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Using AI for eligibility file management

Eligibility files are a source of frustration for HR departments and brokers, but new AI tools can help alleviate some of the headache.

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Technologies like fuzzy matching and approximate string matching can be used to process eligibility files with little or no human interaction and give quicker results. (Photo: Shutterstock)

When a company decides to offer a health care administration platform to its employees, they’ll need to provide a certain level of information to give members the best possible experience. As a general rule, the more information a service provider about an employee’s benefits package, the better a member’s experience will be. Essential information includes name, contact information – such as email or phone number, medical plan information. Additional information could be voluntary benefits like 401K, long-term disability, short-term disability, etc. These files–which rarely come in a single file–are what the industry calls eligibility files.

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