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.
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
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
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Vaccination reminders, education, appointment scheduling, and paperwork
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
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
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)
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
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Vaccination reminders, education, appointment scheduling, and paperwork
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Claim Status
Provide Member with the current status of a Claim.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
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
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
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Digital consent
Ability for members to opt in to digital communications
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
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
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.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
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
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.
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
90-day fill conversion
Support for education and 90-day fill conversion
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
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
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Claim Status
Provide Policy Holder with the current status of a Claim.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Medication adherence
Understand root causes of medication non-adherence and overcome them
Digital consent
Ability for members to opt in to digital communications
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
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
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Chronic condition care navigation
Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
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
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Payment Status
Provide Member with the current status of a payment on a Claim.
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Follow-up appointment scheduling
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...)
Extraction (Basic Life)
Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
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
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
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
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Digital Consent
Ability for Borrowers to opt in to digital communications.
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
Hardship Inquiry
Reach out to delinquent Borrowers with empathy to identify circumstances such as job loss, illness, divorce, deployment that may be eligible for relief measures.
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
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.
