Building trust in AI: A responsible approach

Responsible AI is all about designing and using AI in a way that’s consistent with performance expectations: Is it fair, ethical and safe? In other words, it’s not just about technology — it’s about people, and that means protecting patient privacy and keeping data secure.

Our approach to AI prioritizes human control. We emphasize clinical oversight to ensure that the technology does not replace the decision-making power of a clinician. Through our Responsible AI program and with input from leading experts, we identify and address potential risks that could impact our members, patients and customers.

Here’s what drives our approach to AI:

• Reliability and quality: AI should work the way it’s designed to. We test and monitor our AI for safety and dependability.
• Fairness: Everyone deserves equal treatment. We check for bias so vulnerable groups aren’t left behind.
• Accountability: We own what we build. If something goes wrong, we have monitoring to fix it. And we don’t use AI to replace clinical judgment.
• Transparency and compliance: We know transparency helps build confidence in AI. And we implement processes, consistent with laws and best practices, to keep things clear and compliant.
• Privacy and security: Your data is protected. We follow strict privacy and security standards.
• Continuous improvement: AI is evolving fast, and so are we. We keep learning and improving to stay ahead.

AI is already helping our clients and members in big ways:

Supporting call center agents so they can give faster, more accurate answers. 

• AI tools pull together previous calls, claims summaries and other records, presenting advocates with clues to a member’s incoming request.
• This reduces the need for members to repeat themselves.

Fighting fraud and waste with smart tools in our payment integrity area. 

• $2M in financial recoveries per client with enhanced fraud, waste and abuse audits.¹

Helping members stay healthy.

• Predictive analytics and personal outreach helps 53% of non-adherent members become adherent to their medications within six months, supporting better health outcomes.²

We’re excited about what’s coming. Our AI tools are transforming pharmacy benefits by making them more seamless, intelligent and responsive. By reducing effort, anticipating needs and supporting medication adherence, we’re making health care easier for members while improving efficiency behind the scenes. It’s all part of our mission of helping people live healthier lives.