AI Powered Intelligent Benefits Inquiry Experience

Deliver measurable value through an award-winning benefits inquiry management solution for Payers
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Service1™, a Member and Provider Benefits Inquiry Management Platform by Simplify Healthcare, Wins the 2023 BIG Innovation Award

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The Service1™ Advantage

Deliver seamless omnichannel experience to members, providers, employer groups, brokers/agents, care managers, and other stakeholders
Service1™ Advantage Infographic

Aggregate Multiple Sources of Data

Product and benefits, codesets, provider, drug list, med policy, COB etc.

Digital Content Management

Assemble dynamic digital content rules that translate multiple sources into scripted and understandable English language

Advance Search Capability

IntelliSearch™ powered by Synergistic AI enables advanced search for benefits providing human-friendly content and consistency

Synergistic AI

AI powered cognitive search plus semantic search deliver accurate, complete, and consistent responses

Digital Self-Service

Extend the single consistent benefits inquiry platform to member and provider portals, IVR, and chatbots

Customer Service

Seamless unified view of benefits data eliminating swivel and providing richer response driven by AI and NLP

Analytics

Provide deep insights into benefits engagement

Service1™

Powering an Omnichannel Benefits Inquiry Experience
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Dynamic Content Generation

Digital Content Manager enables dynamic content generation with user-configurable content rules

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Analytics and Predictions

Powerful analytics deliver rich insights based on objective benefits inquiry data and help make smarter predictions

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One-click Operation

CSAs can generate benefit summaries/quotes with a click of a button and push it to downstream systems

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Digital Engagement

Builds trust in digital engagement by feeding the same human understandable benefits content that is available to the customer service team, via self-service portals, mobile apps, chatbots, IVR, and clinical systems

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Plug and Play

Service1™ widget will plug into any of your existing customer experience assets – including call center software and portals based on Pega*, Salesforce*, etc., IVR and chatbots to provide intelligent experience on benefit Inquiries

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IntelliSearch™

Generative AI-powered Advanced Semantic Search using English Text and/or Codes, complemented by Active Learning Mode.
Preloaded NLP Dictionary with 40,000+ Medical Terms

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Omnichannel Experience

Driven by the Simplify Health Cloud™’s innovative API platform, Service1™ widgets can seamlessly embed into your existing tools to deliver a seamless omnichannel experience to members, providers, employer groups, brokers /agents, care managers, and other stakeholders

*Salesforce® or Pega® are registered trademarks of their respective owners.

Service1™ is a part of Simplify Health Cloud™

Power your connected product, benefits, and provider data journeys
Connected Benefit Journey Infographics

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Connected Provider Journey

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What Our Customers Say

Senior Manager

Customer and Client Enrollment and Implementation

Giving our workforce the tools and resources to deliver exceptional customer service is a surefire strategy to keep our clients happy. Service1™ is helping our CSAs deliver superior service to our network of providers and members
Vice President

Client Management

Training new employees to handle benefit inquiries was a constant challenge for us. We have seen reduced training cycles and improved handling of calls by our CSRs after leveraging AI- and NLP-based capabilities of Service1™
Project Manager

Client Programs Integrated Marketing and Client Experience

Service1™ has the potential to be a game changer for our business. Delivering customer delight has always been paramount for us. Service1™ is the only solution we could find in the market that is tailor-made to solve benefits inquiry management challenges for Health Plans

Frequently Asked Questions (FAQs)

Here is what our customers usually ask us

What is member and provider benefits inquiry management?

Most Health Plans, TPAs, and ASOs face challenges with manual and inaccurate explanation tools to improve self-service and handle benefit inquiries, version control issues, redundant and disconnected benefits content across the enterprise, and extended call handle time. Member and provider benefits inquiry management is the process to support health plans by automating end-to-end customer service management and delivering accurate and complete information to your call center and self-service portals

What are the challenges with traditional customer service management processes?

Traditional customer service management for Payers, TPAs, and ASOs are manual and prone to errors. Customer service users are frustrated over the amount of time and steps required to accurately quote benefits leading to many errors and overall reduced member and provider satisfaction. The challenge:

  • Current benefit explanation tools are incapable of providing accurate member or provider self-service
  • The process of searching through benefits data sources for marketing and other documents is time-consuming and error-prone
  • Benefit explanations are not human-friendly with multiple versions and inconsistency across the enterprise
  • Several manual steps, several data sources, and following complex job aids increase errors and result in MTM and NPS impacts
  • With inconsistent data, customer service team may need to spend extended time researching and responding to benefit inquiries, reducing first call resolution rate, and extending call handle time

Why use a client setup and management solution?

Here are some of the key benefits of automating your customer service management processes:

  • Create a single source of truth for your benefits explanation data to provide fast and accurate answers to benefit inquiries across all your channels
  • Automate workflows for easy collaboration across all stakeholders, reduce administrative costs, increase member retention, and service search capabilities using English text or codes
  • Reduce errors, call handle time, and inconsistency across channels
  • Increase first call resolution rate
  • Reduce the amount of time and steps required to accurately address benefit inquiries
  • Automate member and provider self-service and increase satisfaction
  • Improve CMS Star ratings and MTM scores

How can Service1™ help you automate processes using a single source of truth?

Service1™ enables Healthcare Payers, TPAs, and ASOs to provide better member and provider self-service by enhancing their customer service capabilities with an end-to-end automated platform that integrates into their existing CRM investments. The proven platform helps create a single source of truth to deliver accurate and complete information to their call center and self-service portals, thereby improving call handle time, first call resolution rate, member and provider experience, and increasing CMS Star ratings and MTM scores.

Payers and TPAs can automate workflows for easy collaboration across all stakeholders, reduce administrative costs, increase member retention, and service benefit inquiries using English text or codes

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