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
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Eligibility & benefits verification
Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level
Profile Updates
Update Policy Holder information and contact preferences.
Shipping status updates
Shipment status updates
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Vaccination reminders, education, appointment scheduling, and paperwork
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
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)
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Incontinence education and support
Education and connectivity to support resources for incontenence
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Retail-to-mail conversion
Support for education and retail-to-mail conversion
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Make Payment
Securely accept full or partial payment of outstanding installment amount.
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
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
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
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.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Extraction (Vision)
Extract Vision 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
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Chronic Kidney Disease CKD care management and navigation
Year-round support for members with Chronic Kidney Disease - including education, wellness, care gap closure, appointment setting
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
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
Cost transparency and cost relief
Education on cost tranparency and cost relief options
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
Claim Status
Provide Member with the current status of a Claim.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Payment capture
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
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
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
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
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
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
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
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Extraction (Dental)
Extract Dental 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
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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)
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Payment Status
Provide Member with the current status of a payment on a Claim.
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
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
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Digital ID card delivery
Delivery of member ID cards digitally
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
Hospital discharge support
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
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.
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
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.
