Case Study: Humana reduces costly pre-service calls and improves provider experience with IBM Watson conversational AI

Humana, a leading health insurance provider, reduced costly pre-service calls and improved the provider experience with conversational AI.

Humana, one of the largest health insurance providers in the U.S., needed to reduce expensive pre-service calls and improve the experience for healthcare providers using its legacy IVR system. Working with IBM and IBM Watson, the company looked for a better way to answer routine eligibility, benefits, claims, authorization, and referral questions that were driving high call volumes and low satisfaction.

IBM implemented a Watson-based conversational voice agent on IBM Cloud, with watsonx Assistant for Voice running on premises at Humana. The solution now handles provider inquiries faster and more consistently, cutting costs to about one-third of the old system and nearly doubling the response rate, while enabling many calls to be completed in about two minutes.

Humana

Sara Hines

Director of Provider Experience and Connectivity