MEMBER SERVICES
MEMBER SERVICES
DRIVING ENGAGEMENT WITH COMPREHENSIVE MEMBER SUPPORT SOLUTIONS
Enhancing Member Experiences with Comprehensive Support
Fusion CX provides end-to-end member services tailored to improve member satisfaction, engagement, and retention for health plans. Our solutions, including member onboarding, multi-channel support, and preventive care outreach, are designed to deliver seamless experiences at every touchpoint.
With over 35 years of experience, Fusion CX combines advanced technology with a member-focused approach to streamline enrollment, billing, and benefit management. By partnering with us, health plans can ensure their members receive personalized, empathetic, and efficient support, fostering loyalty and long-term success.
TRANSFORMING MEMBER SERVICES THROUGH TAILORED SOLUTIONS
Account Setup, Enrollment, and Maintenance
Simplify member account creation through guided onboarding and ensure accurate updates and maintenance of member information for compliance and seamless management.
Premium Billing and Reconciliation
Manage premium invoicing and payment collection with precision, while reconciling payments and resolving billing discrepancies to maintain accurate financial records.
Preventive Care Outreach & Support
Promote proactive member engagement through annual wellness campaigns and provide reminders for screenings, vaccinations, and other preventive care services.
Multi-Channel Member Support
Engage members via their preferred communication methods, leveraging AI tools and chatbots to handle routine inquiries and provide instant assistance.
Member Onboarding and Education
Provide personalized education and tailored resources to help members understand their plans and benefits while empowering informed healthcare decisions.
Benefit Management
Assist members with benefit clarifications, covered services, claims statuses, and preauthorization requirements to maximize plan utilization and satisfaction.
Member Services Contact Center
Deliver exceptional 24/7 support through phone, email, and chat to address member inquiries and resolve concerns across multiple communication channels.
Health Education and Awareness Initiatives
Deliver targeted health education campaigns to raise awareness about chronic conditions, wellness opportunities, and the benefits of preventive care.
AI SOLUTIONS FOR MEMBER SERVICES
Arya (Member Support Coach)
Provides real-time assistance to service agents, streamlining member inquiries, eligibility verification, and benefits explanations, ensuring accuracy and satisfaction.
Conversational AI
Enhances communication with AI-driven voice bots for eligibility verification, claims updates, and billing inquiries, improving responsiveness and member engagement.
Marketing AI
Drives engagement through targeted outreach campaigns, personalized communication strategies, and reminders for renewals and wellness programs, boosting member satisfaction and retention.
AI QMS
Automates audits and compliance checks to maintain accuracy, regulatory compliance, and high service quality in member support processes.
MindSpeech
Enhances professionalism and clarity in member interactions with voice harmonization and real-time noise cancellation, creating better experiences.
WHY CHOOSE FUSION CX FOR MEMBER SERVICES?
Empathetic and Personalized Support
Fusion CX delivers health plan customer support that prioritizes the needs and experiences of each member.
Preventive Care Expertise
From annual wellness visits to proactive outreach, we empower members to stay on top of their health.
Seamless Multi-Channel Integration
Our member services contact center ensures members can access support through phone, email, chat, or self-service portals.
Data-Driven Insights
Leverage analytics to enhance member experiences, optimize operations, and drive plan retention.
THE FUSION CX-FACTOR
20K+
Skilled
Agents
PCI-DSS
Certified
25+
Language
Support
Ensured Business
Continuity
GET IN TOUCH
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FAQS
FAQS
What services does Fusion CX provide for member onboarding?
We offer guided onboarding, personalized education, and resources to help members understand their plans and benefits.
How does Fusion CX manage premium billing?
Fusion CX handles premium invoicing, payment collection, and reconciliation to ensure accurate financial records and member satisfaction.
Can Fusion CX support preventive care outreach?
Yes, we conduct campaigns for annual wellness visits and reminders for screenings, vaccinations, and other preventive services.
Does Fusion CX offer multi-channel member support?
Absolutely. Members can access our support services via phone, email, chat, and self-service portals.
Why should health plans choose Fusion CX for member services?
Fusion CX combines advanced technology, empathetic support, and 35+ years of experience to deliver exceptional health plan customer support.
