The AI Agent-powered CX platform for regulated industries

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

Support for member retention with renewal education and reminders

Education on benefits of mail order delivery and Rx transfer support

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

Ongong adult preventative wellness education, appointment setting and other actions

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

Provide Policy Holder with the current status of 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.

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

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

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

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

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

Year-round support for diabetic members including education, wellness, care gap closure, appointment setting

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

Shipment status updates

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

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

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

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

Support for education and 90-day fill conversion

Education and connectivity to support resources for incontenence

Update Policy Holder information and contact preferences.

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

Education and scheduling of Medication Reconciliation

Securely accept full or partial payment of outstanding installment amount.

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

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

Ability for members to opt in to digital communications

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

Support for education and 90-day fill conversion

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

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

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

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

Providing out of pocket cost transparency via Good Faith Estimates

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

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

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

Education on cost tranparency and cost relief options

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

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

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

Support for education and retail-to-mail conversion

Ongoing pediatric preventative wellness education, appointment setting and other actions

Update Borrower information and contact preferences.

Ability for Borrowers to opt in to digital communications.

Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.

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

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

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

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

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

Understand root causes of medication non-adherence and overcome them

Support for education and retail-to-mail conversion

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

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

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

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

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

Surveying capability for experiences and NPS scoring

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

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

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

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

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

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

Support for review and e-signature for new patient paperwork

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

Support for shipping / delivery issues, returns and reshipment

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

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

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

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

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

Ability for providers to request clinical guidelines

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

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

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

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

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

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

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

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

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

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.

Refill reminders and ordering facilitation (including payment capture)

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

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

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

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

Surveying capability for experiences and NPS scoring

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

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

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

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

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