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AI-Based Summarization of Unstructured Content for Payers

Publisher IDC
Published Feb 20, 2024
Length 12 Pages
SKU # IDC18560097

Description

AI-Based Summarization of Unstructured Content for Payers


This IDC Perspective takes a deep dive into content summarization of unstructured data and artificial intelligence (AI) for payers. Using AI to use platforms that can take in, study, and learn from data, refine judgments, and generate intelligent insight reduces the need for expensive human data analysts.Pulling together unstructured data for today’s AI is no overnight task. Mergers and acquisitions have resulted in fragmented IT architectures. Important documents have been lost to view, locked in offline proprietary file types.“Within the AI potential, content summarization holds the most short-term promise for payers. Content summarization with AI in health insurance is quickly driving improvements and changing the relationship between payers, providers, and members. It helps to enhance and streamline the member/patient experience and makes internal operations easier,” says Jeff Rivkin, research director, Payer IT Strategies at IDC Health Insights.

Please Note: Extended description available upon request.

Table of Contents

12 Pages
Executive Snapshot
Situation Overview
Use Case: Eligibility and Benefits Verification
Use Case: Medical Records/Service Clinical Review
Sub–Use Case: Identifying Under-Documented Social Determinants of Health
Sub–Use Case: Fraud Detection/Payment Integrity
Sub–Use Case: Prior Authorization
Use Case: Explanation of Benefits
Use Case: Radiological Images
Use Case: Member/Provider Contact Center Recordings and Chatbot Chat Summarization
Use Case: Claims Coding
Use Case: Claims Management/Settlement (Payer Side)
Use Case: Claims Management/Settlement (Provider Side)
Use Case: Claims Denial Resolution
Use Case: Intelligent Content Search and Summarization of Reference Data — Finding Information from Public and Private Data Sources Including the Patient Record
Advice for the Technology Buyer
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Related Research
Synopsis

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