How it works

From first symptom to resolution—AI intake, benefits guidance, and instant clinician handoff designed to lower avoidable costs and improve member experience.

1) Member chats with AI

OurHealthcareConcierge captures a structured history in minutes—without repetitive forms. Members describe what’s going on in natural language; the assistant follows up with targeted questions to ensure clinical completeness.

  • Clinically structured intake: onset/timing, severity, location, red-flag symptoms, meds, allergies, pregnancy, PMH.
  • Guideline-aligned suggestions: home-care steps or same/next-day virtual care when appropriate.
  • Plain-language summaries: the conversation is condensed into an easy-to-read note members can review and share.
  • Safety guardrails: urgent/emergent flags direct members to 911/ER guidance immediately.

Outcome: members get answers fast and only escalate when it’s likely to help.

See the member experience →

2) Benefits navigation

The assistant checks plan details and surfaces the cheapest safe next step before a visit is booked. Members see in-network options, estimated out-of-pocket, and guidance on site-of-care (telehealth, clinic, urgent care).

  • Eligibility & coverage checks: verify plan, deductibles, copays, and telehealth coverage.
  • In-network matching: steer to preferred partners and contracted rates first.
  • Transparent costs: estimate OOP based on plan parameters (PPO/HSA/HRA) and location.
  • Navigation nudges: gentle redirects from high-cost settings when the condition is appropriate.
  • Documentation: members receive a recap they can reference or share with a caregiver.

Outcome: fewer unnecessary ER/urgent care claims and higher member satisfaction.

Why employers love this →

3) Smart triage & clinician handoff

When escalation is appropriate, members connect to a licensed clinician with a prefilled chart note, consent, and relevant history—so the visit starts at the assessment, not the paperwork.

  • Prefilled chart: concise HPI, ROS, meds, allergies, and red-flag screening in a clinician-friendly format.
  • Booking & telehealth: same-day virtual visits where available; routing honors state licensure.
  • e-Rx workflow: when medically appropriate, prescriptions can be sent to the member’s preferred pharmacy.
  • Follow-ups & safety: automated check-ins and escalation paths if symptoms worsen.
  • Compliance & audit: timestamps, consent capture, and encounter summaries retained per policy.

Outcome: faster resolutions, cleaner documentation, and measurable claim reductions.

See how clinicians use it →