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
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
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
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
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
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
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Digital Consent
Ability for Borrowers to opt in to digital communications.
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Payment Status
Provide Member with the current status of a payment on a Claim.
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Extraction (Short Term Disability)
Extract Short Term Disability related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Medication adherence
Understand root causes of medication non-adherence and overcome them
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
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
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Transition of Care Support Readmission Avoidance
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
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
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
Click-to-call or chat to speak to pharmacy staff
Ability for pharma representatives to chat within Ushur journeys, and to warm call transfer to them
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Census Transformation
Identify Census files in an inbound RFP and Transform the file to the standard format required by the Carrier and identify any issues.
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
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.
Payment Status
Provide Borrower with the current status of a payment made to their account.
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Shipping status updates
Shipment status updates
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.
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
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.
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
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
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Stay at Work
Guide the Member through potential insurance benefits and available workplace accommodations, reduced hours, and reassignments to help them decide between different disability options.
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Claim Status
Provide Member with the current status of a Claim.
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
Retail-to-mail conversion
Support for education and retail-to-mail conversion
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
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Digital ID card delivery
Delivery of member ID cards digitally
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
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.
Shipping status updates
Shipment status updates
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Plan Design
Triage inbound RFP emails to identify key attributes regarding Broker, Employer, Quote, and requested Products and automate case setup in Quoting and Underwriting systems.
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.
