Covered California Partners with Google Public Sector to Use AI to Accelerate Healthcare Access for Millions--While Reducing Fraud

Covered California expanded its CalHEERS partnership with Google Public Sector and Deloitte to update how eligibility and enrollment documents were verified under the health insurance application process. The change targeted faster confirmation compared with the prior verification window and focused on handling document information in a more automated workflow.

The release said CalHEERS required applicants to submit documentation related to income and residency status to secure coverage. It stated that verification previously could take between 72 hours and three weeks, often followed by calls weeks after applicants believed they were enrolled.

Covered California implemented a customized, AI-driven system with Google Public Sector and Deloitte that provided real-time, on-screen feedback to applicants within a few seconds. It said DocAI automated the vast majority of document verifications and used a human-in-the-loop approach to route complex or ambiguous cases to service center representatives.

According to the release, the program used Google Cloud’s Document AI across healthcare insurance eligibility workflows and reported a 40% reduction in manual tasks. It also said automated verification covered 25 new document types and flagged potential fraud markers for human specialist review rather than automatically rejecting applications.

“Covered California seeks industry partners to design solutions to support our mission to provide access to affordable, high-quality healthcare as a basic human right,” said Kevin Cornish, Chief Information Officer, Covered California. “By leveraging Google Cloud's Document AI, we have transformed the eligibility journey into a real-time, consumer-friendly experience. This advancement enables our staff to focus their expertise on high-value engagement and problem-solving with applicants, ensuring they receive the support they need.”

“True innovation in the public sector is measured by the lives it improves through modernization,” said Matthew Schneider, U.S. Education, State and Local Government, Google Public Sector. “Leveraging Google Cloud's AI technologies and Deloitte's industry expertise, Covered California has built a system that accelerates access to healthcare while protecting every applicant's data with the highest level of integrity.”