The AI Agent-powered platform for customer experience

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

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

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

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

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

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

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

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

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

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

Surveying capability for experiences and NPS scoring

Support for eating well, exercising as well as weight loss medications like GLP1

Support for education and retail-to-mail conversion

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

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.

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

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

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

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

Confirmation of medication, immunization, DME orders / refills

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

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

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

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

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

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

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

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

Education and connectivity to support resources for incontenence

Triage inbound RFP emails to identify key attributes regarding Broker, Employer, Quote, and requested Products and automate case setup in Quoting and Underwriting systems.

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

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

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

Patient appointment setting support with reminders and ability to reschedule

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

Update Member information and contact preferences.

Support for review and e-signature for new patient paperwork

Support for member retention with renewal education and reminders

Update Borrower information and contact preferences.

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

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

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

Remind and support Borrower in securely verifying address and contact information during KYC Reviews.

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

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

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

Sharing of lab tests and results

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

Ability for members to opt in to digital communications

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

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

Proactive notifications of appointment availability for patients on wait lists

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

Surveying capability for experiences and NPS scoring

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

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

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

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

Support for member app download and app and portal initial registration

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

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

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

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

Support for education and brand to generic fill conversion

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

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

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

Education on benefits of mail order delivery and Rx transfer support

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

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

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

Patient appointment setting support with reminders and ability to reschedule

Notifications to educate on the importance of chronic condition management, related appointment setting

Ability for Members to opt in to digital communications.

Education and scheduling of Medication Reconciliation appointments

Shipment status updates

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.

Ongong adult preventative wellness education, appointment setting and other actions

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

Completion of forms and e-signing records transfer paperwork

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

Ability for Borrowers to opt in to digital delivery of Statements.

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

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

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

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

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

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

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

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

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

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

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

Support for appropriate site of care with appointment setting

Extract Short Term Disability 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.

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