Click the blue text above to select “Set as Favorite“
Key information delivered on D1 time!
Cigna, a health insurance company, is attempting to improve customer experience by connecting clients with AI chatbots, but analysis shows that GenAI can make mistakes. Cigna is adding features to its myCigna member portal, with at least one reform heavily relying on GenAI. According to Cigna, the new AI-based virtual assistant can answer common questions about health benefits coverage, claims, and care options; however, integrating AI into consumer communication may introduce new issues.
On Thursday, Cigna announced a series of digital tools aimed at improving the customer experience of its health benefits portal, including a GenAI-based virtual assistant.
This launch is part of a larger effort by the insurance company to make it easier and more affordable for members to access the benefits they deserve, which also includes a new tool that matches patients with in-network providers.
Experts have expressed concerns about the increasing adoption of AI in healthcare, as this technology has a tendency to make errors. Cigna stated that its new features were developed through “rigorous” research and testing within an AI governance framework.
The vast majority of American adults struggle with health literacy. Research shows that poor ability to obtain and understand health information leads to worse health outcomes, more hospitalizations, and increased emergency use.
Analysis also indicates that low health literacy costs the healthcare system tens of billions, if not hundreds of billions, of dollars each year.
However, the U.S. has made little progress in simplifying the complex bureaucratic systems that make understanding and accessing care more difficult, with insurance being one of the issues. Many consumers are unclear about what their health plans cover, how much they will have to pay out-of-pocket for services, and why they sometimes need to wait for treatment approval.
This lack of understanding led to extreme frustration following the murder of UnitedHealthcare CEO Brian Thompson on the streets of Manhattan last year.
After Thompson’s death, major insurance companies pledged to reduce administrative barriers to accessing care and take more responsibility for their members, and Cigna is no exception. In January, it announced plans to expedite prior authorizations, expand patient advocate access, simplify benefits, and—later—tie executive bonuses to customer satisfaction.
Now, Cigna is adding features to its myCigna member portal, with at least one reform heavily relying on GenAI. According to Cigna, the new AI-based virtual assistant can answer common questions about health benefits coverage, claims, and care options.
Cigna stated in its Thursday release that in early testing, over four-fifths of customers found the AI assistant helpful.
However, integrating AI into consumer communication may introduce new issues.
GenAI models can create original text and images but are prone to errors, although the frequency of issues depends on the model. Models may cite incorrect sources, exhibit bias, or fabricate information—a mistake known as “hallucination.” For example, one analysis showed that the “hallucination” rate varied from 0.7% to 29.9% across different AI systems.
As of the release, Cigna’s spokesperson had not responded to questions regarding the model on which its AI chatbot is based.
However, according to the insurance company, the AI can redirect customers to human representatives when additional help is needed.
Cigna also announced a new tool on Thursday that provides a list of in-network providers based on specific health needs of customers, including different care delivery options.
The Connecticut-based payer has also redesigned its cost-tracking tool, which breaks down deductibles, out-of-pocket costs, and bills, and added features to help members more easily upload claims and choose between employer-sponsored plans.
Many features are now available or will be open to all customers by 2026.
Like other stakeholders in the healthcare industry, insurance companies have been rushing to integrate AI into their operations to streamline processes and save costs, whether through improved claims review, optimized utilization management, or other use cases.
However, vendors and lawmakers have expressed concerns about payers’ use of AI, pointing to incidents where insurance companies allegedly used the technology to deny patients access to medical care for profit, which the insurers have denied.
Copyright notice: This article is a translation by D1Net, and reprints must indicate the source as D1Net at the beginning of the article. If not indicated, D1Net reserves the right to pursue legal responsibility.
(Source: D1Net)
About D1Net (www.d1net.com)
D1Net is a leading B2B IT portal in China, operating the largest database of CIO experts and a platform for intellectual output and social networking—Xinzongzhi (www.cioall.com). It operates 19 IT industry public accounts (search D1net on WeChat to follow).
If you work in a specific field of enterprise IT, networking, or communications and wish to share your insights, you are welcome to submit articles to D1Net.The cover image is sourced from Shetu Network.
Submission Email:
Cooperation Phone:
010-58221588 (Beijing Office)
021-51701588 (Shanghai Office)
Cooperation Email:
D1Net’s Xinzongzhi connects CIOs to provide consulting, training, demand matching, and practical services for digital upgrade and transformation. It is also one of the earliest B2B sharing economy platforms, providing headhunting, selection reviews, and IT department performance promotion services.
Scan the QR code to see more details
