Health Insurance
Streamline enrollment, billing, and claims, with 98% less friction.
Empower members with faster answers, smoother digital journeys, and fewer reasons to call support.
Resolve friction with real-time, AI-powered insights.
Fix member issues in real time.
Proactively monitor enrollment, billing, and claims workflows with real-time alerts. Detect and fix friction—from benefits lookup to prior authorization—before it escalates to costly support.
Understand the full member journey.
Use AI-powered summaries to uncover frustration and intent across every touchpoint, from enrollment to claim resolution. Empower teams to act quickly and ease the burden on support.
Optimize member experiences at scale.
Segment by journey type—claims, billing, or enrollment—and analyze behavior patterns across web and mobile. Continuously improve digital efficiency and member satisfaction.
Quantify friction before it drives up support costs.
Reduce inbound calls by linking digital behavior to intent. Identify and prioritize issues in member flows like billing, EOB viewing, or ID card access—before they become costly call drivers.
Boost CSAT and star ratings with AI-powered clarity.
Uncover the root cause of member frustration, link digital friction to satisfaction scores, and recommend targeted fixes. From broken enrollment forms to confusing deductible displays, teams can resolve issues faster—improving member experience and protecting star ratings.
Unify insights across portals, call centers, and claims systems.
Combine Quantum Metric data with claims, billing, CRM, and call center insights to create a complete view of the member journey. Link digital behaviors with call center activity to uncover friction, reduce support costs, and improve plan satisfaction.
How health insurance teams use Quantum Metric.
Product teams.
Pinpoint usability issues across member enrollment, claims, and benefits workflows. Prioritize fixes based on business impact and reduce costly member escalations with rapid validation.
Tech teams.
Monitor API and system performance in real time. Use session replay and quantified insights to prioritize and fix bugs affecting patient experiences.
CX/VOC & Support teams.
Link digital sessions to feedback, chat, and call transcripts. Reduce handle time and deflect calls with proactive fixes and AI-powered insights.
Customer stories.
98%
Reduction in friction.
A leading health insurance payer identified and resolved a provider search error affecting over 400 users, deploying a fix within days and virtually eliminating the issue.
14%
Error resolution rate.
A leading health insurance payer gained full visibility across three internal claims applications—including a legacy system—reducing MTTR and eliminating checkout errors.
1,500
Support calls prevented.
A top 10 insurance payer uncovered a design flaw in its native app and web funnel, enabling rapid prioritization and resolution.
FAQ
How does Quantum Metric support healthcare insurance operations?
Quantum Metric gives health insurance organizations—from national carriers and regional health plans to payer-provider hybrids and government program administrators—complete visibility into digital member journeys. Whether it’s enrollment, billing, or claims, teams can detect friction in real time, resolve issues before they escalate to support calls, and deliver a seamless, member-first experience.
Can Quantum Metric connect digital and call data?
Yes. Using data enrichment, Quantum Metric links session data with call center activity via member IDs. This helps national payers, state-based plans, and government administrators understand the digital root causes of high call volume—enabling faster fixes, better self-service, and improved operational efficiency.
How does Felix AI help payers?
Felix AI automatically analyzes member sessions, detects friction, and connects issues to member intent—whether it’s checking benefits, submitting claims, or resetting a password. For large carriers, integrated networks, and regional plans alike, it recommends targeted fixes backed by quantified impact, helping teams resolve issues faster, reduce call center volume, lower operational costs, and improve member satisfaction.
What types of data does Quantum Metric capture?
Quantum Metric captures behavioral (clicks, taps, scrolls), technical (errors, load times, API performance), and transactional (claims submissions, EOB views, premium payments) data across portals, mobile apps, IVR flows, and CRM systems. For national payers and regional plans, this creates a 360° view of the member journey.
Can Quantum Metric reduce call center volume?
Absolutely. By helping health insurance payers proactively identify and resolve digital friction, Quantum Metric enables organizations to deflect thousands of calls and save millions annually—while improving member satisfaction and reducing the burden on agents.
Is Quantum Metric HIPAA-compliant and how do you handle PHI?
Yes. Quantum Metric is HIPAA-ready and SOC 2 Type II certified. By default, we avoid collecting PHI and PII, ensuring that national carriers, regional plans, and government administrators gain behavioral and performance insights while staying compliant with HIPAA, PCI, and other privacy regulations.
Can Quantum Metric integrate with our existing insurance tech stack?
Yes. Quantum Metric integrates seamlessly with claims systems, CRMs, IVR solutions, call center tools, and member portals—embedding insights directly into workflows. For national carriers, regional plans, and integrated delivery networks, this ensures faster action and better coordination across teams.
How quickly can provider teams resolve issues with Quantum Metric?
Teams across large carriers, state-based plans, and payer-provider hybrids have cut resolution times from weeks to hours, with some fixes deployed within minutes—leading to better member experiences and lower operational costs.
