Engagement Plus™ (Engagement+™)

Engagement Plus™ (Engagement+™) Product offers health plans a purpose-built CRM which, when paired with Integration Plus™ (Integration+™) product, seamlessly integrates with various Health plans and Health Plan partners' data, providing a comprehensive 360-degree view for members and providers. This integration brings data from the Health Plan claim processing platform, upstream and downstream applications, and other data sources into a consolidated, user-friendly system for end-users, enhancing customer service and operational efficiency. Engagement Plus™ (Engagement+™) is built on the Salesforce platform, providing scalability, flexibility, and best-in-class stability. Engagement Plus™ (Engagement+™) supports Medicare, Medicaid, CHIP, and Commercial lines of business for medical and all specialties such as dental, vision, and behavioral health, crafted to seamlessly integrate, scale, and adapt to meet the evolving needs of healthcare payers, offering a comprehensive solution for a unified view of customer interactions. Engagement Plus™ (Engagement+™) offers personalized care through industry-proven workflows, pre-configured scripts, and data-driven next-best actions, enabling proactive engagement with members, providers, and brokers.

User-Centric Design
Designed to provide easy access to consolidated data from disparate sources, enhancing user experience and efficiency

Configurability
Highly configurable call/case reasons, automated routing, worklist views, and branding options

Dashboards and Reporting
Pre-built and easily configurable dashboards and reports for agents, call center leadership and executives

Multichannel Accessibility
Enable members and providers to engage effortlessly through their preferred channels, including phone, live chat, secure message, emails, and more

Key Features

  • Computer Telephony Integration (CTI): Enhance caller self-service capabilities with screen pop-ups and automated data capture in IVR system
  • PHI Protection: Ensures adherence to predefined security requirements for accessing member/provider data, safeguarding sensitive information
  • Automated Case Routing: Streamline workflows with automated case routing based on call/request reasons, optimizing resource allocation
  • Unified Documentation: Single source for documenting member/provider interactions
  • Benefit Transparency: Accurately displays plan benefits, limits/accumulators, COB details, and other pertinent information in the fields of health and wellness, enhancing transparency for members and providers
  • Gap Closure Support: Enable agents to proactively address gaps in member care, supporting quality measures such as Stars, HEDIS, and other pay-for-performance initiatives