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.
90-day fill conversion
Support for education and 90-day fill conversion
Escrow Review
Guide Borrower through shortfalls or excesses in their escrow account, the tax or insurance payments that led to the shortfall, and to securely accept payments for any shortfall.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
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
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Claim Status
Provide Policy Holder with the current status of a Claim.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Shipping status updates
Shipment status updates
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Incontinence education and support
Education and connectivity to support resources for incontenence
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Extraction (Basic Life)
Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Shipping status updates
Shipment status updates
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Eligibility & benefits verification
Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Shipping status updates
Shipment status updates
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Notification of lab and test results
Sharing of lab tests and results
Profile Updates
Update Policy Holder information and contact preferences.
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Persistency of Benefits
Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Digital Consent
Ability for Policy Holders to opt in to digital communications.
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
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
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Transition of Care Support Readmission Avoidance
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
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 Status
Provide Member with the current status of a payment on a Claim.
Profile Updates
Update Borrower information and contact preferences.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
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
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
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
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
New patient welcome and information gathering
Patient education on provider and information and documentation completion
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
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
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.
