This ebook explores how healthcare payors are using AI to address rising service complexity, fragmented systems, and increasing member expectations. It details how AI-powered automation reduces agent workload by handling routine eligibility, billing, and coverage inquiries. The content highlights proactive engagement use cases such as care reminders and gap closure, as well as AI copilots that support agents with real-time guidance and summarization. The ebook introduces the concept of agentic AI and a maturity model for experience orchestration, showing how payors can evolve toward more autonomous, outcome-driven service delivery.

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