Enhance Sales, Network Performance, and Service Operations

Leverage pre-built AI solutions for Payers to accelerate time to value

Explore our solutions

The next era of intelligence and productivity for health plans is here.

Sales Solutions: Increase Acquisition and Retention

Explore solutions designed to enhance brokers' and sales representatives' ability to acquire and retain customers. These solutions streamline the complex processes of plan comparison, recommendation, and understanding, enabling faster, more informed decision-making. By leveraging advanced Plan Intelligence AI models trained on census data from 80K SBCs, our tools optimize plan comparisons, recommend the best-fit plans based on historical data and member needs, and simplify plan benefits and cost estimations.

Competitive Network Insights

Our network management solution empowers Network Managers to build and maintain high-performing provider networks while ensuring compliance with regulatory standards. Our AI Network Intelligence models trained on 67 TB of CMS data, analyze network adequacy, identify gaps in coverage by specialty and county, and compare provider-negotiated rates against competitors. This allows Payers to strategically enhance their network offerings, ensuring members have access to quality care.

Service Solutions: Improve Agent Productivity and Accuracy

Service solutions enhance agent productivity and accuracy by automating decision-making processes within health plan contact centers. Our AI-driven Agent Assistant identifies caller intent and guides agent actions, reducing guesswork and ensuring compliance with industry standards. This solution improves the agent experience, shortens call handling times, and increases accuracy through controlled business logic.

Find answers and general information

A list of frequently asked questions to help you understand how it works.

What type of AI models does Simplify Healthcare AI™ specialize in?

At Simplify Healthcare AI™, we specialize in Applied AI models. This means we focus on creating smaller, lightweight, and faster models that are tailored to solve specific problems rather than building large, generalized Generative AI models.

How does Simplify Healthcare AI™ ensure the protection of personal information?

User privacy is our #1 priority. No Personally Identifiable Information (PII) is used in any of our processes or datasets, ensuring we maintain the confidentiality and privacy of individuals.

From where does Simplify Healthcare AI™ source its training data?

Simplify Healthcare AI™ sources its training data from public data sets, including Machine Readable Files (MRF) Transparency files published by Payers and publicly available plan data. This ensures our models are trained on data that is open and transparent.

Why does Simplify Healthcare AI™ focus on Applied AI instead of Generative AI?

We believe that Applied AI provides targeted solutions that are more efficient and effective for specific use cases. By focusing on Applied AI, we are able to build models that are faster, more responsive, and better suited to the tasks they are designed for.

How does Simplify Healthcare AI™ ensure the accuracy and reliability of its AI models?

Our models are rigorously tested using industry-standard metrics and validated against external benchmarks to ensure both accuracy and reliability. Furthermore, we continuously monitor and update our models to maintain high performance.

Can Simplify Healthcare AI™’s models be integrated into existing business workflows?

Yes, our models are designed to be flexible and can be easily integrated into existing workflows. Our focus on lightweight models means they can be deployed swiftly and seamlessly, enhancing productivity without disrupting current processes.

Enhance Sales, Network Performance, and Service Operations

Leverage pre-built AI solutions for Payers to accelerate time to value

Explore our solutions

The next era of intelligence and productivity for health plans is here.

Sales Solutions: Increase Acquisition and Retention

Competitive Network Insights

Service Solutions: Improve Agent Productivity and Accuracy

Find answers and general information

A list of frequently asked questions to help you understand how it works.

What type of AI models does Simplify Healthcare AI™ specialize in?

How does Simplify Healthcare AI™ ensure the protection of personal information?

From where does Simplify Healthcare AI™ source its training data?

Why does Simplify Healthcare AI™ focus on Applied AI instead of Generative AI?

How does Simplify Healthcare AI™ ensure the accuracy and reliability of its AI models?

Can Simplify Healthcare AI™’s models be integrated into existing business workflows?

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Get the latest updates and insights from Simplify Healthcare

Blogs

Optimizing Healthcare: How AI is Transforming Payer Operations

Videos

Census Intake

Agent Plan Comparison

Network Management

Agent Assistant

About Simplify Healthcare

Company

Simplify Health Cloud™

Resources

Newsletter Sign-up

Request a Demo

Request the Product Sheet

Sales Solutions: Increase Acquisition and Retention

Competitive Network Insights

Service Solutions: Improve Agent Productivity and Accuracy

What type of AI models does Simplify Healthcare AI™ specialize in?

How does Simplify Healthcare AI™ ensure the protection of personal information?

From where does Simplify Healthcare AI™ source its training data?

Why does Simplify Healthcare AI™ focus on Applied AI instead of Generative AI?

How does Simplify Healthcare AI™ ensure the accuracy and reliability of its AI models?

Can Simplify Healthcare AI™’s models be integrated into existing business workflows?

Blogs

Optimizing Healthcare: How AI is Transforming Payer Operations

Videos

Census Intake

Agent Plan Comparison

Network Management

Agent Assistant

About Simplify Healthcare

Company

Simplify Health Cloud™

Resources

Newsletter Sign-up

Request a Demo