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
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Digital Consent
Ability for Members to opt in to digital communications.
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
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.
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
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
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Profile Updates
Update Borrower information and contact preferences.
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
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
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
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
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.
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
Payment Status
Provide Member with the current status of a payment on a Claim.
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Policy Renewal
Guide the Policy Holder through renewing their policy.
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Make Payment
Securely accept full or partial payment of outstanding installment amount.
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
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
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Shipping status updates
Shipment status updates
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.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
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
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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
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
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Shipping status updates
Shipment status updates
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
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
Escrow Review
Guide Borrower through shortfalls or excesses in their escrow account, the tax or insurance payments that led to the shortfall, and to securely accept payments for any shortfall.
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Medication adherence
Understand root causes of medication non-adherence and overcome them
Digital consent
Ability for members to opt in to digital communications
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Transition of Care Support Readmission Avoidance
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Notification of lab and test results
Sharing of lab tests and results
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.
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
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)
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)
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
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.
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
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.
