Ushur Unveils Intelligent Automation Solution to Handle Benefits Enrollment Influx With Transformed Member Experiences and Improved HEDIS Measures

New AI-enabled journey drives unparalleled efficiency over all channels of engagement for Open Enrollment across ACA, Medicare and Employer Group Plans

Ushur, the leader in AI-powered Customer Experience Automation (CXA), announced Ushur for Open Enrollment – a complete solution that helps health plans optimize their business and member operations across their entire enrollment journey. The solution improves HEDIS measures and member satisfaction and reduces phone calls by up to 25 percent.

On July 14, 2021, the Centers for Medicare and Medicaid Services (CMS) announced that more than 2 million people have enrolled in marketplace coverage since the Biden administration authorized a broad COVID-19 Special Enrollment Period (SEP). This enrollment rate will remain high given reports that a further 2.8 million people have applied for marketplace coverage but have not selected a provider or specific plan. The sharp rise in enrollment means participants and health plans urgently need more efficient ways to complete their enrollment journey without long phone delays.

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Ushur offers the only open enrollment solution that can intelligently provide straight-through-processing (STP) of end-to-end processes across the entire member journey. This includes offering initial plan options, enrolling members in the proper plans, completing health risk assessments, fielding routine inquiries like demographic and beneficiary changes, delivering enrollment notifications and digital ID cards, getting members connected to the right in-network caregivers and ultimately enrolled in the proper care management programs.

As members continue to demand access to more intelligent, digital experiences that don’t require them to file detailed paperwork, understand arcane terms, endure long hold times or lengthy phonecalls with handoffs across channels, progressive health plans are embracing AI to offer digital-first experiences that deliver fast, paperless and easy-to-understand enrollment processes.

Ushur’s open enrollment solution encompasses a broad array of customizable, AI-enabled micro-engagements™ that health plans can deploy, rapidly and securely, alongside their existing IVR, BPM, CRM and Care Management applications. Ushur’s Language Intelligence Solution Architecture™ (LISA) and Document Intelligence Solution Architecture™ (DISA) understand the healthcare lexicon, and intelligently interact with broker, member and provider requests through voice, text and email channels seamlessly in a fully automated, unattended manner. With HIPAA and SOC2 security compliance, Ushur’s solution exceeds all the security and privacy compliance requirements demanded by the healthcare industry.

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“Ushur for Open Enrollment enables carriers to transform the member experience from being an annual, cumbersome transaction,” said Simha Sadasiva, CEO and co-founder of Ushur. “Instead, open enrollment becomes the beginning – or renewal of – a partnership between a member and their health plan focused on wellness, quality of care and savings throughout the year. This includes making it easy for members to select their primary care physician and locate specialists in their network. Other enhancements include a streamlined health risk assessment process and proactive care program education, to ensure each member gets the maximum value of their benefits.”

Ushur’s no-code process and orchestration builder, out-of-the-box APIs and modern machine learning interfaces simplify how these enrollment journeys are implemented, customized and managed over their lifecycle.

Ushur for Open Enrollment is available immediately, and can be deployed within weeks even at large enterprise settings and is priced on a “pay per interaction” model that does not necessitate significant upfront investments. Already battle-tested at major carriers, Ushur has helped millions of members across their healthcare journeys and saved insurers millions of dollars of unnecessary manual costs.

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