The AI Agent-powered platform for customer experience

Surveying capability for experiences and NPS scoring

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

Ability for members to opt in to digital communications

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

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

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

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

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

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

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

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

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

Extract Basic Life 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

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

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

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

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

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

Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.

Support for appropriate site of care with appointment setting

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

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

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

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

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

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

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

Providing out of pocket cost transparency via Good Faith Estimates

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

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

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

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

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

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

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

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

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

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

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

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

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

Update Borrower information and contact preferences.

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

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

Education on cost tranparency and cost relief options

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

Ability for providers to request clinical guidelines

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

Support for shipping / delivery issues, returns and reshipment

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

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

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

Delivery of member ID cards digitally

Education and scheduling of Medication Reconciliation appointments

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

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

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

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

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

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

Completion of forms and e-signing records transfer paperwork

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

Support for member retention with renewal education and reminders

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

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

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

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

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

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

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

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

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

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

Ability for members to opt in to digital communications

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

Update Member information and contact preferences.

Shipment status updates

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

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

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

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

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

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

Ability for Policy Holders to opt in to digital communications.

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

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

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

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

Education and notices on Explanation of Benefits (EOB)

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

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

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.

Confirmation of medication, immunization, DME orders / refills

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