Cost Search Integration into Provider Search

• Current gap: Members searching for a provider must navigate away from results to an individual profile to find cost estimates — a fragmented, multi-step experience.
• New feature (end of Q2): Cost estimates surfaced directly within search results. A sidebar shows the most common services for the searched specialty in member-friendly language (no billing jargon), with costs by encounter type.
  • Members retain the option to search for a specific service if their visit type isn’t listed.
  • First step toward unified search — combining provider search and cost search into one seamless experience.

Virtual Care Tab Shortcuts in Search Results

• Current state: Search results show separate tabs for virtual and in-person care; shortcuts can only link to in-person results by default.
• New feature (Q2): Direct shortcut links to virtual care tabs so members searching for telehealth-only services (e.g., online therapy) are routed directly to those results instead of hitting a dead end.
  • Interim step toward the longer-term vision of a unified, intermixed results experience combining in-person and virtual care.

"Ask” Conversational AI Enhancements

• “Ask” (RevSpring’s conversational AI search, launched 2024) is being refined based on real member usage feedback.
• Upgraded underlying language model powering Ask for better query understanding.
• Refined intent interpretation and improved keyword matching and filter logic for more precise, robust result sets.
• More precise location handling within conversational queries.
• These investments lay the groundwork for expanding Ask to handle cost-related conversational queries and more complex member interactions.

Search by Plan UI Upgrade

• New Search by Plan UI deployed to UAT environments the day of the meeting.
• Key UX improvements: modern consumer-grade design, progress indicators, elevated “Use My Location” option, plan confirmation screens, removal of outdated static content.
• No changes to underlying data or search logic — UI only.
• Custom label/title adjustments will be applied manually by RevSpring support within approximately 8 business days. Customers were asked to review UAT afterward and provide feedback.
• Migration deadline: All customers on legacy “tidal” search must migrate to Unified Search by April 2027.

Unified Search — Common Themes & Ongoing Improvements

• Since launching Unified Search (end of last year), key recurring feedback themes have been identified:
  • Need for better contextual clarity when in-person and virtual provider results are mixed.
  • Cost-related queries not always surfacing cost information in results.
  • Improved labeling and result differentiation needed.
• These themes are actively shaping the roadmap. 
• Call to Action: Customers were encouraged to share additional feedback with their customer success partners.

FHIR API Transition for Provider Data

• Current approach: Health plans send large batch files of provider data on a recurring schedule — slow, file-heavy, and hard to keep current.
• New FHIR approach: Plans push only incremental / changed records in real time via FHIR APIs — data is more current, file management burden is reduced, and member-facing directories update faster.
  • Aligns with CMS mandates and the broader industry shift toward real-time interoperability.
• Call to Action: Customers were asked to engage in discovery conversations about their current data management practices and readiness to transition to FHIR-based exchange.

National Provider Grounding Layer & MCP for AI Agents

• National provider “golden record” being built: a comprehensive, trusted database of all U.S. providers regardless of plan or network affiliation, including credentials, locations, cost data, and (eventually) scheduling availability.
• MCP (Model Context Protocol) tools will be layered on top, enabling AI agents to interact with provider data in a context-aware, conversational way — rather than through isolated, single-call API queries.
  • Use cases include: member-facing AI agents, proactive outreach to members, and internal operational tools.
• Will allow members to find providers accepting any insurance (Blue Cross, Kaiser, etc.) — a broader view than plan-specific network search.
• Call to Action: Customers with AI agent / MCP use cases they’re exploring should reach out to their customer success partner.

Medicare Plan Finder — CMS Compliance

• CMS requirement (Contract Year 2026): Medicare plans must supply provider data to CMS to power the federal Medicare Plan Finder tool. CMS will validate accuracy weekly.
• RevSpring’s approach: Supporting compliance via a FHIR-based JSON API (Base Contract Management Model) — RevSpring provides URLs per Medicare contract ID that CMS calls to validate data.
• Timeline: Development and regulatory clarification ongoing → target mid-to-late May for passing and validation → customer testing through end of September.
• Dedicated information sessions on Medicare Plan Finder compliance
• Call to Action:(1) Formally confirm participation by May 5th; (2) provide primary executive and data contacts for the compliance process; (3) register for office hours.