IBM supercomputer to recommend action on thousands of insurance claims for WellPoint Inc

Demo of IBM WatsonIBM’s famed supercomputer, Watson, is taking on a new challenge, the results of which may have a sweeping impact on the nation’s insurance industry. The supercomputer has successfully overcome several challenges in the past, including a “Jeopardy!” competition in which the computer won a decisive victory against some of the brightest minds in trivia knowledge. Watson has shown that its computing power surpasses the capabilities of a human mind and, because it is a machine, is not prone to typical human error. For this reason, the computer is now being tasked with investigating insurance claims coming from WellPoint Inc., one of the nation’s largest health insurance companies.

WellPoint operates Blue Cross Blue Shield, which itself does business in 14 states, accounting for some 34.2 million members. Because of the company’s expansive clientele, fraud is an unavoidable concern, and one that must be met with staunch action. In an attempt to root out fraud, the Watson supercomputer will be used to investigate the several thousand medical claims the insurer receives on a daily basis. Action on these claims will be determined by the computer.

Watson is a store of the entirety of humanity’s medical knowledge. By granting the computer access to patients medical records and the insurance company’s history of authorizing treatments, the computer can recommend a line if treatment that would be effective for a client’s specific needs. Normally, such a task would take an insurance investigator weeks, or months to complete. Watson can finish the work on thousands of claims in seconds.

Watson’s work will not begin until next year, pending the approval of federal regulators.

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