Rather than replacing human representatives, the tool was created to support staff by providing clear, plain-language responses during customer interactions.
In efforts to improve customer service efficiency and accuracy, Independence Blue Cross (IBX) launched a generative AI (GenAI) tool designed to assist its customer service representatives.
The pilot program, which began in February 2025, is made up of more than 40 representatives who use the tool to handle member-specific questions, explain complex medical policies and look up benefits information in real time.
Rather than replacing human representatives, the tool was created to support staff by providing clear, plain-language responses during customer interactions.
According to an IBX press release, the intention is to reduce the number of steps representatives need to take to locate answers, helping improve first-call resolution rates.
It also automatically generates documentation, allowing representatives to validate answers against the company’s customer relationship management system.
"The customer service GenAI tool serves as a tool to empower our representatives, not replace them,” Michael R. Vennera, executive vice president and chief strategy, technology and operations officer at Independence Blue Cross, said in the release "Our associates have always been our greatest asset. By harnessing cutting-edge technologies, we’re equipping them with the tools they need to enhance their work experience and satisfaction, reinforcing our commitment to putting our members first.”
So far, the tool has received positive and early feedback from staff, with 90% of participating customer service representatives reporting enthusiasm about its potential.
A broader rollout is planned over the next 12 months.
Sushma Akunuru, senior vice president and chief information officer at IBX, said in the release that this tool is an “example of how GenAI can elevate operational excellence and member satisfaction, ultimately helping to empower (it’s users) to make informed health care decisions.”
IBX is one of several Blue Cross Blue Shield plans currently piloting AI technologies to streamline service delivery.
For example, Blue Cross and Blue Shield of Minnesota has integrated a chatbot into its Blue Care Advisor program to guide members through benefits and care decisions.
Early outcomes have shown that those who engaged with the AI tool were nearly twice as likely to follow preventive care guidelines compared to those who did not.
Similar to IBX, the AI implementation at BCBS Minnesota highlights the importance of human-AI collaboration by pairing digital tools with clinical and service professionals.
Public opinion research also supports this hybrid approach.
In a 2024 Deloitte survey, it was discovered that while 30% of U.S. adults expressed concerns about generative AI overall, 64% said they support healthcare providers using AI to improve care and 74% said they trust clinicians the most when it comes to health information.
It’s important to note that more than 80% of respondents said they wanted transparency when AI is involved in their care experience.
According to the release, IBX’s strategy—keeping customer service representatives in control while allowing AI to enhance efficiency and accuracy—appears to align closely with those expectations.
The growing interest in generative AI within the payer space spotlights the pressures to improve member engagement while managing administrative costs.
By starting with a customer service use case and grounding the pilot in a responsible framework, IBX is setting itself up for growth and potential in this emerging space.
As more data becomes available on outcomes and member satisfaction and the growth of AI rises, it’s likely health plans across the country will be watching closely to see if AI-enabled service tools can truly improve both operations and member trust.
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