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.

Benefitfocus

AI Agents That Deliver Better CX — Built on Trust

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increase in CSAT score
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Outbound calls eliminated
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Automated Resolution rate
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ROI on AI investment

Trust-Native Architecture

Built with trust, security and compliance engineered into the platform core–not layered on later.
Security & Compliance
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Governance

Built-in governance embeds guardrails, policy enforcement, and human oversight directly into AI execution.

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Observability

Maintain real-time visibility into agent behavior, reasoning, and performance.

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Auditability

Replay conversations end to end and generate regulator-ready records on demand.

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Data Protection

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.

Ushur Dashboard screen
Illustration showing ushur's omnichannel capability
Ushur Studio screen preview
Ushur Insights screen

Inbound and Outbound

Compliant, end-to-end customer engagement that proactively connects, resolves, and preserves context.

Omnichannel Continuity

Engage across SMS, email, voice, and web in one persistent, compliant interaction thread.

Built for Business Speed

A purpose-built orchestration environment designed for business users to bring journeys to life quickly.

Actionable Insights

Understand behavior, measure performance, and maintain audit-ready visibility with built-in compliance controls.

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.

Company Type:
Health Payer
Provider
PBM
Pharmacy
LA&H
P&C
Consumer Lending
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Journey:
Acquisition
Retention
Member Service
Population Health & Quality
Claims & Administrative
Provider Service
Pre Visit
During Visit
Post Visit
Population Health & Quality
New Member Onboarding & Welcome
Member Service
Population Health & Quality
Mail Order Enrollment & Fulfillment
Claims and Administrative
New Member Onboarding & Welcome
Member Service
Population Health & Quality
Mail Order Enrollment & Fulfillment
Claims and Administrative
Group Quote Intake
Group Onboarding
Individual Acquisition
Member Service
Claims
Absence Management
Acquisition
Policyholder Service
Claims
Loan Originations
KYC and Onboarding
Loan Servicing
Loss Mitigation

Certificate of Insurance (COI)

Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.

Pediatric preventative wellness

Ongoing pediatric preventative wellness education, appointment setting and other actions

Co-payment collection

Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing

Payoff Request

Guide Borrower through requesting an official Payoff Letter for their loan.

Trailing Documents

Remind and support Applicant in securely uploading required supporting documents post Application.

Benefits Education

Answer policy holder questions on Plan benefits, coverage, and eligibility.

Retail-to-mail conversion

Support for education and retail-to-mail conversion

Sales appointment setting and reminders

Member appointment setting with service or sales agents in support of their buying process

Health Risk Assessment HRA surveys

Full Health Risk / Needs Survey completion with feeds to core systems for follow-up

Care plan adherence

Notifications to educate on the importance of care plan adherence, related appointment setting

Borrower After hours Support

Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7

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

Post-visit check-in and follow-up details / instructions

Sharing of pre visit 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

Confirmation of medication, immunization, DME orders / refills

Confirmation of medication, immunization, DME orders / refills

Medication (Rx) reconciliation

Education and scheduling of Medication Reconciliation

New member welcome

New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)

Medication reconciliation

Education and scheduling of Medication Reconciliation appointments

Schedule Appointment

Schedule follow up call with Sales Representative with reminders and rescheduling.

Premium Payment

Securely accept full or partial payment of outstanding premium amount.

Timely notifications to meet regulatory requirements

Ability to send notifications to members more timely to meet regulatory timing requirements

Patient after hours support

Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7

Member information updates (i.e. add dependant)

Collection of member information updates such as adding dependants, changing address, etc

Cost transparency and cost relief

Education on cost tranparency and cost relief options

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

Member After hours Support

Accurate, secure and compliant AI Member inquiry and task completion support 24x7

Disaster Preparedness

Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.

Update Beneficiaries

Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.

First Notice of Loss

Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.

Digital Consent

Ability for Policy Holders to opt in to digital communications.

Medication adherence

Medication Adherence (overcome barriers - cost, transportation, adverse effects)

Digital Consent

Ability for Members to opt in to digital 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.

Appeal filing and updates

Ability for members to understand and file Appeals, and receive status updates

Provider credentialing with Plan

Support for provider credentialing information submission and status updates

Digital consent

Ability for members to opt in to digital communications

Policy Reinstatement

Guide the Policy Holder through re-instating a lapsed policy.

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.

Digital Consent

Ability for Borrowers to opt in to digital communications.

Cancer Screening outreach and scheduling

Education and appointment setting support for Cancer Screening with appointment reminders and reschedules

Renewal education and reminders

Support for member retention with renewal education and reminders

Delivery Confirmation

Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.

Hospital discharge support

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Extraction (Hospital Indemnity)

Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Medication adherence

Understand root causes of medication non-adherence and overcome them

Eligibility & benefits verification

Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level

Medication reconciliation appointment setting

Education and scheduling of Medication Reconciliation

SDOH Resources (transportation, food)

Support for understanding and accessing SDOH resources such as nutrition, transportation

Grievance filing and updates

Ability for members to understand and file Grievances, and receive status updates

Post-discharge information / education

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Member after hours support

Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7

Sales appointment setting and reminders

Member appointment setting with service or sales agents in support of their buying process

Return to Work

Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.

Supporting Documents

Remind and support Member in securely uploading required supporting documents for a Claim.

Member contact information collection / updates

Collection of cross-channel member contact information to support better communications

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.

Traditional app and portal registration support

Support for member app download and app and portal initial registration

ER avoidance

Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)

Timely notifications to meet regulatory requirements

Ability to send notifications to members more timely to meet regulatory timing requirements

Prior authorization education and updates for transparency

Ability for patients to receive push notices for, or make inquiries about, prior authorization status

Claim status, adjudication and payment updates

Ability for providers to inquire about claim status, adjudication and payments

Community meeting invitations

Proactive invitations and RSVPs for community events and meetings (virtual and in person)

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.

SDOH Resources (transportation, food)

Support for understanding and accessing SDOH resources such as nutrition, transportation

Preventative Wellness Care Gap Closure

Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)

Annual Notice of Change (ANOC) FAQs

Proactive notifications and inquiry handling about Medicare Annual Notices of Change. Including FAQ support for top ANOC call drivers

Incontinence education and support

Education and connectivity to support resources for incontenence

Make Payment

Securely accept full or partial payment of outstanding installment amount.

Proactive member out of pocket notifications

Proactive member out of pocket notifications – with support for “price shocks”

Support for shipping / delivery issues, returns and reshipment

Support for shipping / delivery issues, returns and reshipment

Click-to-call or chat to speak to pharmacy staff member

Click-to-call or chat to speak to pharmacy staff member when needed

Retail-to-mail conversion

Support for education and retail-to-mail conversion

Provider roster directory updates

Ability for any provider to update their roster information for provider directory accuracy

Supporting Documents

Remind and support Claimant in securely uploading required supporting documents for a Claim.

Payment Status

Provide Member with the current status of a payment on a Claim.

Provider appointment setting and reminders

Patient appointment setting support with reminders and ability to reschedule

Records transfer paperwork

Completion of forms and e-signing records transfer paperwork

KYC Supporting Documents

Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.

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.

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)

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.

Eligibility of Insurability (EOI)

Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.

Care education (chronic condition management)

Notifications to educate on the importance of chronic condition management, related appointment setting

Clinical guideline requests and inquiries

Ability for providers to request clinical guidelines

Member contact information collection / updates

Collection of cross-channel member contact information to support better communications

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

Claim Status

Provide Policy Holder with the current status of a Claim.

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)

Vaccination outreach and scheduling

Education and appointment setting support for Vaccination with appointment reminders and reschedules

Adult Preventative Wellness

Ongong adult preventative wellness education, appointment setting and other actions

Vaccination reminders, education, appointment scheduling, and paperwork

Enrollment in mail order program and Rx transfers

Education on benefits of mail order delivery and Rx transfer support

Payment Status

Provide Member with the current status of a payment on a Claim.

Cardiac Disease care management and navigation

Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting

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

Digital ID Card

Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.

Shipping status updates

Shipment status updates

Paperless Statements

Ability for Borrowers to opt in to digital delivery of Statements.

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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.

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