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.

Benefitfocus

AI Agents That Deliver Better CX — Built on Trust

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increase in CSAT score
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Outbound calls eliminated
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Automated Resolution rate
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ROI on AI investment

Trust-Native Architecture

Built with trust, security and compliance engineered into the platform core–not layered on later.
Security & Compliance
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Governance

Built-in governance embeds guardrails, policy enforcement, and human oversight directly into AI execution.

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Observability

Maintain real-time visibility into agent behavior, reasoning, and performance.

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Auditability

Replay conversations end to end and generate regulator-ready records on demand.

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Data Protection

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.

Ushur Dashboard screen
Illustration showing ushur's omnichannel capability
Ushur Studio screen preview
Ushur Insights screen

Inbound and Outbound

Compliant, end-to-end customer engagement that proactively connects, resolves, and preserves context.

Omnichannel Continuity

Engage across SMS, email, voice, and web in one persistent, compliant interaction thread.

Built for Business Speed

A purpose-built orchestration environment designed for business users to bring journeys to life quickly.

Actionable Insights

Understand behavior, measure performance, and maintain audit-ready visibility with built-in compliance controls.

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.

Company Type:
Health Payer
Provider
PBM
Pharmacy
LA&H
P&C
Consumer Lending
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Journey:
Acquisition
Retention
Member Service
Population Health & Quality
Claims & Administrative
Provider Service
Pre Visit
During Visit
Post Visit
Population Health & Quality
New Member Onboarding & Welcome
Member Service
Population Health & Quality
Mail Order Enrollment & Fulfillment
Claims and Administrative
New Member Onboarding & Welcome
Member Service
Population Health & Quality
Mail Order Enrollment & Fulfillment
Claims and Administrative
Group Quote Intake
Group Onboarding
Individual Acquisition
Member Service
Claims
Absence Management
Acquisition
Policyholder Service
Claims
Loan Originations
KYC and Onboarding
Loan Servicing
Loss Mitigation

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

Payment capture

Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing

Paperless Statements

Ability for Borrowers to opt in to digital delivery of Statements.

Payment capture

Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing

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.

Pediatric preventative wellness

Ongoing pediatric preventative wellness education, appointment setting and other actions

Medication adherence

Medication Adherence (overcome barriers - cost, transportation, adverse effects)

Medication reconciliation

Education and scheduling of Medication Reconciliation appointments

Diabetes care management and navigation

Year-round support for diabetic members including education, wellness, care gap closure, appointment setting

Follow-up appointment scheduling

Patient appointment setting support with reminders and ability to reschedule

Prior authorization communications and intake

Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates

Respiratory Care care management and navigation (COPD, Asthma)

Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting

Census Upload

Guide the Broker / Employer through uploading an updating Census file, Transforming it to the standard format required by the Carrier, and identifying any issues.

First Notice of Loss

Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.

Payoff Request

Guide Borrower through requesting an official Payoff Letter for their loan.

Overview of PBM supports and services

Overview of PBM support and services and population health and quality programs

Extraction (Critical Illness)

Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Musculoskeletal (MSK) care management and navigation

Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting

SDOH resources (transportation, food)

Support for understanding and accessing SDOH resources such as nutrition, transportation

Extraction (Vision)

Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Social Determinant of Health SDOH surveys

Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up

Health Risk Assessment HRA surveys

Full Health Risk / Needs Survey completion with feeds to core systems for follow-up

Endorsements and Riders

Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.

Payment Status

Provide Borrower with the current status of a payment made to their account.

Policy Cancellation

Guide the Policy Holder through cancelling their policy.

Preventative Wellness Care Gap Closure

Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)

Member information updates

Member information updates – including cross-channel contact details and change of insurance

Medication reconciliation

Education and scheduling of Medication Reconciliation appointments

Adult Preventative Wellness

Ongong adult preventative wellness education, appointment setting and other actions

Member After hours Support

Accurate, secure and compliant AI Member inquiry and task completion support 24x7

Ongoing website, portal, & app adoption and utilization

Support for member ongoing utilization of website, traditional apps and portals

Timely notifications to meet regulatory requirements

Ability to send notifications to members more timely to meet regulatory timing requirements

Persistency of Benefits

Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.

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)

Appeal filing and updates

Ability for members to understand and file Appeals, and receive status updates

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.

Return to Work

Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.

Email Triage

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Cost transparency and cost relief

Education on cost tranparency and cost relief options

Follow-up appointment scheduling

Patient appointment setting support with reminders and ability to reschedule

Policy Reinstatement

Guide the Policy Holder through re-instating a lapsed policy.

Trailing Documents

Remind and support Applicant in securely uploading required supporting documents post Application.

Member after hours support

Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7

Member information updates (i.e. add dependant)

Collection of member information updates such as adding dependants, changing address, etc

Proactive Rx status notifications

Proactive Rx status notifications (fill status, issues like prior auth)

Member information updates

Member information updates – including cross-channel contact details and change of insurance

KYC Supporting Documents

Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.

Digital Consent

Ability for Policy Holders to opt in to digital communications.

Digital consent

Ability for members to opt in to digital communications

Provider after hours support

Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7

Prior Authorization transparency support

Ability for members to receive push notices for, or make inquiries about, prior authorization status

Member warm welcome benefits education and literacy

Member welcome notifications that educate on plan benefits, deliver digital ID cards

Extraction (Dental)

Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Site of care guidance (wayfinding)

Support for appropriate site of care with appointment setting

Provider roster directory updates

Ability for any provider to update their roster information for provider directory accuracy

SDOH Resources (transportation, food)

Support for understanding and accessing SDOH resources such as nutrition, transportation

Ongoing website, portal, & app adoption and utilization

Support for member ongoing utilization of website, traditional apps and portals

Cardiac Disease care management and navigation

Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting

Shipping status updates

Shipment status updates

Medication refills and reminders

Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence

Product Comparison

Support for Applicants to find Insurance Plan options that best fit their needs.

Extraction (Hospital Indemnity)

Extract Hospital Indemnity 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

Benefits Education

Answer Member questions on Plan benefits, coverage, and eligibility.

Delivery Confirmation

Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.

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

Schedule Appointment

Schedule follow up call with Sales Representative with reminders and rescheduling.

Premium Payment

Securely accept full or partial payment of outstanding premium amount.

Refill reminders and ordering facilitation

Refill reminders and ordering facilitation (including payment capture)

Payment Status

Provide Policy Holder with the current status of a payment on a Claim.

Proactive Rx status notifications

Proactive Rx status notifications (fill status, issues like prior auth)

Surgery Confirmation

Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.

Employer Onboarding

Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.

Hospital discharge support

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Medication adherence:

Understand root causes of medication non-adherence and overcome them

Fall prevention education and action

Education and connectivity to support resources for fall prevention (movement, home safety...)

Digital ID Card

Securely deliver a digital copy of Member's Insurance ID Card upon request.

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

SCRA Protection

Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.

Email Triage

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Email Triage

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Digital consent

Ability for members to opt in to digital communications

Patient questionnaire automation

Capture of patient information updates and support for review and e-signature for new patient paperwork

Transition of Care Support Readmission Avoidance

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Retail-to-mail conversion

Support for education and retail-to-mail conversion

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

Weight loss support

Support for eating well, exercising as well as weight loss medications like GLP1

Claim Status

Provide Member with the current status of a Claim.

Digital ID Card

Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.

Proactive member out of pocket notifications

Proactive member out of pocket notifications – with support for “price shocks”

Eligibility & benefits verification

Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level

Live Member Service chats and warm call transfers

Ability for service 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

Borrower After hours Support

Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7

Product Comparison

Support for Applicants to find Lending options that best fits their needs.

Issues and Complaints

Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.

Update Beneficiaries

Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.

Member ID card and driver's license digital collection

Safe and secure collection of member ID card(s), driver's license images

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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.

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