The AI Agent-powered CX platform for regulated industries

Education and scheduling of Medication Reconciliation

Providing out of pocket cost transparency via Good Faith Estimates

Support for education and 90-day fill conversion

Ability for Policy Holders to opt in to digital communications.

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

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

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

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

Answer policy holder questions on Plan benefits, coverage, and eligibility.

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

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

Support for education and retail-to-mail conversion

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

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

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

Support for education and retail-to-mail conversion

Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.

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

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

Guide the Policy Holder through cancelling their policy.

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

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

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

Update Policy Holder information and contact preferences.

Education and notices on Explanation of Benefits (EOB)

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

Shipment status updates

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

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 members to opt in to digital communications

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

Support for provider credentialing information submission and status updates

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

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

Securely upload a signed HIPAA release form from the Claimant.

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

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

Surveying capability for experiences and NPS scoring

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

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

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

Education on cost tranparency and cost relief options

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 Claimant through reporting an injury and filing a Claim.

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

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

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

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

Patient education on provider and information and documentation completion

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 Borrowers to opt in to digital communications.

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

Ability for providers to request clinical guidelines

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

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...)

Update Borrower information and contact preferences.

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

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.

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

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

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

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

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

Patient appointment setting support with reminders and ability to reschedule

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

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

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

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

Securely accept full or partial payment of outstanding premium amount.

Surveying capability for experiences and NPS scoring

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

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

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

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

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

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

Support for education and retail-to-mail conversion

Support for appropriate site of care with appointment setting

Completion of forms and e-signing records transfer paperwork

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

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

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

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

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

Support for education and brand to generic fill conversion

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

Shipment status updates

Confirmation of medication, immunization, DME orders / refills

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

Support for member retention with renewal education and reminders

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

Support for review and e-signature for new patient paperwork

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.