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
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
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Cost transparency and cost relief
Education on cost tranparency and cost relief options
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
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
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Shipping status updates
Shipment status updates
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
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)
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
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
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
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
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
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
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)
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
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 (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.
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
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
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 Care Surveys (NPS, CAHPs and HOS- like)
Post care and pharmacy visit surveys to understand experience gaps for proactive outreach and support as needed
Waitlisting
Proactive notifications of appointment availability for patients on wait lists
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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
Profile Updates
Update Borrower information and contact preferences.
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Notification of lab and test results
Sharing of lab tests and results
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Renewal education and reminders
Support for member retention with renewal education and reminders
Shipping status updates
Shipment status updates
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Incontinence education and support
Education and connectivity to support resources for incontenence
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
Digital consent
Ability for members to opt in to digital communications
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Co-payment collection
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 service representatives to chat within Ushur journeys, and to warm call transfer to them
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.
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
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.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
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
Policy Renewal
Guide the Policy Holder through renewing their policy.
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
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.
