The AI Agent-powered CX platform for regulated industries

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

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

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

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

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

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

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

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

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

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

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

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

Patient support in finding in network doctors (of any type) that best fit their needs

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

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

Support for shipping / delivery issues, returns and reshipment

Patient appointment setting support with reminders and ability to reschedule

Education on benefits of mail order delivery and Rx transfer support

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

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

Guide the Policy Holder through renewing their policy.

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

Patient education on provider and information and documentation completion

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

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

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

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

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

Ability for members to opt in to digital communications

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

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

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

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

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

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

Ongong adult preventative wellness education, appointment setting and other actions

Confirmation of medication, immunization, DME orders / refills

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

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

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

Education and scheduling of Medication Reconciliation

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

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

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

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

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

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

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

Ongong adult preventative wellness education, appointment setting and other actions

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

Support for education and 90-day fill conversion

Update Borrower information and contact preferences.

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

Member surveys of health risks and needs, SDOH and post care experience and NPS surveys

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

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

Completion of forms and e-signing records transfer paperwork

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

Surveying capability for experiences and NPS scoring

Provide Policy Holder with the current status of a Claim.

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

Provide Member with the current status of a Claim.

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

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

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

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

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

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

Securely upload a signed HIPAA release form from the Claimant.

Support for review and e-signature for new patient paperwork

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

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

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

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

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

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

Support for education and retail-to-mail conversion

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

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

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

Education and appointment setting support for Cancer Screening with appointment reminders and reschedules

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

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

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

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

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

Education and scheduling of Medication Reconciliation

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

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

Ability for providers to request clinical guidelines

Support for Applicants to find Lending options that best fits their needs.

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

Guide Borrower through requesting an official Payoff Letter for their loan.

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

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

Providing out of pocket cost transparency via Good Faith Estimates

Ability for members 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.

Support Applicants in finding Insurance Plan options that best fit their needs.

Education and scheduling of Medication Reconciliation appointments