How HIPAA compliance
is taking in place through Voice AI in 2021


This blog will help you to understand the need for the digital transformation of communication and assistance of users.

Here is the most common question everybody asks “what is HIPAA compliance.”

HIPAA, basically known as “The Health Insurance Portability and Accountability Act of 1996”, sets the regulatory standards that outline the lawful use and disclosure of protected health information.

Companies involved in the health sector and keeping sensitive patient data should have the physical network and procedure to security measures and maintain HIPAA compliance.

Why is HIPPA required?

HIPPA is existed to maintain the individual’s privacy and ensure everyone has complete control over the copy of their medical data. These issues relate to civil rights. It protects everyone who creates, stores or uses the individual’s health information.

The security roles ensure to protect the medical data privacy of every human existed. At the same time, it allows new technology to covered entities to adopt new running technologies to improvise the efficiency and the quality of medical care.

What is the need for the payer and provider side?

A Payer is a company that bears the cost of an administered medical services. An insurance provider company (Health insurance) is the most common example of a payer.

The Payer in the healthcare sector is a community that bargain and fix the rates for provider side services, collect revenue on behalf of provider side, receive and process the claims for their services. This claim will be paid to the provider claim using the collected premium.

A Provider is a company that administers or provides healthcare services; the most common example of providers are “Hospitals.”

It can be an individual medical professional or a hospital having a license to provide the healthcare services, diagnosis and treatment services, including surgery, medical devices, medications etc. The provides accordingly receive payment settlement for their provided services from insurance providers.

Payer and Provider both are not patient themselves, and this authorisation becomes mandatory because of the nature of sensitive information.

Who should essentially follow the HIPAA compliances

The Below mentioned parties should essentially follow the regulations of HIPAA. And these parties refer to as “Covered entities” by law.
1. Health Care Plans/Insurance Plans
2. Cleaning houses of the health care sector
3. Health Care Providers are hospitals, clinics, nursing homes, pharmacies, doctors etc.


What Challenges Industry Facing During Implementation

A high agent call (AHT)
The less automation, less time to taking calls and processing them, ineffective routines for attending calls leads to increased Average Handle Time. This industry is at the top priority, and It’s an “urgent” industry to focus on; that is why the calls from agents are higher side.

The health care industry really need attention in terms of providing a better experience to the customer. But right now, it lacks to provide the same due to less workforce and resources.

High peak hours call traffic, unable to address maximum calls. Due to the lack of resources and automation, Employees are working manually, and even in peak hours, it continues without any significant changes.
Attending the calls and processing the query of a single agent can consume loads of time that further calls will remain unattended till the queue got clear for the next availability.

Increasing OPEX cost for live agents
We live in a world where we introduce new technologies every day, and chat boat is one of them. Due to lack of knowledge, the industry is trying these technologies to shot the problem.
But by Installing a chat boat with limited features and hiring a few live agents are not that much help with the customer calls, And ultimately, it’s increasing the operating cost for the industry.

Introduce AI without sacrificing patient experience
In the healthcare industry patients are the topmost priority, and the sector is trying different techniques to resolve their challenges.
Artificial Intelligence is one of them, but not every healthcare provider is part of the AI community.
AI is a new concept for the world, and because of less knowledge and trust for securing the patient data, which will take time to build in the mind of payer and provider both sides.

How can be this done through humonics AI?

Humonics helps in Activate the Conversational Al oriented Digital Humans for HIPAA, Pre-Authorization Status process on self-service mode.

Humonics AI will provide natural Language query processing with modules like Speech Recognition, Text-to-Speech, deep learning models.

Humonics services help Live Agent Transfers; in case of authentication failure, User requests post HIPAA verification with context to current conversations.

Humonics help to analyse the data and reports to measure the accuracy level. Also, the performance of the digital humanities, enhance the customer conversations, Identify user queries, Business KPI and so on.

How can claim processing be completed by humonics voice boat?

Here are five parameters are taken by the bot for HIPAA Compliance

70% of calls related to HIPPA are successfully reached to closure directly through HUNA voice AI
30% of calls related to status checking directly handled by the voice AI
45% of reduction records in calls average handle time
20% reduction records in OPEX cost as of now.
Humonics voice ai having the capacity to handle 1,000 calls per day. It can take the peak hour traffic in autoscale mode. All in average, 2,500 man-minutes saved with the self-service channel, and it is close to the working hours of 5 agents.

Who is Humonics Global?

Humonics global offers a platform to create an end-to-end solution for better customer service and engagement. Humonics is having World's first Autonomous Cloud Contact Center. Now you will never miss your customer call. It brings unique and innovative AI products that can help businesses and their customers deliver quality and exceptional service. If you like what you read, subscribe to us and get unlimited access to intriguing discussions, interviews, and articles - all about AI.


HIPPA and Precertification for faster service.

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