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
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Payment Status
Provide Member with the current status of a payment on a Claim.
Payment Status
Provide Member with the current status of a payment on a Claim.
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
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.
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Shipping status updates
Shipment status updates
90-day fill conversion
Support for education and 90-day fill conversion
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Digital Consent
Ability for Borrowers to opt in to digital communications.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
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.
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Digital consent
Ability for members to opt in to digital communications
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
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
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
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
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
Shipping status updates
Shipment status updates
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 pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
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
Shipping status updates
Shipment status updates
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)
Profile Updates
Update Member information and contact preferences.
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Vaccination reminders, education, appointment scheduling, and paperwork
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
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)
Post Disaster Outreach
Proactively reach out to Policy Holders after a Disaster, such as storm, wildfire, or flood to connect them to required services and relief, and to file any Claims if required.
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Persistency of Benefits
Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
90-day fill conversion
Support for education and 90-day fill conversion
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
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.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
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.
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
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
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Profile Updates
Update Policy Holder information and contact preferences.
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Digital consent
Ability for members to opt in to digital communications
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Digital Consent
Ability for Policy Holders to opt in to digital 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.
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.
