A leading Medicaid and Medicare health plan in California, serving over 1 million members, faced operational challenges due to excessive routine inquiries in its provider service operations. Issues such as benefits verification, prior authorizations, and credentialing overloaded call centers, leading to delays in care delivery and rising administrative costs. The introduction of Ushur’s AI Agent for Provider Servicing revolutionized the process by providing 24/7 self-service capabilities directly in the provider portal. This AI solution automates high-volume inquiries, allowing instant access to coverage details and claims status, significantly reducing call center traffic. As a result, the health plan improved operational efficiency, reduced costs, and enhanced provider satisfaction with quick, dependable service. Ushur specializes in AI-driven customer experience automation for regulated sectors, having raised $92 million in funding to accelerate product expansion. Their innovative approach showcases how AI can transform healthcare operations, optimize costs, and strengthen provider relationships.
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