A Suite of AI Enabled Web Portals & Native Mobile Applications for Your Stakeholders & Consumers
Purpose-built for the Modern Needs of Payers, TPAs, and PBMs
Designed to Enhance Your Member Engagement, Drive Better Health Outcomes & Reduce Care Delivery Efforts
Empowering Brokers with Full Control, Insight, and Efficiency for Better Client Acquisition and Retention
Enable Employers To Manage Group Memberships & Benefits Utilization With Ease
Tools, Insights, and Transparency at Every Stage of Interaction with Payers
Intelligent Portals Designed for Experience, Engagement & Efficiency.
Advanced technology and human-centered design that engage consumers deeply, empower seamless self-service, and streamline complex operations. All while improving health outcomes and giving Payers the agility to scale for the future.
Design
Human-centered, intuitive interfaces that make complex healthcare interactions simple for every user.
Technology
Scalable, AI-powered, and compliance-ready platforms built on modern architecture for tomorrow’s needs.
Enhances Engagement
Keeps all stakeholders actively connected through smart campaigns, notifications, and multi-channel experiences.
Promotes Self Service
Empowers every user to manage benefits, claims, and care independently, reducing support calls and delays.
Streamlining Operations
Automates workflows, integrates data seamlessly, and cuts through administrative complexity for faster outcomes.
Elevate Your Consumer Experience
By Combining Conversational & Predictive Intelligence
For Seamless Personalized Engagement
Elevate your consumer experience by offering a dynamic, personalized portal solution that understands and anticipates customer needs, ensuring seamless engagement at every touchpoint. Through real-time conversations and proactive recommendations, empower your business to forge deeper, more meaningful connections, cultivating lasting loyalty and exceptional satisfaction.
Intelligent Features That Are Seamlessly Integrated Across All Portals
- End-to-End Transparency Across Workflows
- Multi-Channel Access (Web, Mobile, Messaging, Phone)
Dive Into the Capabilities of Feature-Rich Portals
Empowering Every Consumer
Designed to Enhance Your Member Engagement, Drive Better Health Outcomes & Reduce Care Delivery Efforts
A One Stop Shop for Members to manage their coverage, search for benefits, find care, understand claims, and track prior authorizations. While it primarily focuses on enabling ease of self-service, thereby reducing operational workload for enterprises, it also simplifies and enhances interactions with Member Engagement teams.
Web
Mobile
Intelligent AI-Driven Assistance and Insights
- Enable natural language interaction allowing members to chat, type, or speak to get things done – from checking claim status to navigating benefits – all in plain, conversational language.
- Provide smart document understanding by highlighting key sections in policies, claim summaries, or EOBs, explaining confusing terms, and answering “what does this mean?” instantly.
- Deliver personalized health insights by surfacing relevant alerts, reminders, and care recommendations based on each Member’s profile, benefits usage, and wellness goals.
- Drive engagement with proactive nudges & notifications that keep members on track with timely alerts about pending actions, upcoming authorizations, or available programs – without extra manual outreach.
Full Self-service Capabilities
- Provide instant access to coverage & benefits for members to view plan details, coverage levels, accumulators, and tier-based eligibility – all in one place.
- Enable claims & prior authorization tracking by letting members monitor claim statuses, view EOBs, and track authorizations in real time with clear, jargon-free breakdowns.
- Offer a smart document hub where members can access policies, claims documents, treatment bills, and more, with AI-powered summaries and contextual help.
- Simplify policy management by allowing members to add or remove dependents, report life events, and update coverage — no paper forms, emails, or delays.
- Deliver a seamless multi-channel experience to empower members to self-serve on web or mobile, anytime and anywhere.
Seamless Experience Across All Channels
- Provide consistent multi-channel access so members can manage their benefits on web, mobile apps, or even messaging platforms like iMessage, with the same intuitive experience everywhere.
- Enable instant switch from AI to human support by connecting members directly to a live Agent via chat or call when AI can’t resolve their query – no hold times, no system toggling.
- Ensure persistent conversations by carrying chats across channels, so Members never have to repeat themselves – improving satisfaction and speeding up resolution.
- Deliver 24/7 convenience by letting members self-serve anytime, get support when needed, and switch between channels effortlessly without losing context
Tailored Campaigns to Drive Better Health Outcomes
- Launch payer & employer sponsored programs and education campaigns to promote wellness, prevent chronic conditions, that aligned with Member needs and engagement goals.
- Enable flexible program delivery by running in-house initiatives or seamlessly integrating campaigns from trusted third-party vendors.
- Drive relevance with personalized member targeting by tailoring campaigns to age, risk profile, conditions, location, or engagement history for stronger participation and outcomes.
- Boost engagement through Multi-Channel Reach by delivering nudges, reminders, and CTAs via web, mobile, email, and in-portal messaging, all tied back to Member action.
- Optimize with Real-Time Engagement Metrics by tracking participation, measuring message resonance, and refining campaigns with live insights
Making Healthcare Decisions Easier and More Transparent
- Help members find the right care by searching for in-network doctors, specialists, clinics, and urgent care, filtered by location, availability, gender, specialty, language, and more.
- Enable integrated scheduling so members can book appointments with providers directly from the portal – no phone calls or separate logins required.
- Provide telehealth access on-demand to let members connect with virtual care providers in just a few clicks – ideal for busy schedules, rural Members, or urgent non-emergency needs.
- Offer drug & pharmacy lookup to compare drug prices, view covered medications, and find nearby in-network pharmacies, including generic alternatives and formulary insights.
- Deliver cost estimations & coverage clarity so members can see what’s covered and what’s not, with smart, easy-to-read breakdowns of costs before care is received.
Drives Adoption
- Deliver an intuitive, modern UX with clean layouts, contextual prompts, and zero jargon, so Members feel confident using it from day one.
- Provide guided onboarding & help through step-by-step walkthroughs, in-app tooltips, and embedded FAQs to ensure Members know exactly where to go and what to do.
- Enable multi-channel access for more usage by making the platform accessible via web, mobile, and even iMessage, letting Members use it when and how they prefer.
- Drive proactive engagement with smart nudges, reminders, and program invitations that keep Members returning with purpose, not just when problems arise.
- Offer integrated support to prevent dead ends by providing live Agent access and natural language assistance, reducing frustration and encouraging continued self-service.
Tools, Insights, and Transparency At Every Stage of Interaction With Payers
Empowering Providers at every step of their interaction with Payers — Pre-Service, During Service, and Post-Adjudication - by providing them with the tools, insights, and transparency they need to focus on what matters most: patient care.
Web
Mobile
Intelligent AI-Driven Assistance and Insights
- Enable smarter Prior authorizations with AI that auto-fills requests, predicts approval likelihood, and tracks statuses in real time – reducing delays and administrative back-and-forth.
- Deliver clinical insights at the point of care by summarizing member health history and highlighting critical details from Continuity of Care (COC) documents, ensuring Providers get actionable, HL7-compliant insights without digging through records.
- Offer transparent claim support by identifying common denial reasons, recommending resolution steps, and drafting appeal narratives, helping Providers recover faster with less effort.
- Provide proactive notifications & nudges so Providers receive timely reminders for pending authorizations, claim updates, or required documentation – ensuring nothing falls through the cracks.
Pre-Service
- Enable instant eligibility & benefits verification so providers can check Member eligibility, coverage details, and cost-sharing responsibilities on demand.
- Streamline prior authorizations by allowing requests to be submitted digitally, tracked in real time, and appealed with ease.
- Provide price & reimbursement estimates to show providers what they’ll get paid before rendering care, while also guiding Members on their expected out-of-pocket costs.
- Ensure administrative readiness by eliminating back-and-forth with Payers, enabling Providers to arrive at every encounter fully prepared.
Post-Service
- Enable secure service documentation upload, allowing providers to attach clinical notes, lab results, and treatment updates directly to the Member’s record.
- Facilitate care coordination by allowing providers to share post-visit information with other providers, specialists, or care teams – ensuring continuity without duplication.
- Streamline Member Communication with secure updates, instructions, and follow-up reminders sent directly from the portal.
- Simplify claim submission by enabling Providers to submit claims with guided steps, supporting documentation, and instant confirmation – reducing errors and delays.
Post Adjudication
- Enable real-time claims tracking, allowing Providers to monitor statuses from submission through adjudication with clear indicators of progress and outcomes.
- Provide instant access to Electronic Remittance Advice (ERA) to simplify reconciliation with detailed, accurate remittance information.
- Streamline denial management & appeals by offering clear explanations for denials, enabling digital appeal submissions with supporting documentation, and real-time tracking.
- Ensure audit-ready records by maintaining a complete history of claims, remittances, and appeals with built-in audit trails for compliance and reporting.
Provider Onboarding & Network Management
- Simplify digital onboarding by providing guided, self-service registration for new providers and facilities.
- Streamline credentialing & compliance through digital management of documentation, licenses, and certifications, with built-in alerts for renewals and expirations.
- Enhance contract management by digitizing workflows, tracking agreement statuses, and ensuring transparency across Provider relationships.
- Gain real-time network visibility & insights into active network data, including specialties, capacity, and geographic distribution.
- Enable providers to seamlessly update their information – including address, hours, and services – directly through the portal, keeping the network accurate and compliant.
Transforming Benefits Administration for your Employers with Efficiency, Engagement, Insight, and Cost Control
With the needs of employers in mind, the platform is designed to allow effortless management and oversight of employee benefits and usage. Employers can easily manage their group membership, including open enrollment, life change events, member profile information, understanding plan benefits, invoices, and plan performance.
Web
Mobile
Intelligent AI-Driven Assistance and Insights
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Enable natural language support for admin tasks, allowing Employers to get instant answers to questions like “Show me this month’s invoices” or “How are claims trending?” without digging through reports.
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Enable smart renewal recommendations, leveraging AI to analyze utilization patterns and cost trends, suggesting plan adjustments or alternatives for better renewal outcomes.
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Enable proactive alerts & notifications, nudging Employers about upcoming renewals, unusual spend patterns, pending approvals, or missing documents to keep everything on track.
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Enable simplified data interpretation, translating complex financial and benefits data into clear, visual insights so Employers can focus on decisions, not deciphering spreadsheets.
Simplified & Flexible Benefits Management
- Enable Effortless Enrollment by managing life event changes – marriage, childbirth, dependent updates – and open enrollment seamlessly in one place.
- Provide Flexible Coverage Management to adjust plans, coverage tiers, and employee profiles with ease, ensuring benefits keep pace with workforce needs.
- Deliver Clear Benefits Oversight by giving access to up-to-date plan details and benefit usage, helping Employers and employees understand coverage better.
- Streamline Collaboration by connecting directly with Payers and Brokers through the platform for faster resolutions and fewer administrative bottlenecks.
View & Manage Your Financial Spends
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Enable pre-payment registers, allowing Employers to review and approve payments before they’re made with full clarity on cash flow.
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Enable cash outflow trend analysis, helping Employers track spending patterns over time and plan ahead with confidence for upcoming expenses.
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Enable savings insights, showing how plans drive savings for both the business and employees while guiding smarter renewal decisions.
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Enable integrated payments, empowering Fully-Insured Employers to view and pay invoices directly from the portal while securely managing EFT accounts.
Employee Health & Wellness Engagement
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Launch tailored campaigns that allow Employers or Payers to promote preventive care, chronic condition management, fitness, or mental health.
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Integrate third-party vendor support, seamlessly connecting wellness initiatives such as gym benefits, digital health apps, and more.
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Deliver personalized employee outreach with relevant nudges based on age, risk factors, or utilization, driving stronger participation.
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Offer multi-channel engagement by reaching employees through web, mobile, and in-portal notifications — meeting them where they are.
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Measure and optimize outcomes using real-time analytics to track participation, effectiveness, and ROI on wellness initiatives.
Communication, Notifications & Engagement Tools
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Facilitate two-way communication with Payers and Brokers by exchanging secure messages that eliminate delays and drive quick resolutions.
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Deliver smart notifications with real-time alerts on invoices, pending approvals, unusual spend patterns, renewals, and benefit program updates, ensuring nothing slips through the cracks.
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Create an employee engagement hub to share updates, reminders, and educational content that boost awareness and utilization.
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Run targeted outreach campaigns by segmenting communications to specific employee groups for more relevant engagement and stronger response rates.
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Provide integrated support access, allowing Employers to connect directly with service teams or live agents from the portal, with notifications that track the progress of their queries.
Analytics & Reporting for Decision-Making
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Gain a consolidated view of benefits costs with a single dashboard that highlights company-wide spending, utilization trends, and plan performance at a glance.
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Leverage smart forecasting to predict future healthcare costs and employee health trends, enabling proactive adjustments to offerings and budgets.
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Use renewal intelligence to make informed, data-driven decisions based on cost and savings insights — no more guesswork.
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Generate customizable reporting by group, department, or coverage type, ensuring every stakeholder gets insights tailored to their needs.
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Rely on visual, actionable dashboards that simplify complex data into clear visuals and KPIs, empowering HR and finance teams to quickly spot trends and take action.
Empowering Brokers with Full Control, Insight, and Efficiency for better client acquisition and retention.
Designed to simplify Client Acquisition, Management & Retention for Agencies & Agents. It brings capabilities to manage the entire lifecycle of clients, covering pre-sales, sales, and post-sales at fingertips. Some of the most used and high-impact features include quoting and proposals, managing their book of business, accessing commission statements, and gaining ready access to insightful analytics.
Web
Mobile
Intelligent AI-Driven Assistance & Insights
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Enable natural language support for broker tasks, allowing quick answers to questions like “Show me my renewal pipeline” or “What’s my commission status?” without digging through reports.
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Accelerate quoting with AI-powered assistance that auto-fills details, generates accurate proposals, and surfaces the best-fit plans for client needs.
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Unlock client insights and opportunities by identifying utilization trends, groups at risk of churn, and cross-sell or upsell potential.
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Stay ahead with proactive alerts and reminders for renewals, compliance deadlines, and outstanding proposals.
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Gain smarter commission transparency with simplified statements, anomaly detection, and earnings projections that make payouts crystal clear.
Comprehensive Book of Business with Complete Control
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Unify client management with a single view of all Employer groups and Member accounts tied to your relationship with the Payer.
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Bring billing transparency by accessing invoices, payment statuses, and outstanding balances to better support Employers and build trust.
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Stay ahead of renewals with clear visibility into timelines, policy changes, and pending actions.
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Gain confidence with commission oversight, tracking real-time statements and overrides to manage revenue streams effectively.
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Leverage actionable insights through built-in analytics that highlight growth opportunities and retention risks within your Book of Business.
Elevating Payer → Broker → Client Collaboration & Engagement
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Foster shared visibility by giving Payers, Brokers, and Employers access to the same billing, policy, and membership information — reducing confusion and ensuring alignment.
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Streamline communication with built-in messaging tools that keep discussions centralized, cut through email clutter, and enable faster resolutions.
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Align renewals seamlessly, allowing Brokers and Payers to jointly manage timelines, proposals, and plan adjustments while keeping Employers fully informed.
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Drive adoption with co-branded engagement programs, enabling Payers and Brokers to launch wellness or health campaigns that deliver measurable value.
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Build trust through transparency with real-time updates on claims, billing, and commissions that give every stakeholder clarity and confidence.
Enable Brokers to Provide Above & Beyond Services
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Simplify client education by sharing benefit updates, compliance resources, and plan explanations in clear, accessible formats.
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Roll out wellness and engagement programs in collaboration with Payers, driving preventive care, employee participation, and measurable outcomes for Employer clients.
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Provide billing and claims transparency with visibility into invoices, payment statuses, and claims trends, helping reduce confusion and strengthen trust.
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Deliver analytics-driven advisory by surfacing utilization patterns, cost drivers, and renewal insights to guide smarter benefit decisions.
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Stay proactive in service delivery with alerts on renewals, unusual spend patterns, and program opportunities that keep clients engaged and supported.
Designed to Elevate Your Consumer Engagement Strategy
Unlock The Power of Integrated Self-Service, Automation, Conversational AI, and Omnichannel Access
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