Expedited Claims and AI Policy

HealthEquity is committed to delivering our best user experience by leveraging advanced technology, ensuring that members fully benefit from their elected plans. Our latest innovation, Expedited Claims, is a leap forward—an Artificial Intelligence (AI)-powered feature available on our EZ Receipts mobile app that transforms claims processing, ensuring that reimbursement funds are utilized to their full potential.

This new functionality lets members quickly capture a photo of their receipt and upload it directly through the mobile app. The required information is automatically extracted and populated, ready to be submitted for swift approval or denial. Within minutes, members receive the decision on their claim!

The AI-powered feature reduces time spent in claims filing and decisioning; what was days is now less than 2 minutes. It enhances the member experience by providing real-time updates and ensures funds aren’t left unclaimed, maximizing their benefits usage.

Early member adopters are experiencing heightened satisfaction with their Flexible Spending Account (FSA), Health Reimbursement Arrangement (HRA), and Limited Purpose FSA claims, with Expedited Claims initially processing pay me back prescription and over-the-counter claims. The improvement is largely due to several key benefits: eliminating manual entry errors that can cause claim rejections or delays, drastically reducing the time required to file a claim to just a few minutes and shortening the end-to-end claims filing to decision period. Additionally, the EZ Receipts App enables anytime, anywhere, at your fingertips claims filing, minimizing the hassle of searching for lost receipts.

HealthEquity is applying technology in the development of our innovative products and features to improve our member and client experience:

Optical Character Recognition (OCR) reads the content of a receipt and converts it to text, Natural Language Processing (NLP) helps us create meaning from the text (e.g., this text is a purchased item, this is a patient name, this is a purchase date), and AI helps with the decisioning by quickly identifying what is eligible for reimbursement and what is not. (e.g., this item is eligible, this item is not, this item may be eligible when accompanied by a letter of medical necessity). Further, it does not distinguish or factor who is seeking reimbursement, meaning the AI is not processing Personally Identifiable Information (PII).

Members benefit from a technology enriched experience that has been developed with a carefully created set of principles, policies, and practices regarding the use of AI.

As HealthEquity creates features to enhance our ability to serve clients and members well, we apply principles informed by global thinking about technology and bring forward the careful principles and practices that we have always operated with.

Our use of AI is governed by principles, policies, and practices.

Governments and companies across the world are figuring out how to use AI responsibly. Of concern is how to ensure algorithms support and not override consumer protections established by law. We have adopted a set of responsible AI use principles that are informed by worldwide industry best practices and identified by the Federal Trade Commission (FTC).

The principles ensure that we use AI technology in a responsible manner, going beyond its efficiencies to carry forward practices and protections, and to comply with applicable laws.

Products that incorporate the use of AI are reviewed by our AI governance council and must meet criteria driven by these principles.

The principles are:

(i) be transparent with consumers about their interaction with AI tools.

(ii) clearly explain decisions that result from the AI;

(iii) ensure that decisions are fair;

(iv) ensure that the data and models being used are robust, secure, and empirically sound; and

(v) be accountable to applicable rules and regulations, ethics, fairness, and nondiscrimination.

In addition to AI principles, we ensure that our established contractual obligations, practices, and protections for privacy are honored.

These include policies that address HIPAA, personal data, customer data, considerations to the Gramm Leach Bliley Acy and others to ensure we meet audit scrutiny and standards¹. Among them are our:

Information Security Policy

Information Technology Policy

Privacy Policy

Record Retention Policy

Marketing Policy

To administer these principles and policies, HealthEquity established and operates an AI governance council. The purpose of the AI Council is to:

Vet all proposed use cases of AI in our products.

Begins with a formal approval request and requires unanimous agreement by the council (executive leadership team, subject matter experts, cross functional- legal, technology, privacy).

The use must have auditable quality that meets the AI standards of use and complies with AI governance principles.

Further, our practices require ongoing assessment of all AI use cases, monitoring and reporting to the company’s Board of Directors.

As a leader in our industry, we will continue to learn and evolve our principles and practices as we consider other leading industries and companies, federal law and guidance of learned counsel.

We understand the importance of maintaining rigorous data privacy governance. We prioritize safeguarding data privacy in the design, implementation, and use of AI innovations, incorporating our privacy practices consistent with applicable laws, regulations, contractual requirements, and internal policies. As new laws governing AI go into effect, we are prepared to adapt and comply quickly with continuous improvement efforts and application of industry best practices. As a company, we are committed to our ongoing investment in the technology and processes that support data security, consumer privacy and responsible AI use.

¹HealthEquity policy documents are for internal use only, not for external distribution. Please contact Legal and/or Compliance team members for additional support as necessary.