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.
Policy Renewal
Guide the Policy Holder through renewing their policy.
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Make Payment
Securely accept full or partial payment of outstanding installment amount.
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Notification of lab and test results
Sharing of lab tests and results
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Digital Consent
Ability for Borrowers to opt in to digital communications.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Click-to-call or chat to speak to other clinical staff member
Click-to-call or chat to speak to other clinical staff member when needed
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
Profile Updates
Update Borrower information and contact preferences.
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
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
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
Claim Status
Provide Policy Holder with the current status of a Claim.
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
Vaccination reminders, education, appointment scheduling, and paperwork
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
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.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
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
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
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
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
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
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Extraction (Basic Life)
Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Vaccination reminders, education, appointment scheduling, and paperwork
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
Profile Updates
Update Policy Holder information and contact preferences.
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)
Incontinence education and support
Education and connectivity to support resources for incontenence
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
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
Provider after hours support
Accurate, secure and compliant AI Agent provider 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...)
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Shipping status updates
Shipment status updates
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Payment Status
Provide Member with the current status of a payment on a Claim.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
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
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Digital Consent
Ability for Members to opt in to digital communications.
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
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)
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
Medication adherence
Understand root causes of medication non-adherence and overcome them
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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.
