Deliver an Intelligent Benefits Inquiry Experience

With a Two-Time Award–Winning Benefits Inquiry Management Platform for Payers
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As the healthcare market grows, so does competition.

For Payers, top-tier customer service is key to staying competitive and capturing the market.

While Payers face multiple challenges in customer service

Multiple Disconnected Systems
Limited or Non-existent Self-service
Redundant Benefits Content
Inconsistent Benefits Explanation
Stringent Star Rating Measures

Consumers demand a superior benefits inquiry experience

Accurate Benefits Information in First Call
Access to Benefits Data on the go
Treatment Recommendations
Omnichannel Experience
Human-Understandable Benefits Explanations

Deliver omnichannel, human-understandable benefits explanations with Service1™

Powered by the Simplify Apps Fabric™, Service1™ can deliver rich benefits content across customer-service and self-service channels.
Seamless Omnichannel Experience
Digital Engagement
Advanced Search Capabilities
Plug and Play with Widgets
One-click Operation
Dynamic Content Generation

Why choose Service1™?

Senior Manager

Customer and Client Enrollment and Implementation

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™.
Vice President

Client Management

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.
Project Manager

Client Programs Integrated Marketing and Client Experience

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.

Frequently Asked Questions (FAQs)

Here is what our customers usually ask us

What are the challenges with the traditional benefits inquiry management process?

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

 

  • The process of searching through benefits data sources for marketing and other documents is time-consuming and error-prone
  • With inconsistent data, the customer service team may need to spend extended time researching and responding to benefit inquiries, reducing the first call resolution rate, and extending call handle time
  • Current benefit explanation tools are incapable of providing accurate member or provider self-service
  • Benefit explanations are not human-friendly, with multiple versions and inconsistency across the enterprise
  • 12+ steps and 15+ clicks across 7–11 different systems/applications, and following complex job aids increase errors and result in MTM and NPS impacts

What are some key benefits of automating your benefits inquiry management process?

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

 

  • Create a single source of truth for your benefits explanation data to reduce the number of steps/sources to fetch data and 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 address benefit inquiries accurately
  • Automate member and provider self-service and increase satisfaction
  • Improve CMS Star ratings and MTM scores

How can Service1™ deliver an intelligent benefits inquiry experience?

Service1™ enables Payers to provide better member and provider self-service by enhancing their customer service capabilities with a ready-to-use, out-of-the-box platform with a widget 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.