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
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)
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Digital consent
Ability for members to opt in to digital communications
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
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
Shipping status updates
Shipment status updates
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
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.
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
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
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
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
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Claim Status
Provide Member with the current status of a Claim.
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
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
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Digital Consent
Ability for Borrowers to opt in to digital communications.
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
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.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
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
Profile Updates
Update Borrower information and contact preferences.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Claim Status
Provide Policy Holder with the current status of a Claim.
Brand-to-generic conversion
Support for education and brand to generic fill 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 member service
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
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
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
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.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
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
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Cost transparency and cost relief
Education on cost tranparency and cost relief options
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
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
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
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.
Renewal education and reminders
Support for member retention with renewal education and reminders
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
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Profile Updates
Update Member information and contact preferences.
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Payment Status
Provide Member with the current status of a payment on a Claim.
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
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.
