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.
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.Â
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.Â
Mitigate
compliance risks
Built-in compliance features and AI-powered audit tools support regulatory adherence and mitigate compliance risks.Â
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
Health Plan Marketing CRM
Drive engagement, grow membership, and maximize ROI
Health Plan Services CRM
Support members with intelligent automation
Member Portal
Improve member experience through a secure interface
Call Log Scrubber
Map your member journey to elevate member experiences
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.Â
Appeals & Grievances Management
Resolve issues faster and ensure compliance
Appeals & Grievances Universe Generator
Drive compliance and enhance satisfactionÂ
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.
Potential Quality Issues (PQI)
Improve member experience through a secure interface
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 summarizationÂ
Usher AI simplifies the handling of complex regulatory documents such as HPMS memos by summarizing key points and identifying necessary compliance actions.Â
Monitoring for continuous complianceÂ
Have quick and accurate access to compliance-related information, ensuring member inquiries are resolved efficiently.
Integrate with existing systems
Usher AI integrates seamlessly with your existing systems, ensuring a smooth transition and minimal disruption to workflows.Â
Related products
Elevate your member operations with additional offerings
Provider relationship management
Provider Dispute Resolution
Provider relationship management
Provider CRM
Provider relationship management