The AI Agent-powered platform for customer experience
Deliver proactive inbound and outbound engagement across every customer interaction — with compliance and auditability embedded by design.
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 the modern enterprise. Secure, compliant, and designed to resolve customer needs from start to finish.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
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.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Vaccination reminders, education, appointment scheduling, and paperwork
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
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.
Chronic condition care navigation
Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Payment Status
Provide Member with the current status of a payment on a Claim.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Waitlisting
Proactive notifications of appointment availability for patients on wait lists
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Claim Status
Provide Policy Holder with the current status of a Claim.
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
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)
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Incontinence education and support
Education and connectivity to support resources for incontenence
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
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
Digital consent
Ability for members to opt in to digital communications
Notification of lab and test results
Sharing of lab tests and results
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Live clinical chats and warm call transfers
Ability for clinical representatives to chat within Ushur journeys, and to warm call transfer to them (RN, Pharma, Care Manager)
Medication adherence
Understand root causes of medication non-adherence and overcome them
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
Shipping status updates
Shipment status updates
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Payment Status
Provide Member with the current status of a payment on a Claim.
Payment Status
Provide Borrower with the current status of a payment made to their account.
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
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
90-day fill conversion
Support for education and 90-day fill conversion
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
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
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Eligibility & benefits verification
Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Annual Notice of Change (ANOC) FAQs
Proactive notifications and inquiry handling about Medicare Annual Notices of Change. Including FAQ support for top ANOC call drivers
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Live Member Service chats and warm call transfers
Ability for member service representatives to chat within Ushur journeys, and to warm call transfer to them
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Digital ID card delivery
Delivery of member ID cards digitally
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
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.
