Surest uses artificial intelligence (AI) to help improve member experience
Shopping for health care can be like other digital shopping experiences where health care consumers have the ability to compare costs and care options upfront to find services and providers that meet their needs.
Advanced technology and the responsible use of artificial intelligence (AI) is helping to improve those experiences for members of Surest® a UnitedHealthcare company. The Surest health plan offers upfront pricing with no deductibles and is designed to help make health care simpler and more affordable.
Surest members can use the app to identify providers that have a track record of delivering effective, cost-efficient care. And they pay a lower co-pay when they choose those providers. Surest members comparison shop for health care the same way they do for other non-health care services they buy, and and they pay less out of pocket compared to people enrolled in traditional employer-sponsored health plans.1
Surest uses AI to advance these services in four ways:
- Empowering members with the insights they need to make informed benefit related decisions
- Delivering answers instantly about costs and finding care options
- Creating a simpler health plan experience
- Pioneering the member’s ability to shop for health care
How Surest uses AI to help improve the member experience
1. Smarter search
Surest uses natural language processing (NLP) technology in its search experience, allowing members to find providers or answer questions about their benefit plan using everyday language in English or Spanish. This removes the need for medical jargon and helps make it easier to locate services, conditions or treatments covered by the member’s benefit plan.
2. Provider evaluation for value-based co-pays
Surest uses AI to help evaluate providers using a broad set of factors — including efficiency and cost-effectiveness metrics — based on historical UnitedHealthcare claims data. These evaluations inform variable copays, so members can understand their benefit plan options and costs before scheduling an appointment. Surest uses more than 1 million value-based copays displayed on a service-by-service basis, not some confusing grid or tiers,2 providing greater choice and transparency so members can comparison shop for options the way they shop for other services and products.
3. Quote-to-claim accuracy
Surest uses AI to help keep your costs consistent through regular re-evaluations. Copays for services by provider and location are set for the year, but sometimes billing arrangements can change, especially within a large network. Surest uses AI to help ensure changes in network billing arrangements do not impact copays in any given plan year. The copay you saw when you searched for care options should match what appears on your bill during the same plan year — so you can feel more confident in your decisions and the cost you will pay.
4. Feedback collection
Surest uses AI to help understand member feedback, like spotting patterns and common issues every time a member shares a comment through the app or website. For example, if an update made it harder to find a provider’s phone number, Surest can identify that trend across multiple feedback forms through AI, helping to fix problems faster and improve the member experience.
Looking ahead
Recent data shows that 83% of members engage with the Surest app before seeking care.3 As AI evolves, Surest will continue to focus on ways the member experience can be simplified and improved through the responsible use of this technology.
Surest is just one of more than 1,000 AI use cases in production across UnitedHealth Group, including many within UnitedHealthcare’s commercial business.
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