Orchestrators / Payor / AI Onboarding
The first 90 days shape the member’s health journey — and determine whether the plan starts with an accurate picture of risk, an activated care relationship, and a member who is getting full value from their benefits.
Today, those outcomes depend on a series of disconnected outreach programs. The plan may identify chronic conditions, unmet social needs, behavioral health concerns, or gaps in care, but identifying the need is only the beginning. The value comes from acting on it.
AI Onboarding turns assessment into action across three critical goals:
Assess the member accurately. Build a complete picture of the member’s health and documented conditions so the plan can manage the right risks and improve revenue accuracy.
Start the care journey. Help members establish a PCP relationship, schedule their Annual Wellness Visit, recover missed appointments, and close the loop on follow-up care.
Connect members to the benefits they need. Identify unmet clinical, behavioral, and social needs and enroll members directly into the programs, services, and benefits available through their plan.
Without a coordinated onboarding motion, these opportunities are lost across handoffs: an AWV never gets scheduled, a no-show never gets recovered, an identified need never becomes an enrollment, or a documented condition never reaches the systems that determine risk-adjusted revenue.
AI Onboarding brings these workflows together into one continuous member journey — helping plans capture a more accurate view of member risk, accelerate engagement with care, and ensure members receive the full value of their benefits from day one.
Features:
Revenue: AEP onboarding — $1.7M+ savings; every 1% churn reduction in first 90 days = ~130 members x $13K annual revenue. AWV scheduling: $1–2K risk-adjusted revenue per completed AWV; 30% schedule an AWV (21–37% observed); $6M expected value on 20K members.
