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
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
90-day fill conversion
Support for education and 90-day fill conversion
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Brand-to-generic conversion
Support for education and brand to generic fill conversion
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
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
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
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)
Extraction (Basic Life)
Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
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)
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Vaccination reminders, education, appointment scheduling, and paperwork
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Medication adherence
Understand root causes of medication non-adherence and overcome them
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Cost transparency and cost relief
Education on cost tranparency and cost relief options
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Incontinence education and support
Education and connectivity to support resources for incontenence
Notification of lab and test results
Sharing of lab tests and results
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
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
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.
Transition of Care Support Readmission Avoidance
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
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
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.
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
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
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.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Shipping status updates
Shipment status updates
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
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.
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Shipping status updates
Shipment status updates
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Claim Status
Provide Member with the current status of a Claim.
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
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.
