The AI Agent-powered platform for customer experience

Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.

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

Provide Policy Holder with the current status of a payment on a Claim.

Member appointment reminders for care management, provider appointments (any type), home health visits and more

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

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

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

Capture of patient information updates and support for review and e-signature for new patient paperwork

Ability for Borrowers to opt in to digital communications.

Member information updates – including cross-channel contact details and change of insurance

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

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

Support for education and retail-to-mail conversion

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

Education on benefits of mail order delivery and Rx transfer support

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

Update Member information and contact preferences.

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

Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.

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

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

Proactive notifications and inquiry handling about Medicare Annual Notices of Change. Including FAQ support for top ANOC call drivers

Refill reminders and ordering facilitation (including payment capture)

Securely upload a signed HIPAA release form from the Claimant.

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

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

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

Shipment status updates

Support for member app download and app and portal initial registration

Ability for members to opt in to digital communications

Refill reminders and ordering facilitation (including payment capture)

Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.

Education and appointment setting support for Vaccination with appointment reminders and reschedules

Guide the Policy Holder through re-instating a lapsed policy.

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

Provide Member with the current status of a Claim.

Notifications to educate on the importance of care plan adherence, related appointment setting

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

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

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

Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level

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

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

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

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

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

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

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

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

Understand root causes of medication non-adherence and overcome them

Ability for Policy Holders to opt in to digital communications.

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

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

Support for appropriate site of care with appointment setting

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

Understand root causes of medication non-adherence and overcome them

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

Securely accept full or partial payment of outstanding premium amount.

Confirmation of medication, immunization, DME orders / refills

Education and connectivity to support resources for incontenence

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

Support for Applicants to find Insurance Plan options that best fit their needs.

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

Click-to-call or chat to speak to Care Manager / Navigator when needed

Support member ability to search for any type of in network provider and click-to-call to set appointments

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

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

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

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

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

Education on cost tranparency and cost relief options

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.

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

Guide the Policy Holder through reporting a loss and filing a Claim.

Ability for providers to inquire about claim status, adjudication and payments

Patient appointment setting support with reminders and ability to reschedule

Guide the Policy Holder through renewing their policy.

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

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

Update Borrower information and contact preferences.

Patient appointment setting support with reminders and ability to reschedule

Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up

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

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

Shipment status updates

Update Policy Holder information and contact preferences.

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

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

Identify Census files in an inbound RFP and Transform the file to the standard format required by the Carrier and identify any issues.

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

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

Support for shipping / delivery issues, returns and reshipment

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

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

Education and scheduling of Medication Reconciliation

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

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

Patient appointment setting support with reminders and ability to reschedule

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