The AI Agent-powered platform for customer experience

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

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

Education and notices on Explanation of Benefits (EOB)

Shipment status updates

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

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

Proactive notifications of appointment availability for patients on wait lists

Answer Member questions on Plan benefits, coverage, and eligibility.

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

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

Support for finding a primary care doctor or pediatrician in network and setting appointment via click-to-call

Provide Borrower with the current status of a payment made to their account.

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

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

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

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

Refill reminders and ordering facilitation (including payment capture)

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

Securely upload a signed HIPAA release form from the Claimant.

Ability for members to inquire about eligibility and verify out of pocket costs

Member welcome notifications that educate on plan benefits, deliver digital ID cards

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

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

Support medication adherence with retail, mail order and 90-day refill request support

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

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

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

Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.

Provide Policy Holder with the current status of a Claim.

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.

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

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

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

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

Education on cost tranparency and cost relief options

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

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

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

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

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

Guide Borrower through shortfalls or excesses in their escrow account, the tax or insurance payments that led to the shortfall, and to securely accept payments for any shortfall.

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

Understand root causes of medication non-adherence and overcome them

Full Health Risk / Needs Survey completion with feeds to core systems for follow-up

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

Education on benefits of mail order delivery and Rx transfer support

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

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

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

Ability for members to opt in to digital communications

Patient appointment setting support with reminders and ability to reschedule

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

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

Support for member retention with renewal education and reminders

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

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

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

Support for member education on benefits and how to utilize them throughout the plan year

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

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

Ongong adult preventative wellness education, appointment setting and other actions

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

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

Ability for Policy Holders to opt in to digital communications.

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

Patient appointment setting support with reminders and ability to reschedule

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

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

Support for education and retail-to-mail conversion

Support for education and 90-day fill conversion

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

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

Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.

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

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

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

Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.

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

Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules

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

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

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

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

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

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

Delivery of member ID cards digitally

Ongoing pediatric preventative wellness education, appointment setting and other actions

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

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

Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.

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

Guide the Member through potential insurance benefits and available workplace accommodations, reduced hours, and reassignments to help them decide between different disability options.

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

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

Sharing of lab tests and results

Provide Member with the current status of a payment on a Claim.

Confirmation of medication, immunization, DME orders / refills

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

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