and immediate answers to questions about their health, especially during public health crises such as the current pandemic. Concerned patients overwhelming hotlines, packing hospitals and urgent care facilities, and inundating providers with emails is no way to provide information to the public.
Amelia can be trained to screen for common illnesses and conditions using Conversational AI. She can be up-and-running in a few days and follow strict screening guidelines.
For example, during the first weeks of the US coronavirus outbreak, Amelia was trained to screen for COVID-19. She asked users questions and delivered basic information, all of which was outlined and approved by the Centers for Disease Control. Her skills in this area can be applied to pre-screening for chronic conditions as well.
63% of research subjects agreed that AI and machine learning are already providing excellent value in specialty care departments like radiology, generic pharmacy, and pathology.
20%
AI and machine learning can help meet 20% of all clinical demands, reducing the number of unnecessary patient visits to the clinics.
75%
75% of healthcare professionals believe that automating tasks with AI will allow clinicians to spend more time with their patients.
25%
The average US nurse spends 25% of work time on regulatory and administrative activities.
$42 Billion
The Centers for Medicare and Medicaid Services (CMS) uses AI to engage in predictive analysis of fraudulent and improper healthcare payments. This process has saved the government approximately $42 billion, according to CMS.
Learn Why Amelia is a Leader Across Industries
In Everest Group’s recent report, Conversational AI – Technology Vendor Landscape with Products PEAK Matrix® Assessment 2021, Amelia is recognized as a Leader in Conversational AI. Among the leaders, Amelia was ranked highest by the analyst firm for both Vision & Capability, and Market Impact. In Everest Group’s assessment of the competitive landscape, Amelia is the only vendor to be listed amongst the largest players in all major business functions, geographies and industries by revenue —including banking, insurance, healthcare, and travel & logistics. Read the report to learn more.
Download the Analyst ReportEverest Group: Conversational AI - Technology Vendor Landscape with Products PEAK Matrix® Assessment 2021
Create Better Outcomes for Patients and Providers
Who is Amelia? She is a Digital Employee who works with humans to locate information and perform complex tasks with Conversational AI and AIOps. She uses state-of-the-art Natural Language Processing to work in collaboration with humans. However, there's more to Amelia than innovative technology; she speaks, interacts and understands the way humans do. She’s not confused by catchphrases, regional accents or speech patterns. All of this adds up to a more human experience — an experience that patients, providers or anyone involved in healthcare will prefer over time-consuming 800-numbers, generic service emails and scripted simple chatbots.
Interested in meeting Amelia? We would be glad to arrange an introduction.