The AI Agent-powered platform for customer experience

Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Member appointment setting with service or sales agents in support of their buying process

Ability to send notifications to members more timely to meet regulatory timing requirements

Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.

Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.

Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting

Ability for Members to opt in to digital communications.

Patient appointment setting support with reminders and ability to reschedule

Support for member ongoing utilization of website, traditional apps and portals

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Ability for members to receive push notices for, or make inquiries about, prior authorization status

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Support for shipping / delivery issues, returns and reshipment

Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete

Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)

Click-to-call or chat to speak to other clinical staff member when needed

Ability for patients to receive push notices for, or make inquiries about, prior authorization status

Proactive invitations and RSVPs for community events and meetings (virtual and in person)

Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.

Education and scheduling of Medication Reconciliation appointments

Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them

Surveying capability for experiences and NPS scoring

Ability for Borrowers to opt in to digital communications.

Update Borrower information and contact preferences.

Ability for members to understand and file Grievances, and receive status updates

Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Education and connectivity to support resources for fall prevention (movement, home safety...)

Notifications to educate on the importance of chronic condition management, related appointment setting

Collection of cross-channel member contact information to support better communications

Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)

Proactive notifications of appointment availability for patients on wait lists

Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7

Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7

Triage inbound RFP emails to identify key attributes regarding Broker, Employer, Quote, and requested Products and automate case setup in Quoting and Underwriting systems.

Proactive member out of pocket notifications – with support for “price shocks”

Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.

Medication Adherence (overcome barriers - cost, transportation, adverse effects)

Securely accept full or partial payment of outstanding premium amount.

Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting

Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)

Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.

Ability for members to opt in to digital communications

Overview of PBM support and services and population health and quality programs

Reach out to delinquent Borrowers with empathy to identify circumstances such as job loss, illness, divorce, deployment that may be eligible for relief measures.

Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.

Support for full maternity journeys with education, appointment setting, wellness and more

Ability for any provider to update their roster information for provider directory accuracy

Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)

Proactive Rx status notifications (fill status, issues like prior auth)

Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Remind and support Member in securely uploading required supporting documents for a Claim.

Notifications to educate on the importance of Care Management and set appointments

Collection of member information updates such as adding dependants, changing address, etc

Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.

Click-to-call or chat to speak to pharmacy staff member when needed

Notification of shipment with tracking number and delivery instructions (i.e. someone needs to be home at delivery)

Education on cost tranparency and cost relief options

Guide the Policy Holder through cancelling their policy.

Shipment status updates

Notification of shipment with tracking number and delivery instructions (i.e. someone needs to be home at delivery)

Schedule follow up call with Sales Representative with reminders and rescheduling.

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Ongong adult preventative wellness education, appointment setting and other actions

New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)

Remind and support Applicant in securely uploading required supporting documents post Application.

Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)

Support for review and e-signature for new patient paperwork

Support for understanding and accessing SDOH resources such as nutrition, transportation

Click-to-call or chat to speak to pharmacy staff member when needed

Sharing of lab tests and results

Support for education and brand to generic fill conversion

Collection of cross-channel member contact information to support better communications

Click-to-call or chat to speak to other clinical staff member when needed

Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7

Education and appointment setting for preventative wellness medications, immunizations and tests

Education on benefits of mail order delivery and Rx transfer support

Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing

Provide Borrower with details of the current balance on their account.

Delivery of member ID cards digitally

Remind and support Applicant in securely uploading required supporting documents post Application.

Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting

Support for education and retail-to-mail conversion

Proactively reach out to Policy Holders after a Disaster, such as storm, wildfire, or flood to connect them to required services and relief, and to file any Claims if required.

Extract Accidental Death and Dismemberment related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration

Provide Member with the current status of a Claim.

New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)

Surveying capability for experiences and NPS scoring

Member support in finding a health insurance plan that best fits their needs

Schedule follow up call with Sales Representative with reminders and rescheduling.

Refill reminders and ordering facilitation (including payment capture)

Sharing of pre visit preparation instructions with ability to automate answers to inquiries

Support for eating well, exercising as well as weight loss medications like GLP1

Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.

Ongoing pediatric preventative wellness education, appointment setting and other actions

Patient education on provider and information and documentation completion