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
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Claim Status
Provide Member with the current status of a Claim.
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
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 refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
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)
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
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.
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Shipping status updates
Shipment status updates
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Digital Consent
Ability for Borrowers to opt in to digital communications.
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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
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
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Shipping status updates
Shipment status updates
Balance Inquiry
Provide Borrower with details of the current balance on their account.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Shipping status updates
Shipment status updates
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Profile Updates
Update Borrower information and contact preferences.
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
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
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Extraction (Basic Life)
Extract Basic Life 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
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Profile Updates
Update Member information and contact preferences.
New patient welcome and information gathering
Patient education on provider and information and documentation completion
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)
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
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.
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Claim Status
Provide Policy Holder with the current status of a Claim.
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.
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
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
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
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.
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
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.
