Building a better member experience through AI
You’re at the pharmacy counter. Or the doctor’s office calls. Or a medical bill arrives in the mail. In moments like these, questions about your health insurance tend to come up fast, and so does the need for clarity.
At Regence, we’re investing in technology that connects you to the right information quickly, whether you’re talking with our customer service team or finding answers online.
AI with purpose
When it comes to your healthcare, how we build matters as much as what we build. That’s why we use AI only where it makes a real difference — and always with people involved. Clinical decisions stay with clinical experts. And every tool we build is designed with your privacy in mind, drawing from verified plan documents to ensure accuracy from the start.
That philosophy shows up in every tool we create, including those used behind the scenes. One example is our Customer Service Virtual Assistant (CVA), a tool that helps our customer service professionals (CSPs) quickly find accurate answers to your benefit questions. Before CVA or any AI tool reaches our members or customer service team, it goes through rigorous testing with the people who know our plans best. Our most experienced CSPs help us evaluate new features and audit system performance, ensuring responses are both accurate and complete. This human-in-the-loop approach means real expertise guides how these tools improve over time.
CVA is already making a big impact. It’s now being used to serve 1 million members, cutting time it takes for CSPs to find answers from minutes to seconds.
Balancing personalization and privacy
We’re also bringing that same approach directly to members, starting with how you search.
If you’ve used our provider search recently, you may have noticed Ask, a feature that lets you search the way you think. Instead of sorting through drop-down menus, you can type something like “primary care doctor accepting new patients near me” and get more relevant results right away.
But finding a provider is one thing. Understanding what your plan actually covers is another. That’s where Regence Assistant comes in — the member-facing version of CVA, built to help you understand your benefits and navigate coverage questions on your own time. We’re testing it now, with a gradual rollout planned for later this year. Members will be able to ask things like “What does my plan cover?” and get straightforward answers.
Because this tool deals directly with your personal coverage, privacy is built in from the start. Regence Assistant requires authentication to ensure your information stays yours, and it draws only from verified plan documents and your specific coverage details. The result is a system that’s both personalized and private.
What’s next
As we move forward, we’ll continue exploring how technology can create more natural, helpful interactions while protecting your privacy and ensuring accuracy. With each step, we’ll keep refining what we build based on what we learn.
The goal isn’t to eliminate human connection; it’s to remove the barriers that get in the way. Our commitment is simple: make it easier for you to get the information you need, so you can focus on what matters most — your health.
