Prudential partners Google Cloud to use Generative AI in healthcare insurance

Prudential will use Google’s MedLM family of language models to simplify and summarize claim-related documents, including medical reports and invoices, for quicker approvals and pay-outs

AI in healthcare continues to see innovations revolutionize the industry. Around the world, more healthcare facilities are investing in generative AI solutions not only to improve their service but also take off some of the mundane tasks that healthcare officials deal with.

For patients, healthcare does not only begin and end with a visit to a medical facility. For most patients, the healthcare experience begins when they start communicating with their health insurance providers about which hospital or medical facility they can go to. This includes setting the appointment and also understanding the payment and claim process for their health issues.

Most patients normally rely on their insurance agents to sort this out for them. However, the process can be rather time-consuming, especially with insurance agents having to deal with multiple clients. To deal with this, insurance service providers are also implementing generative AI into their products, or specifically their medical booking apps to help patients have a more seamless experience.

Prudential has become one of the first insurance providers in the world to use MedLM to help its customers simplify their healthcare experience. Prudential has partnered with Google Cloud to use MedLM, Google’s family of foundation models that have been fine-tuned for healthcare industry use cases.

Currently, MedLM is used by healthcare organizations to build solutions for doctors, hospitals, and other medical providers to deliver better experiences for healthcare workers and patients. Prudential will be applying MedLM to its healthcare app to improve the accuracy and efficiency of medical insurance claim decisions.

Already implemented in Singapore and Malaysia, Prudential’s use of MedLM includes analyzing documents submitted alongside health insurance claims, such as diagnostic reports, prescriptions and invoices. MedLM supports human decision-making with its ability to extract relevant information and code it accurately for claims, helping to reduce the potential for errors caused by manual data entry, so claims can be processed faster and more accurately.

Following several proof-of-concept tests by Prudential, the use of MedLM doubled the automation rate of claim reviews and assessments. Apart from that, it has also improved the accuracy of claims decisions – allowing the insurer to handle a higher volume and velocity of claims while improving overall customer experience.

According to Arjan Toor, CEO of Health at Prudential, Prudential’s early tests with MedLM demonstrate that generative AI can play a major role in efficiently tackling the growing volume of health insurance claims, resulting in more frictionless processing and a faster turnaround time for customers.

While the service is available in Singapore and Malaysia, Prudential stated that only selected medical insurance claims will be used with MedLM over a period of 3-4 months. This is to compare the AI’s analysis and advice to actual decisions using current approvals processes. Doing so will help Prudential identify areas where MedLM can deliver the greatest productivity improvements and most useful advice to claims assessors, while maintaining a “human in the loop” at critical stages of the decision-making process.

“In a fragmented and often confusing healthcare landscape, data and AI are enabling us to provide care beyond coverage for our customers. Our strategic partnership with Google Cloud has given us a valuable first-mover advantage in adopting generative AI to improve customer experience at an important moment of truth. This is just the first step in using generative AI to deliver seamless, digitally enabled healthcare experiences at every step of our customers' health journey; from the point of diagnosis, through treatment, recovery and prevention,” added Toor.

At the same time, Toor also mentioned that the use of MedLMs by Prudential is only to facilitate and improve its product offerings on its app and that the insurance company will not be looking to go into the healthcare industry. It will, however, work with medical facilities to reduce the burden on healthcare professionals, allowing them to focus on patients with more serious conditions.

Moor also stated that while the service is available to customers in Singapore and Malaysia, there is still a portion of society that may not be able to comprehend the use of the app to make medical bookings or submit claims. As such, the insurance agents will still be assisting them in doing so, ensuring that the service provided remains seamless.

For Karan Bajwa, Vice President for Google Cloud in Asia Pacific, Prudential innovative approach of adapting MedLM’s advanced healthcare and medical-specific capabilities to one of its core business processes, exemplifies how Google Cloud’s strategic partnership with Prudential can empower its workforce to drive confident decision-making, improve the overall experience for policy holders, and create meaningful innovation in healthcare and finance.