Covered California: Streamlining Health Insurance Eligibility and Verification with AI
公司规模
Large Corporate
地区
- America
国家
- United States
产品
- Google Cloud
- Document AI
- Assured Workloads
技术栈
- Machine Learning
- Cloud Computing
实施规模
- Pilot projects
影响指标
- Productivity Improvements
- Cost Savings
- Customer Satisfaction
技术
- 分析与建模 - 机器学习
- 应用基础设施与中间件 - API 集成与管理
适用行业
- 医疗保健和医院
- Software
适用功能
- 商业运营
服务
- 云规划/设计/实施服务
- 系统集成
关于客户
Covered California is a state service dedicated to increasing the number of insured Californians, improving healthcare quality, lowering costs, and reducing health disparities. It offers a competitive marketplace where residents can choose high-value health plans and providers, with options for affordable healthcare based on income. The organization plays a crucial role in connecting Californians to quality, affordable health insurance, significantly reducing the number of uninsured residents in the state. Covered California is committed to innovation and improving the healthcare experience for both residents and employees.
挑战
In 2014, nearly 20% of California's 39 million residents lacked access to basic health insurance. By 2024, this number had decreased to just under 8%, largely due to Covered California, a state service bridging the gap between uninsured residents and affordable health insurance. The challenge was the time-consuming and manual process of verifying eligibility documents, which required residents to submit identity and income documents. Covered California staff processed most documents by hand, leading to delays and additional work when incorrect forms were submitted. This manual process was inefficient and created extra work for both staff and consumers.
解决方案
Covered California partnered with Deloitte and Google Cloud to automate the document verification process using Document AI. This AI-powered solution uses machine learning to automate the repetitive task of verifying resident information, improving the speed and accuracy of data extraction. The solution was tested in a pilot program, achieving a document verification rate of 80-96% depending on document type, with an average of 84%. This was a significant improvement over the legacy system's 28-30% automated verification rate. The new system also simplifies security and compliance with Assured Workloads, supporting FedRAMP compliance and ensuring all network traffic is private and encrypted.
运营影响
数量效益
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