Why AI agents get harder to scale, and how Playbooks solves it
As AI agents tackle more complex workflows, three challenges emerge: latency, adherence, and customer behavior. Here's how Playbooks addresses them.
Empower members with an AI agent that simplifies coverage, cuts costs, and encourages healthier choices—with built-in trust and compliance.
Meet Vita, Ada’s healthcare AI agent.
Ask Vita the questions below to see Ada Voice in action!
Boost satisfaction and plan usage with instant, accurate answers about coverage, benefits, and eligibility.
Handle Open Enrollment, Medicare AEP, and January onboarding spikes without sacrificing service quality.
Guide members to in-network care, understanding deductibles and out-of-pocket maximums, track claims, and speed pre-authorizations.
Support screenings, medication adherence, and chronic care education to improve outcomes and drive higher plan ratings.
Instantly answer questions like “When will I get my card?” and “Can dependents use it?” with automated customer service.
Resolve claims, coverage questions, and billing issues with clarity and care. Playbooks help your AI agent resolve high-volume workflows with the same logic, precision, and policy adherence as your human team. Every step is executed exactly how you define it—no delays, no escalations.
HIPAA, SOC2, and GDPR compliant.
Complete control over handing off member questions to human agents when needed.
Full visibility into AI interactions with insights that uncover opportunities for improvement.
AI strictly follows your knowledge and policies.
Provide feedback on past interactions— fine-tune tone, add context, or adjust answers. Improvements are automatically applied to future conversations.
Get clarity into every AI agent conversation—understand how it performed and which internal knowledge sources were used.
Customize your AI agent’s tone and voice to match your brand, and enable it to engage members in 60+ languages.
Support members via voice, messaging, SMS, and email.
Yes. Ada is HIPAA compliant and maintains zero data retention (ZDR) with all LLM providers. Member data, including PHI, coverage details, and claims information, is never stored or used by third-party AI models. For health insurance companies, that's foundational.
Member conversations involving sensitive health information, plan details, and eligibility data must meet HIPAA requirements at every layer of the technology stack. Ada provides full compliance documentation—covering SOC 2 Type II, HIPAA, GDPR, PCI DSS, and AIUC-1 (the first AI agent-specific compliance standard), and more—during the procurement process.
For more information, check out our trust and safety page.
Ada handles PHI, claims, and coverage information under enterprise-grade controls: built-in PII and PHI redaction, secure authentication before any account-level data is accessed, role-based access controls, MFA, audit logging, and zero data retention with all LLM providers.
Sensitive member information is governed by your configured data policies and never exposed in analytics dashboards or third-party systems. For health insurers managing high volumes of member inquiries involving protected health information, this privacy-by-design architecture and HIPAA-compliant infrastructure are core requirements—not optional add-ons.
For more information, check out our trust and safety page.
Yes. Ada's Playbooks are purpose-built for exactly this kind of structured, multi-step workflow. With Playbooks, you can train your AI agent to follow your standard operating procedures (SOPs) with the same skill as your best human agents, responding naturally, using real-time member and system data to personalize every step with built-in checks to ensure accuracy and consistency at scale.
Common Playbook use cases for health insurers include prior authorization status lookups and submission guidance, claims status inquiries and explanation of benefits (EOB) questions, benefits verification and plan coverage inquiries, enrollment and plan selection support, and provider directory and network lookups.
Explore more Health Insurance industry Playbooks.
Ada offers stringent data privacy and security policies for health insurance enterprises, including certifications such as SOC 2 Type II, HIPAA, GDPR, PCI DSS, and AIUC-1 (the first AI agent-specific compliance standard), zero data retention with LLM providers, and audit rights.
For more information, check out our trust and safety page.
As AI agents tackle more complex workflows, three challenges emerge: latency, adherence, and customer behavior. Here's how Playbooks addresses them.