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.
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 the modern enterprise. Secure, compliant, and designed to resolve customer needs from start to finish.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
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
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Notification of lab and test results
Sharing of lab tests and results
90-day fill conversion
Support for education and 90-day fill conversion
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
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
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Persistency of Benefits
Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.
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)
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Renewal education and reminders
Support for member retention with renewal education and reminders
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Premium Payment
Securely accept full or partial payment of outstanding premium amount.
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
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
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
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Policy Renewal
Guide the Policy Holder through renewing their policy.
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Shipping status updates
Shipment status updates
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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.
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Vaccination reminders, education, appointment scheduling, and paperwork
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Profile Updates
Update Borrower information and contact preferences.
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Profile Updates
Update Policy Holder information and contact preferences.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
Brand-to-generic conversion
Support for education and brand to generic fill conversion
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
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
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)
Extraction (Voluntary Life)
Extract Voluntary Life 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 sales representative
Ability for service or sales representatives to chat within Ushur journeys, and to warm call transfer to them
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
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
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Make Payment
Securely accept full or partial payment of outstanding installment amount.
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Digital Consent
Ability for Borrowers to opt in to digital communications.
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
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.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Post-discharge information / education
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
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
Payment Status
Provide Borrower with the current status of a payment made to their account.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
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.
