The AI Agent-powered platform for customer experience

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

Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.

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

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

Education on cost tranparency and cost relief options

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

Post care and pharmacy visit surveys to understand experience gaps for proactive outreach and support as needed

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

Support for education and retail-to-mail conversion

Education on cost tranparency and cost relief options

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

Ability for Borrowers to opt in to digital communications.

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

Year-round support for diabetic members including education, wellness, care gap closure, appointment setting

Education and connectivity to support resources for incontenence

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

Shipment status updates

Ability for Policy Holders to opt in to digital communications.

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.

Provide Policy Holder with the current status of a Claim.

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

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

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

Support for education and brand to generic fill conversion

Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence

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

Support for appropriate site of care with appointment setting

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

Support for member retention with renewal education and reminders

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

Shipment status updates

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

Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.

Ability for members to opt in to digital communications

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

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

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

Patient appointment setting support with reminders and ability to reschedule

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

Securely upload a signed HIPAA release form from the Claimant.

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

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

Guide the Policy Holder through renewing their policy.

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

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

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

Support for education and brand to generic fill conversion

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

Provide Member with the current status of a Claim.

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

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

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

Shipment status updates

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

Ability for clinical representatives to chat within Ushur journeys, and to warm call transfer to them (RN, Pharma, Care Manager)

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

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

Securely accept full or partial payment of outstanding installment amount.

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 other clinical staff member when needed

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

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

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

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.

Education and scheduling of Medication Reconciliation appointments

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

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

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

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

Ability for providers to request clinical guidelines

Guide the Broker / Employer through uploading an updating Census file, Transforming it to the standard format required by the Carrier, and identifying any issues.

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

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

Guide the Claimant through reporting an injury and filing a Claim.

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

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

Patient appointment setting support with reminders and ability to reschedule

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

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

Education and scheduling of Medication Reconciliation appointments

Ability for members to opt in to digital communications

Update Policy Holder information and contact preferences.

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

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

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

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

Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates

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

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

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

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

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

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

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

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

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

Education on benefits of mail order delivery and Rx transfer support