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
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Shipping status updates
Shipment status updates
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
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
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
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.
Persistency of Benefits
Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
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
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)
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
Premium Payment
Securely accept full or partial payment of outstanding premium amount.
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Renewal education and reminders
Support for member retention with renewal education and reminders
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Cost transparency and cost relief
Education on cost tranparency and cost relief options
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
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
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Profile Updates
Update Member information and contact preferences.
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
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
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
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
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
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)
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Digital Consent
Ability for Borrowers to opt in to digital communications.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
90-day fill conversion
Support for education and 90-day fill conversion
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Policy Renewal
Guide the Policy Holder through renewing their policy.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
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
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
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
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
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.
