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.
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Digital consent
Ability for members to opt in to digital communications
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
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)
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
Profile Updates
Update Policy Holder information and contact preferences.
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Notification of lab and test results
Sharing of lab tests and results
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
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.
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)
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Digital consent
Ability for members to opt in to digital communications
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
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
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Balance Inquiry
Provide Borrower with details of the current balance on their account.
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.
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
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
Payment Status
Provide Member with the current status of a payment on a Claim.
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
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.
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
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.
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Renewal education and reminders
Support for member retention with renewal education and reminders
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
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
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Digital Consent
Ability for Members to opt in to digital communications.
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Medication adherence
Understand root causes of medication non-adherence and overcome them
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
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
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 information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Member contact information collection / updates
Collection of cross-channel member contact information to support better 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
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
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
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
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
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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.
