The AI Agent-powered platform for customer experience

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

Shipment status updates

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

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

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

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

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

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

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

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

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

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

Update Policy Holder information and contact preferences.

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

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

Education and scheduling of Medication Reconciliation appointments

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

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

Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration

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

Provide Member with the current status of a Claim.

Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.

Ongong adult preventative wellness education, appointment setting and other actions

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

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

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

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

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

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

Ability for Borrowers to opt in to digital communications.

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

Support for member app download and app and portal initial registration

Support for member app download and app and portal initial registration

Education and scheduling of Medication Reconciliation appointments

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

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

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

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

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

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

Education and scheduling of Medication Reconciliation

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

Guide the Policy Holder through reporting a loss and filing a Claim.

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

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

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

Safe and secure collection of member ID card(s), driver's license images

Ongoing pediatric preventative wellness education, appointment setting and other actions

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

Support for education and brand to generic fill conversion

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

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

Support for provider credentialing information submission and status updates

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

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

Ongoing pediatric preventative wellness education, appointment setting and other actions

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

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

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

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

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

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

Reach out to delinquent Borrowers with empathy to identify circumstances such as job loss, illness, divorce, deployment that may be eligible for relief measures.

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

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

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

Support for education and 90-day fill conversion

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

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

Support for education and retail-to-mail conversion

Patient appointment setting support with reminders and ability to reschedule

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

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

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

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

Provide Policy Holder with the current status of a Claim.

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

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

Refill reminders and ordering facilitation (including payment capture)

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.

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

Education and scheduling of Medication Reconciliation

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

Ability for Members to opt in to digital communications.

Patient appointment setting support with visit prep instructions, reminders and ability to reschedule

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

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

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

Providing out of pocket cost transparency via Good Faith Estimates

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

Ability for members to opt in to digital communications

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

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

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

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

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

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

Support for shipping / delivery issues, returns and reshipment