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Simplify Healthcare Unveils Simplify Healthcare AI: Pre-Built AI Solutions for Payers

Simplify Healthcare Unveils Simplify Healthcare AI: Pre-Built AI Solutions for Payers

Simplify Healthcare, a leading provider of enterprise SaaS solutions to Payers (health insurance companies), announced the launch of Simplify Healthcare AI — a suite of pre-built AI solutions for Payers designed to enhance sales, network performance, and service operations. This launch marks the next strategic step in the company’s AI roadmap, following its acquisition of Virtical.ai earlier this year. By combining Simplify Healthcare’s in-house innovations with the cutting-edge AI technologies acquired from Virtical.ai, Simplify Healthcare AI is set to revolutionize how Payers approach key operational challenges.

Simplify Healthcare AI will:

  • Enable Payers to Increase Acquisition and Retention through Sales: Enhance brokers’ and sales reps’ ability to acquire and retain customers by streamlining plan comparison and recommendation processes using AI-driven tools that enable easy intake of Census data. Enable faster decision-making and optimize plan selections based on historical data and member needs.
  • Enable Payers to Build High Performing Provider Networks: Empower Network Managers to build high-performing provider networks by analyzing network adequacy, identifying coverage gaps, and comparing provider rates with competitors. Ensure regulatory compliance and improve network offerings for better member access to care.
  • Enable Payers to Improve Customer Service Agent Productivity and Accuracy: Increase agent productivity by automating decision-making in health plan contact centers with AI-driven tools that guide agents to easily access benefits information. Reduce call handling time, enhance accuracy, and ensure compliance with industry standards.

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Reflecting on the launch, Deepak Bandi, EVP and GM, Simplify Healthcare AI™, stated, “Simplify Healthcare AI™ represents the culmination of years of innovation and the strategic acquisition of Virtical.ai, allowing us to bring Payers a truly transformative AI solution. By integrating AI across sales, network management, and service operations, we enable Payers to not only keep pace but to lead in a fast-evolving market. This launch is a testament to our commitment to embedding AI deeply into Payers’ workflows, driving both operational efficiency and member satisfaction. We are confident that Simplify Healthcare AI™ will unlock new potential for Payers, enabling smarter decisions that directly impact growth and performance.”

Simplify Healthcare powers connected benefits and provider journeys for Payers through a scalable, enterprise-grade, secure, compliant, and configurable cloud based software platform — Simplify Health Cloud™. Packaged on the Simplify Health Cloud™ — Benefits1™, Provider1™, Service1™, Claims1™, and Experience1™ provide Payers with discrete and precise solutions to complex problems and opportunities in delivering a rich set of products, benefits, and provider data. Simplify Healthcare also enables Payers to build enterprise solutions with speed and innovation on a configurable, secure, and low-code application development platform — Simplify App Fabric™. We also offer Simplify Healthcare AI™ — our pre-built AI solutions for Payers to enhance sales, network performance, and service operations.

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