Streamlining Healthcare: Google Cloud's AI & Health Insurance

Google Cloud's Solution: Data Activator

Simplifying the Process, Not Automating Decisions

Google's AI tools are intended to simplify the prior authorization process, not replace human decision-making. The objective is to reduce the time it takes to transfer information from providers to reviewers and optimize the valuable time of the reviewers themselves. Amy Waldron, Director of Global Health Plans Strategy and Solutions at Google Cloud, emphasizes that the software does not automate yes or no decisions but aims to enhance the efficiency of the review process.

Data Privacy and Partnerships: Securing Patient Information

To ensure data privacy, Google Cloud's software tool kit operates within the customer's cloud environment, with no access to the customers' data. Before implementing the suite, health insurers work with a consultant (Google Cloud's partnership with Accenture is highlighted) to train the AI models on the data stored within their own cloud infrastructure. This approach emphasizes the importance of maintaining data security and adhering to privacy regulations.

Piloting Success: Collaboration with Insurers to Streamline Prior Authorization

Google Cloud has conducted successful pilot programs with several insurers, including Blue Shield of California and a subsidiary of U.K.-based health insurer Bupa. Blue Shield of California, processing around 1 million prior authorization requests annually, aims to reduce the manual extraction and entry of data, allowing human reviewers to focus on reviewing requests. Moreover, the insurer has been collaborating with Google Cloud for the past two years to develop a near real-time claims processing system, providing patients with immediate cost transparency at the point of care.