Smarter support. Better health outcomes
Empower members with an AI agent that simplifies coverage, cuts costs, and encourages healthier choices, with built-in trust and compliance.
Speak to an expertAda voice in real life
Meet Vita, Ada’s healthcare AI agent.
Ask Vita the questions below to see Ada Voice in action.
Chat casually
Ask how Vita’s day is going · Tell her to “hold on,” “wait a second,” “repeat that” · Mention if your day’s been rough, kids are noisy, etc. · Jump in and interrupt, she can handle it!
Make account updates
Change the name on your account · Check your policy status (say your member ID ends in 3301 and your zip code is 02339) · Ask to enroll a new dependent (mention you had a child!) · Make a mistake and watch how she gently guides you back
Ask common questions
Ask about your policy details, like your deductible and coverage · Request a text with your coverage details · Ask to find the closest doctor to Hanover, MA 02339 · Bonus: ask her to repeat steps or pause while you catch up
Escalate when needed
Say you have a problem with a prior authorization · Ask to talk to someone about a sensitive topic
The real CX blockers in health insurance
51%
of Americans say understanding their health insurance is overwhelming and confusing
3×
wait times during Open Enrollment and AEP
$55B
in avoidable healthcare costs are attributed to underuse of preventive care each year in the U.S
AI built to understand members, and their coverage
Help members understand their plan
Boost satisfaction and plan usage with instant, accurate answers about coverage, benefits, and eligibility.
Scale effortlessly during peak periods
Handle Open Enrollment, Medicare AEP, and January onboarding spikes without sacrificing service quality.
Deliver better care at lower costs
Guide members to in-network care, understanding deductibles and out-of-pocket maximums, track claims, and speed pre-authorizations.
Boost Medicare star rating
Support screenings, medication adherence, and chronic care education to improve outcomes and drive higher plan ratings.
Resolve insurance card questions with ease
Instantly answer questions like “When will I get my card?” and “Can dependents use it?” with automated customer service.
Turn your SOPs into automated workflows with Playbooks
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.
An AI agent you can trust
Enterprise grade security
HIPAA, SOC2, and GDPR compliant.
Human in the loop
Complete control over handing off member questions to human agents when needed.
Full transparency into agent performance
Full visibility into AI interactions with insights that uncover opportunities for improvement.
Built-in guardrails
AI strictly follows your knowledge and policies.
Smarter tools to optimize every interaction
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.
Frequently asked questions
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.
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.
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.
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.