Haris Ashley
One of the largest insurance providers in the US, Humana offers Medicare supplements, health insurance, dental insurance, vision insurance, and pharmacy coverage to over 13 million customers across the country. Humana receives a high volume of calls from customers and healthcare providers. To improve its customer service, the company has implemented an interactive voice response (IVR) system and a Voice Assistant solution that uses artificial intelligence to understand the intent of a caller, verify their identity, and address their query. Customers can call Humana Customer Care for assistance with their Humana plan, and healthcare providers can use the Voice Assistant to quickly get information on patient insurance coverage.
| Characteristics | Values |
|---|---|
| Type of company | Health insurance provider |
| Call services | Interactive voice response (IVR) system, Voice Agent with Watson |
| Call volume | Over one million provider calls every month |
| Call wait time | Approximately two minutes |
| Call center environment | Low-bandwidth |
| Call center staff | Human agents |
| Call transfer rate | High |
| Call outsourcing | Outsourced call centers |
| Call costs | Paid by Humana per call |
| Call inquiries | Eligibility, benefits, claims, authorization, referrals |
| Call accuracy | 90–95% sentence error rate accuracy level |
| Call availability | Monday to Friday, 8 am to 8 pm Eastern time |
| Call number | 800-273-2509 (TTY: 711) |
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What You'll Learn
Humana Customer Service contact number: 800-273-2509
Humana is a leading health insurance provider in the US, offering Medicare supplements, health insurance, dental insurance, vision insurance, and pharmacy coverage to over 13 million customers across the country.
If you are a customer with MSU and have questions about your Humana plan, you can call the Humana Customer Service team at 800-273-2509 (TTY: 711). This line is open Monday through Friday, from 8 am to 8 pm Eastern time.
The Humana Customer Service team can assist with any queries related to your Humana plan, including health and prescription coverage. For example, if you are searching for a provider, the team can help you find a doctor or provide information on finding a provider.
In addition to the general customer service line, Humana also has a dedicated Member Services line for members with specific medical conditions or those undergoing active treatment. This line can be reached at 866-432-0001 (TTY: 711).
Humana has also implemented an interactive voice response (IVR) system to improve the efficiency of its customer service. This system uses AI to understand the intent of the caller, verify their access to the system, and provide the requested information without the need to speak to a live agent. This has helped Humana reduce the number of costly pre-service calls and improve the overall provider experience.
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Humana's Voice Agent with Watson
Humana, a leading US health insurance provider, has implemented an innovative solution to enhance its customer service and improve the provider experience: Humana's Voice Agent with Watson. This cutting-edge technology leverages the power of artificial intelligence (AI) to revolutionize how administrative staff at healthcare providers interact with Humana.
Previously, Humana's interactive voice response (IVR) system was transferring a significant number of calls to human agents, resulting in high costs and decreased customer satisfaction. Most callers were opting out of the IVR system, choosing to speak with live agents instead. Recognizing the need for improvement, Humana's Provider Services Innovation (PSI) team collaborated with IBM Watson Expert Services Lab to develop a sophisticated voice assistant.
The implementation goes beyond simple query resolution by addressing various sub-intents within critical categories such as eligibility, benefits, claims, authorization, and referrals. This comprehensive approach ensures that Humana can swiftly answer a wide range of questions, reducing the need for live agent support. As a result, healthcare providers can obtain information on patient insurance coverage swiftly and conveniently, completing inquiries in about two minutes without waiting for a call center representative.
By embracing AI technology, Humana has successfully transformed the way it handles pre-service calls, enhancing the overall provider experience. This innovation underscores Humana's commitment to continuous improvement and differentiation in the highly competitive healthcare and insurance industry, ultimately benefiting millions of customers across the United States.
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Humana Medicare Insurance Contract Expiration
Humana is a Medicare Advantage organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. Humana Inc. complies with Federal civil rights laws and does not discriminate.
MUSC Health's contract with Humana Medicare Advantage and Humana's Healthy Horizons Medicaid Insurance is set to expire on December 31, 2024. This means that patients will need to switch plans or find an in-network provider. This termination does not impact patients with a Humana Medicare Supplemental plan or Tricare. MUSC Health has expressed concerns about the number of denials of treatment plans ordered by their physicians, causing unnecessary delays and anxiety for patients.
MUSC Health and Humana Healthy Horizons will coordinate care for patients with certain medical conditions or those undergoing active treatment for up to 90 days or until a new provider is found. Patients can contact Humana Healthy Horizons' Member Services line at 866-432-0001 (TTY: 711) for more information.
MUSC Health encourages patients to select an insurance plan during open enrollment that has a contract for 2025 to continue care with MUSC Health. It is important to review alternative plans during the current Medicare Open Enrollment period to ensure uninterrupted access to the MUSC Health network.
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Humana's Voice Assistant solution
Humana is a leading health insurance provider in the US, offering Medicare supplements, health insurance, dental insurance, vision insurance, and pharmacy coverage to over 13 million customers. To differentiate itself in the market, Humana has to continuously innovate to enhance customer service and retention.
Previously, Humana's interactive voice response (IVR) system was transferring too many calls to human agents, which was costly and negatively impacted customer satisfaction. To address this issue, Humana partnered with IBM Watson Expert Services Lab to develop a Voice Assistant solution.
The IBM team customized their tools to better understand healthcare terminology, which is now used in Humana's Voice Assistant solution. This voice agent provides a faster and more efficient way for administrative staff at healthcare providers to access information without speaking to a live agent. The AI-powered assistant can understand the intent of the caller, verify their access to the system, and determine the best way to provide the requested information. With seven language models and two acoustic models, the voice assistant can handle various sub-intents within eligibility, benefits, claims, authorization, and referrals.
As a result, Humana has reduced the number of costly pre-service calls and improved the provider experience. The Voice Assistant solution has achieved high accuracy levels, enabling Humana to quickly answer questions and improve self-service capabilities for healthcare providers. This innovation allows providers to obtain information on patient insurance coverage in about two minutes without needing to reach a call center representative.
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Humana insurance plans and prescription drug coverage
Humana offers Medicare Advantage PPO insurance plans with a range of prescription drug coverage options. Original Medicare does not include prescription drug coverage, so Humana offers stand-alone Medicare Part D prescription drug plans. These plans can help individuals save money on prescription drugs, with over 3,600 drugs covered under the Humana Value Rx Plan.
Humana's Medicare Part D prescription drug plans vary by location, with different pharmacies included in the plan networks. These include preferred pharmacies in urban, suburban, and rural areas across the United States. The Humana Premier RX Plan and the Humana Value RX Plan include limited lower-cost, preferred pharmacies in several states, with varying costs depending on the pharmacy used.
The Humana Basic Rx Plan (PDP) is another option for those who qualify for Medicare Extra Help, which may cover the entire cost of the premium. This plan offers basic coverage and access to a preferred mail-order cost-sharing pharmacy.
All of Humana's 2025 Medicare Part D plans feature a $2,000 maximum out-of-pocket cost. Once an individual reaches this limit, their Part D plan will pay 100% for covered drugs for the rest of the plan year. The Insulin Savings Program is not included in all plans and is not available to members receiving Extra Help.
To find out more about Humana's insurance plans and prescription drug coverage, individuals can enter their ZIP code on the Humana website to see the specific plans and pharmacies available in their area.
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Frequently asked questions
Yes, Humana Insurance may call its customers in certain situations. For example, if you are undergoing active treatment, Humana Healthy Horizons will coordinate care with your doctor for up to 90 days.
You can contact Humana Customer Service for assistance with anything related to your Humana plan by calling 800-273-2509 (TTY: 711). They are available Monday through Friday, 8 am to 8 pm Eastern time.
Humana has implemented an interactive voice response (IVR) system and a Voice Assistant solution using artificial intelligence (AI). These tools help provide faster and more efficient service by understanding the intent of the caller and providing accurate information without the need to speak to a live agent.
