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.
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
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
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
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
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
90-day fill conversion
Support for education and 90-day fill conversion
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Diabetes care management and navigation
Year-round support for diabetic members including education, wellness, care gap closure, appointment setting
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
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 Status
Provide Member with the current status of a payment on a Claim.
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
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
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
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Digital Consent
Ability for Borrowers to opt in to digital communications.
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
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.
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.
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Waitlisting
Proactive notifications of appointment availability for patients on wait lists
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)
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
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
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Profile Updates
Update Borrower information and contact preferences.
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Digital consent
Ability for members to opt in to digital communications
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
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
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.
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Digital Consent
Ability for Members to opt in to digital 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
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
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
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Vaccination reminders, education, appointment scheduling, and paperwork
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Notification of lab and test results
Sharing of lab tests and results
Policy Renewal
Guide the Policy Holder through renewing their policy.
Extraction (Critical Illness)
Extract Critical Illness 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.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
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
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Payment Status
Provide Borrower with the current status of a payment made to their account.
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Premium Payment
Securely accept full or partial payment of outstanding premium amount.
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
Education and appointment setting for preventative wellness medications, immunizations and tests
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
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)
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
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.
