AI in health insurance has become a hot topic, but not always for the right reasons. Headlines like “AI-Driven Health Care Is Turning Us Into Numbers on a Spreadsheet” highlight the risks of using AI in ways that undermine member trust—automating claims denials, influencing coverage decisions, or mishandling sensitive data.
But AI doesn’t have to work this way. There’s an alternative model: one where AI is used to streamline upstream activities, like responding to RFPs and RFIs, allowing insurers to allocate more resources to direct, person-to-person engagement with members.
Current AI Concerns in Health Insurance
Recent controversies paint a concerning picture of how some insurers use AI. For example, automated systems that deny claims without human review have made headlines for their impact on patient care. These applications raise ethical questions about transparency, fairness, and the role of AI in decisions that directly affect people’s health.
But it’s important to recognize that not all AI applications carry these risks. The same technology can be applied to internal operations, boosting efficiency and freeing up resources to improve member-facing experiences.
A Different Kind of AI: Streamlining Operational Processes
AI has immense potential to streamline business operations that don’t involve direct patient care or coverage decisions. For health insurers, these areas often include administrative and operational processes that, while critical, can be time-consuming and resource-intensive. Streamlining these tasks allows insurers to focus their resources on higher-value initiatives.
Take the process of responding to RFPs and RFIs as an example. These detailed documents are essential for securing new business and maintaining strong partnerships with brokers and consultants. Yet, preparing responses can take teams hundreds of hours, requiring extensive coordination, ensuring accuracy, and crafting persuasive messaging.
Worse still, RFP and RFI responses require input from subject-matter experts across every part of the business, including functions like claims, health advocacy, and member engagement. When you take people away from their core work in those areas to instead spend time completing RFP and RFI responses, that reduces the resources available to enhance member experience across the whole organization.
Shifting Resources to What Matters
When AI streamlines upstream activities like proposal management, insurers can reinvest those savings in areas that build trust and engagement. Instead of stretching teams thin across administrative tasks, you can prioritize efforts that require the human touch—like answering member questions, resolving issues, or personalizing services.
By leveraging AI to handle repetitive and routine aspects of RFP and RFI responses, insurers can reduce internal workloads, increase efficiency, and redirect energy toward strategic priorities like growth and relationship-building.
This approach aligns AI with the priorities that make health insurance work best for members and providers alike. It’s about enhancing productivity without compromising trust.
How AI Solutions like Fastbreak Deliver Low-Controversy ROI
Operational AI solutions like Fastbreak can operate entirely within the B2B space. The particulars will vary from solution to solution, but to give an example here’s how Fastbreak avoids the risk of AI having an impact on care:
- No Member Data: Our platform doesn’t access or process sensitive member information, ensuring privacy and compliance.
- No Impact on Coverage Decisions: We’re not involved in claims, benefits, or anything that directly affects members’ care.
- Pure Productivity Gains: Our AI helps insurers handle RFPs more efficiently, ensuring accuracy and reducing time spent on repetitive tasks.
A clear separation from member-facing processes means you can adopt AI with confidence, knowing it strengthens your operations without creating new risks.
Practical Steps to Reimagine AI in Health Insurance
If you’re considering how AI fits into your organization, here are three ways to get started:
- Identify Non-Consumer-Facing Tasks: Look for areas where AI can save time and resources without touching member data or decision-making.
- Choose Tools Built for Operational Efficiency: Invest in platforms like Fastbreak that focus on productivity and compliance, not consumer interactions.
- Reinvest Savings in Member Engagement: Use the time and resources saved to improve member-facing initiatives, like personalized communication or enhanced support.
Conclusion: AI That Works for Insurers and Members
AI doesn’t have to turn healthcare into “numbers on a spreadsheet.” By focusing on upstream activities like RFP response, insurers can use AI to drive growth and efficiency while reinforcing the trust that’s critical to member relationships. Fastbreak RFP offers a powerful example of how AI can support health insurers’ goals without creating new risks.
Ready to see how our solution works? Contact us for a demo.
