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
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
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)
Diabetes care management and navigation
Year-round support for diabetic members including education, wellness, care gap closure, appointment setting
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
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
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)
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Waitlisting
Proactive notifications of appointment availability for patients on wait lists
Notification of lab and test results
Sharing of lab tests and results
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
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
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Profile Updates
Update Member information and contact preferences.
Shipping status updates
Shipment status updates
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
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
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
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.
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
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Shipping status updates
Shipment status updates
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
90-day fill conversion
Support for education and 90-day fill conversion
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
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.
Policy Renewal
Guide the Policy Holder through renewing their policy.
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
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
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
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
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Policy Review (KYC)
Remind and support Member 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
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
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
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Digital Consent
Ability for Borrowers to opt in to digital communications.
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Extraction (Basic Life)
Extract Basic Life 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
Payment Status
Provide Member with the current status of a payment on a Claim.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Digital consent
Ability for members to opt in to digital communications
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Renewal education and reminders
Support for member retention with renewal education and reminders
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
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.
