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Member services

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Redefine the traditional member experience

Our goal is simple – helping modern health plans deliver high value care.

For over 18 years, we have delivered complex customer experience management (CXM) programs for some of the largest health plans, helping them build enduring member relationships. Our wide-ranging solutions leverage a powerful blend of human intelligence, digital support pathways, AI, automation, and analytics to elevate the end-to-end member journey.

The outcome-focused solutions drive down costs, improve accuracy, and increase efficiency for your health plan while unlocking better health outcomes, experience, and affordability for your members.

member-services
centralized-licensing

Dedicated centralized licensing department

  • Oversees licenses, renewals, and advocate appointments
  • Houses over 5000 advocate files and 32,000 licenses
  • Acts as 50-state purchasing platform for new licenses and renewals
  • Syncs with National Producers Database to update advocate license and appointment data
  • In house pre-licensing school accelerates path to licensing
  • Partnership with licensed staffing experts offers access to an expanded pool of advocates

#ResultsMatter

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Above client set goal for appointments scheduled
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Financial accuracy for managed Medicare claims
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Improvement in CSAT with Conversational AI
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Point increase in overall NPS driven by analytics

Our services

How we do it

Building a strong foundation
Our recruitment and training strategy ensures that our advocates deliver outstanding member experiences.

From using targeted profiles and AI-driven algorithms to identify the right candidates to enabling best practices-based training in industry knowledge, language, soft skills, culture, and customer personas.
Taking the member experience beyond sales and support
Our unique Health Advocacy Model places individual members at the center of everything we do – listening with empathy and building genuine connections to fully understand member needs and respond with caring assistance that makes lives better.
Driving frictionless journeys
On the one hand, our comprehensive complaint management program (CIP) fueled by speech analytics acts as an early warning system – helping us proactively identify issues and mitigate risks. On the other, our AI-enabled knowledge management system provides deep insights, driving continuous process improvements and easing the member journey

What sets us apart

AI operations & bots
Driving business outcomes in three critical areas: Revenue Acceleration, Cost Reduction, and Enhanced Customer Experience

Over 30 years of CX experience across multiple industries

KPI-driven delivery for consistent and measurable quality and exceptional CX

Flexible and scalable engagement model to identify issues, analyze CX challenges, and collaborate together

End-to-end expertise across hiring, training, operational execution, and workforce management

Discover new ideas, insights & solutions

Improving-Healthcare-Outcomes-and-Experiences-Using-AI-and-Chatbots

Improving Healthcare Outcomes and Experiences Using AI and Chatbots

Blog

May 9, 2023

Health-Insurer-Member-Service-Plan-Boosts-NPS-12%-with-Analytics

Health Insurer’s Member Service Plan Boosts NPS 12% with Analytics

Operational Excellence

Case Study

March 30, 2023

Appointment-Setting-Campaign-for-Health-Plan-Exceeds-Goal-by-45%

Appointment Setting Campaign for Health Plan Exceeds Goal by 45%, Supporting Better Outcomes

Case Study

March 30, 2023

Transform Your Customer Experience, Act Now!

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