Artificial intelligence (AI) dominates today’s headlines, with the stories see-sawing between two fears: AI will take over our brains, or humans will also lose their jobs to AI. “AI doomerism,” as the Techdirt blog calls it, sees little middle ground between humans and AI. 

But at Infinitus, we have a more positive vision of the cooperation between humans and AI. In the healthcare market, we see opportunities for AI and humans to collaborate in fast, productive, and highly accurate partnerships, which are designed to improve the patient experience and help providers save time and money. 

AI has the edge on exchanging information

Healthcare is a people-driven industry – and it has a low tolerance for errors. Clinical interactions require a good deal of empathy, and while they’re beginning to find support in AI, they still have a long way to go. On the other hand, back-office processes – like calling insurance payors to confirm coverage and payments – are transactional. They are vital to speedy treatment for patients, and to the smooth operations of the healthcare organization. 

Machines are very good at back-office transactions that require a simple exchange of information. Humans are good at these transactions as well, but can be prone to mistakes, and often find the work tedious and time consuming. AI can assist the people who manage the process of confirming insurance coverage and deductible payments, so procedures and treatments can move ahead without delay.

Another advantage of an AI platform: It can learn and manage highly complex and constantly changing details about healthcare procedures and payor guidelines. As an example, the Infinitus platform keeps track of 1,000 therapies across diseases such as cancer, rheumatoid arthritis, cardiovascular disease, and many more. That’s a lot of data for humans to retain. 

With help from humans, AI improves accuracy

Notice that I said AI can “assist” with human work – I didn’t say “replace.” At Infinitus, we firmly believe that humans and AI solutions should work together for the best results. Humans aren’t perfect, and AI isn’t perfect, so it makes sense to combine the strengths of the two for the best results.

Here’s how the AI-human team works for Infinitus customers. Eva, our AI-powered digital assistant, automatically calls a payor’s support team, asks questions of the human respondents, and records the responses in each patient’s file. Eva is based on a platform that learns from every interaction with a payor – for example, the fact that patients getting certain treatments from specific insurers don’t need prior authorization, or that these treatments always have a $50 copay.

If Eva hears that prior authorization isn’t required for a certain therapy, whereas the Infinitus platform knows it is, Eva can push back and ask the human to recheck the response. More often than not, the support agent will come back with the correct information. This confirmation is very powerful, because it avoids situations where the patient’s claim is denied months later, potentially causing loss of income to the healthcare provider and time-consuming appeals by the patient.

(If you’re thinking the people who talk to Eva don’t like to be questioned by a digital assistant, you’d be mistaken: Payors are diligent about giving accurate answers, because if they don’t, they can spend hours fixing the errors. You can see some examples of real feedback Eva has received here, here, and here.)

Humans as AI guardrails

And what if Eva still isn’t confident that she’s received the correct information? She can “raise” a virtual hand and ask for help from a human staff member who can review that part of the call. One of our operations team members can then, if needed, investigate further to check the call recording to confirm that Eva got the correct answer. 

We consider the human intervention in healthcare back-office transactions to be a powerful guardrail – one that should be part of any AI adoption. The right guardrails serve to not only build confidence in AI, but also guide change management as we move into a future where humans and technology work even more closely together than they are today. 

With AI assistance, healthcare businesses run smoothly

Most of our customers, for example ambulatory surgery centers, are overloaded with work. They don’t want to devote so much time to confirming insurance coverage that their patients don’t get the personal touch. By bringing in AI as a collaborator and not a competitor, staff can spend more time on meaningful patient tasks.

For healthcare, the future is about exchanging information and focusing on strengths, and it isn’t about 100% AI or 100% humans. The end goal is about making sure patients get the care they need, as soon as possible. Automation will become a valuable assistance to the people who provide care.

Learn more about how Infinitus prioritizes human-AI collaboration by exploring our offerings.