Our Member-Centric System

  • Enables the customer service center to handle all account activities — account implementation and management, customer service, claims processing and adjudication, management of membership and eligibility information, and medical care management.
  • Automatically and quickly routes a member's call to the service center assigned to that member's benefit plan, and even to a customer advocate team member responsible for that account.
  • Is organized to provide one-stop access for member inquiries. The customer advocate can explain benefits, answer claims questions and make adjustments on the spot, contact a provider to resolve issues while the member is on the line, and educate members on health and wellness benefits offered through their employer's plan.