Booking an appointment with a provider often means confirming they’re in network, working through an automated phone menu and trading available times with a receptionist. But for some UnitedHealthcare and Aetna members, an AI agent is now handling that work.…
Virtual Care
A Clover Health July data breach affected 138,677 people, according to a notice filed with HHS’ Office for Civil Rights. Clover flagged the incident to the Securities and Exchange Commission on July 17 after first learning of unauthorized activity on…
Highmark has been considering its next era of AI-driven member engagement, putting a spotlight on what members may say in passing. Emily Iacolo is Highmark’s vice president of customer data, insights and guidance product management. She told Becker’s that the…
Blue Shield of California is expanding its virtual care program, Virtual Blue, in January 2027, with total enrollment in plans containing the benefit to increase from 150,000 to more than 410,000 members. This boost includes 200,000 mid-size employer PPO members…
CMS’ interoperability rule will require many insurers to have application programming interface capabilities by Jan. 1, 2027. The clock is ticking, but some health plans are ahead of the curve. CMS is seeking patient access, provider access, provider directory, payer-to-payer…
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In 2026, Aetna offers the best digital experience among major insurers on both desktop and mobile, according to new research from Corporate Insight shared with Becker’s. Corporate Insight’s “2026 Commercial Health Plan Experience Benchmark,” published Aug. 5, evaluated 24 commercial…
Members may not think they are talking to AI when they call their health plan, but the person assisting them might be. Some insurers have been leaning into member-facing AI capabilities. One of UnitedHealth Group’s 1,000 AI use cases has…
The No Surprises Act, passed in 2020 and implemented in 2022, was designed to protect patients from unexpected out-of-network medical bills. It also established the federal independent dispute resolution (IDR) process, allowing out-of-network providers and health plans to resolve payment…
Stellarus, a healthcare technology company born out of a Blue Shield of California restructuring, is rolling out its AI-powered Customer Service Representative Chat for health plan customer service representatives. According to a July 30 news release, CSR Chat is Stellarus’…
Cigna Healthcare estimates $200 million in medical cost reductions over three years by enhancing its care management programs with expanded AI-enabled capabilities. In a July 23 news release, the insurer aims to reach roughly 20% more customers with complex or…