The AI Agent-powered CX platform for regulated industries
Purpose-built for regulated industries, delivering proactive outbound and inbound engagement — with compliance and auditability embedded into every interaction.
AI Agents That Deliver Better CX — Built on Trust
Trust-Native Architecture
Built-in governance embeds guardrails, policy enforcement, and human oversight directly into AI execution.
Maintain real-time visibility into agent behavior, reasoning, and performance.
Replay conversations end to end and generate regulator-ready records on demand.
Safeguard PHI, PII, and financial data with policy-aware segmentation and governed access.
The Ushur Agentic Platform
Enterprise AI Agents
AI agents that plan, reason, retrieve data, validate inputs, and resolve complex customer requests end-to-end — with built-in governance, human-in-the-loop safeguards, and full audit visibility.
One Platform. Endless Possibilities
A curated suite of Customer Experience Automation use cases built for regulated enterprises. Secure, compliant, and designed to resolve customer needs from start to finish
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Revenue cycle support - payment collection / auto-pay
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Shipping status updates
Shipment status updates
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Notification of shipment with tracking number and delivery instructions
Notification of shipment with tracking number and delivery instructions (i.e. someone needs to be home at delivery)
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Hardship Inquiry
Reach out to delinquent Borrowers with empathy to identify circumstances such as job loss, illness, divorce, deployment that may be eligible for relief measures.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Vaccination reminders, education, appointment scheduling, and paperwork
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Click-to-call or chat to speak to sales representative
Ability for service or sales representatives to chat within Ushur journeys, and to warm call transfer to them
Transition of Care Support Readmission Avoidance
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Chronic condition care navigation
Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)
Persistency of Benefits
Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Click-to-call or chat to speak to member service
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Shipping status updates
Shipment status updates
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Surveys - Health Risk & Need Assessments, SDOH, Post Care / Rx Fill Experiences
Member surveys of health risks and needs, SDOH and post care experience and NPS surveys
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Notification of lab and test results
Sharing of lab tests and results
Provider search and selection support (any provider)
Support member ability to search for any type of in network provider and click-to-call to set appointments
Find a Primary Care doctor or Pediatrician
Support for finding a primary care doctor or pediatrician in network and setting appointment via click-to-call
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Extraction (Accidental Death & Dismemberment)
Extract Accidental Death and Dismemberment related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Digital ID card delivery
Delivery of member ID cards digitally
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Make Payment
Securely accept full or partial payment of outstanding installment amount.
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Waitlisting
Proactive notifications of appointment availability for patients on wait lists
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Post Care Surveys (NPS, CAHPs and HOS- like)
Post care and pharmacy visit surveys to understand experience gaps for proactive outreach and support as needed
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Surveys - Health Risk & Need Assessments, SDOH, Post Care / Rx Fill Experiences
Member surveys of health risks and needs, SDOH and post care experience and NPS surveys
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Extraction (Long Term Disability)
Extract Long Term Disability related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Extraction (Basic Life)
Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Medication adherence:
Understand root causes of medication non-adherence and overcome them
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Renewal education and reminders
Support for member retention with renewal education and reminders
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Chronic Kidney Disease CKD care management and navigation
Year-round support for members with Chronic Kidney Disease - including education, wellness, care gap closure, appointment setting
Payment Status
Provide Member with the current status of a payment on a Claim.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Profile Updates
Update Borrower information and contact preferences.
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Don’t see the use case you are looking for? Let’s talk about your unique requirements. Schedule time with our team to explore what is possible.
