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
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Eligibility & benefits verification
Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level
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.
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
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.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Payment Status
Provide Member with the current status of a payment on a Claim.
Make Payment
Securely accept full or partial payment of outstanding installment amount.
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
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
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
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
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
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
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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.
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Policy Renewal
Guide the Policy Holder through renewing their policy.
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
90-day fill conversion
Support for education and 90-day fill conversion
Vaccination reminders, education, appointment scheduling, and paperwork
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
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
Retail-to-mail conversion
Support for education and retail-to-mail conversion
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
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
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.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Transition of Care Support Readmission Avoidance
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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.
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Shipping status updates
Shipment status updates
Premium Payment
Securely accept full or partial payment of outstanding premium amount.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
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 to member service
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
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.
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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 reconciliation
Education and scheduling of Medication Reconciliation appointments
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
Digital Consent
Ability for Borrowers to opt in to digital communications.
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.
Persistency of Benefits
Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.
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
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
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
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
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Incontinence education and support
Education and connectivity to support resources for incontenence
Chronic condition care navigation
Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Profile Updates
Update Policy Holder information and contact preferences.
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Digital consent
Ability for members to opt in to digital communications
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
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.
