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product suite / member experience

Optimize Member Experience with AI-Powered Solutions

Optimize workflows and automate manual processes to deliver better outcomes and improve member experience.

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Key value & Benefits

Maximize efficiency, satisfaction, and compliance

Our intelligent tools and automated workflows deliver personalized experiences, help ensure timely issue resolution, and support better star ratings. 

Reduce operating
costs

Centralize data to facilitate stronger collaboration and drive regulatory compliance.

Increase member satisfaction

Boost member satisfaction scores by delivering personalized experiences, resolving issues faster, and improving communications.

Boost star
ratings

Enhance quality measures and member engagement to boost your star ratings, retain your valued members and grow your business. 

Mitigate
compliance risks

Built-in compliance features and AI-powered audit tools support regulatory adherence and mitigate compliance risks. 

Enhancing member operations is key to delivering exceptional healthcare experiences. With a focus on operational efficiency and member satisfaction, we bring a suite of benefits that transform how you manage member services, leading to better outcomes and stronger relationships.

Automated case management

Streamline the A&G process with automated workflows, ensuring quick and consistent handling of member cases.

Compliance tracking and reporting

Built-in compliance monitoring ensures that every appeal and grievance is tracked and reported in accordance with regulatory guidelines.

Faster resolution
times

Reduce the time spent on manual tasks and improve response times by automating case intake, tracking, and follow-up.

Enhanced member
engagement

Deliver personalized communication and support, improving member experience and fostering stronger relationships.

our products

Automate operational processes to improve
total experience

Eliminate systemic inefficiencies and compliance headaches with our Member Experience Platform to enhance the experiences of your members, providers, delegates, and employees. Our HIPAA-compliant, HITRUST CSF®-certified modular platform can offer individual solutions or a comprehensive suite that drives seamless, secure, efficient, and cost-effective operations. 
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Health Plan Marketing CRM

Drive engagement, grow membership, and maximize ROI

Eliminate data silos with a healthcare-centric CRM that centralizes member data, enabling precise, insight-driven outreach. Automate campaigns, track engagement, and deliver personalized experiences that boost member acquisition and loyalty—all while optimizing marketing efficiency and ROI.
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Health Plan Services CRM

Support members with intelligent automation

Manage service requests and outreach efficiently with our Healthcare CRM solution. Personalize communication with the GenAI platform and deliver messages via preferred channels. Gain actionable insights into member behavior and trends to enhance retention strategies. 
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Member Portal

Improve member experience through a secure interface

Empower your members with convenient access to their health data and services on demand. Our secure, user-friendly portal enhances satisfaction by simplifying information access and putting control at their fingertips. 
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Call Log Scrubber

Map your member journey to elevate member experiences

Elevate your operations with a reliable, responsive complaints tracking tool that helps you deliver exceptional member experiences.    
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Member360

Support compliance to elevate satisfaction 

Empower smarter decisions and improve member experiences with Member360. Reduce fragmented customer journeys by empowering member retention leaders with comprehensive view of the member experience. 

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Appeals & Grievances Management

Resolve issues faster and ensure compliance

Our appeals & grievances product helps you ensure timely, transparent resolutions, which improves member satisfaction and sustains compliance. Automate processes, simplify case management, reduce turnaround times, and leverage one-click regulatory report generation. 
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Appeals & Grievances Universe Generator

Drive compliance and enhance satisfaction 

Supported by a sophisticated compliance rules engine, this robust solution helps generate Part C & D Grievance and Appeal universes in one click, enabling you to manage compliance even when it’s not top of mind.

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Potential Quality Issues (PQI)

Improve member experience through a secure interface

Empower your members with convenient access to their health data and services on demand. Our secure, user-friendly portal enhances satisfaction by simplifying information access and putting control at their fingertips. 
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Healthcare Operation Copilot

Power member services with AI

Enhance your member services and boost productivity with Usher AI, your ultimate AI-powered copilot.

AI chatbot

Handle common inquiries, provide instant responses and reduce workloads, with the ability to escalate complex issues to human agents when necessary. 

Smart and quick summarization 

Usher AI simplifies the handling of complex regulatory documents such as HPMS memos by summarizing key points and identifying necessary compliance actions. 

monitor

Monitoring for continuous compliance 

Have quick and accurate access to compliance-related information, ensuring member inquiries are resolved efficiently. 

integrate

Integrate with existing systems

Usher AI integrates seamlessly with your existing systems, ensuring a smooth transition and minimal disruption to workflows. 

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Related products

Elevate your member operations with additional offerings

Tap into additional capabilities and streamline your member operations with our comprehensive add-on solutions to experience enhanced efficiency, improved compliance, and superior member satisfaction. 
Provider relationship management
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Provider Dispute Resolution

Efficiently manage and resolve provider disputes with streamlined workflows and foster transparency and trust with providers.  
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Provider relationship management
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Provider CRM

Build and maintain strong provider relationships with our robust CRM solution. Centralize provider information, track interactions, and ensure personalized communication.
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Provider relationship management
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Quality Improvement Organization (QIO)

Ensure continuous quality improvement for members through systematic quality assessments and interventions. 
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Explore our AI-driven technologies

Want to learn how to optimize your healthcare operations and compliance processes?

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