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
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
90-day fill conversion
Support for education and 90-day fill conversion
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
90-day fill conversion
Support for education and 90-day fill conversion
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
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
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
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
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
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
Digital consent
Ability for members to opt in to digital communications
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
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)
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
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.
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
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
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
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.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Profile Updates
Update Borrower information and contact preferences.
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
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Policy Renewal
Guide the Policy Holder through renewing their policy.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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.
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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.
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
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
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
Shipping status updates
Shipment status updates
Payment Status
Provide Member with the current status of a payment on a Claim.
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
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
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
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.
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
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.
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Balance Inquiry
Provide Borrower with details of the current balance on their account.
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
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Shipping status updates
Shipment status updates
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.
