How EmblemHealth Uses Artificial Intelligence
EmblemHealth uses artificial intelligence (AI) tools to help support certain business and healthcare-related functions. AI refers to computer-based technologies that can assist with analyzing information, generating content, identifying patterns, or supporting decision-making processes.
AI tools may be used to:
- Support customer service and member communications.
- Improve administrative efficiency and business operations.
- Assist with care management activities.
- Support data analysis, reporting, and quality improvement efforts.
- Provide recommendations or information to employees who perform healthcare and business functions.
AI tools support our workforce, but they do not replace the judgment of qualified healthcare professionals or EmblemHealth employees. There are mandatory human reviews and defined escalation paths for all AI-generated recommendations.
Sharing information with AI service providers
EmblemHealth may share protected health information (PHI) or other member information with vendors who help develop, host, maintain, or operate AI-enabled services used by EmblemHealth.
When information is shared, EmblemHealth requires vendors to safeguard the information in accordance with applicable laws, regulations, contractual requirements, and privacy and security standards, including HIPAA where applicable.
Commitment to fairness and nondiscrimination
EmblemHealth is committed to the responsible use of AI.
We do not intend for AI tools to unlawfully discriminate against any individual or group. EmblemHealth evaluates AI-enabled solutions and implements governance, oversight, testing, monitoring, and risk management practices to help reduce the risk of bias, unfair treatment, or unlawful discrimination.
Questions about our use of AI
If you have questions about EmblemHealth's use of AI tools, please contact us at aiquestions@emblemhealth.com.
FAQ(s) and relevant AI information will also be published on emblemhealth.com.
Accessibility and language assistance
This information is available free of charge in alternative formats, including large print, accessible electronic formats, and other formats upon request.
Language assistance services are available at no cost for individuals whose primary language is not English.
If you need help reviewing this information or require language assistance, please contact EmblemHealth Customer Service at 800-447-8255 (TTY: 711).