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.

Benefitfocus

AI Agents That Deliver Better CX — Built on Trust

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increase in CSAT score
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Outbound calls eliminated
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Automated Resolution rate
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ROI on AI investment

Trust-Native Architecture

Built with trust, security and compliance engineered into the platform core–not layered on later.
Security & Compliance
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Governance

Built-in governance embeds guardrails, policy enforcement, and human oversight directly into AI execution.

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Observability

Maintain real-time visibility into agent behavior, reasoning, and performance.

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Auditability

Replay conversations end to end and generate regulator-ready records on demand.

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Data Protection

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.

Ushur Dashboard screen
Illustration showing ushur's omnichannel capability
Ushur Studio screen preview
Ushur Insights screen

Inbound and Outbound

Compliant, end-to-end customer engagement that proactively connects, resolves, and preserves context.

Omnichannel Continuity

Engage across SMS, email, voice, and web in one persistent, compliant interaction thread.

Built for Business Speed

A purpose-built orchestration environment designed for business users to bring journeys to life quickly.

Actionable Insights

Understand behavior, measure performance, and maintain audit-ready visibility with built-in compliance controls.

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.

Company Type:
Health Payer
Provider
PBM
Pharmacy
LA&H
P&C
Consumer Lending
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Journey:
Acquisition
Retention
Member Service
Population Health & Quality
Claims & Administrative
Provider Service
Pre Visit
During Visit
Post Visit
Population Health & Quality
New Member Onboarding & Welcome
Member Service
Population Health & Quality
Mail Order Enrollment & Fulfillment
Claims and Administrative
New Member Onboarding & Welcome
Member Service
Population Health & Quality
Mail Order Enrollment & Fulfillment
Claims and Administrative
Group Quote Intake
Group Onboarding
Individual Acquisition
Member Service
Claims
Absence Management
Acquisition
Policyholder Service
Claims
Loan Originations
KYC and Onboarding
Loan Servicing
Loss Mitigation

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

Chronic Condition care gap closure

Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)

Digital ID Card

Securely deliver a digital copy of Member's Insurance ID Card upon request.

Provider appointment setting and reminders

Patient appointment setting support with reminders and ability to reschedule

Preventative wellness actions and care gap closure

Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)

Benefit awareness and literacy

Support for member education on benefits and how to utilize them throughout the plan year

Certificate of Insurance (COI)

Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.

Payment Status

Provide Member with the current status of a payment on a Claim.

Profile Updates

Update Member information and contact preferences.

Timely notifications to meet regulatory requirements

Ability to send notifications to members more timely to meet regulatory timing requirements

Prior Authorization transparency support

Ability for members to receive push notices for, or make inquiries about, prior authorization status

New member welcome

New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)

Extraction (Vision)

Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Medication adherence

Medication Adherence (overcome barriers - cost, transportation, adverse effects)

Claim Status

Provide Member with the current status of a Claim.

Notification of lab and test results

Sharing of lab tests and results

Member after hours support

Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7

Retail-to-mail conversion

Support for education and retail-to-mail conversion

Digital Consent

Ability for Members to opt in to digital communications.

Patient after hours support

Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7

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

Enrollment in mail order program and Rx transfers

Education on benefits of mail order delivery and Rx transfer support

Traditional app and portal registration support

Support for member app download and app and portal initial registration

Preventative wellness

Education and appointment setting for preventative wellness medications, immunizations and tests

Sales appointment setting and reminders

Member appointment setting with service or sales agents in support of their buying process

Shipping status updates

Shipment status updates

Brand-to-generic conversion

Support for education and brand to generic fill conversion

Email Triage

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Retail-to-mail conversion

Support for education and retail-to-mail conversion

Medication reconciliation

Education and scheduling of Medication Reconciliation appointments

Medication reconciliation appointment setting

Education and scheduling of Medication Reconciliation

Member information updates

Member information updates – including cross-channel contact details and change of insurance

Hardship Inquiry

Reach out to delinquent Borrowers with empathy to identify circumstances such as job loss, illness, divorce, deployment that may be eligible for relief measures.

Experience and Net Promoter Score (NPS) surveys

Surveying capability for experiences and NPS scoring

Digital Consent

Ability for Policy Holders to opt in to digital communications.

Policy Renewal

Guide the Policy Holder through renewing their policy.

Ongoing website, portal, & app adoption and utilization

Support for member ongoing utilization of website, traditional apps and portals

Provider after hours support

Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7

Digital Consent

Ability for Borrowers to opt in to digital communications.

First Notice of Loss (FNOL)

Guide the Policy Holder through reporting a loss and filing a Claim.

Provider roster directory updates

Ability for any provider to update their roster information for provider directory accuracy

Payoff Request

Guide Borrower through requesting an official Payoff Letter for their loan.

Medication (Rx) reconciliation

Education and scheduling of Medication Reconciliation

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

Member information updates (i.e. add dependant)

Collection of member information updates such as adding dependants, changing address, etc

Financial Health Education

Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.

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

Prior Authorization transparency support

Ability for members to receive push notices for, or make inquiries about, prior authorization status

Member contact information collection / updates

Collection of cross-channel member contact information to support better communications

Update Beneficiaries

Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.

Hospital discharge support

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Member After hours Support

Accurate, secure and compliant AI Member inquiry and task completion support 24x7

Digital consent

Ability for members to opt in to digital communications

Appeal filing and updates

Ability for members to understand and file Appeals, and receive status updates

Product Comparison

Support Applicants in finding Insurance Plan options that best fit their needs.

Annual Notice of Change (ANOC) FAQs

Proactive notifications and inquiry handling about Medicare Annual Notices of Change. Including FAQ support for top ANOC call drivers

Payment Status

Provide Borrower with the current status of a payment made to their account.

Chronic Condition care gap closure

Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)

SDOH Resources (transportation, food)

Support for understanding and accessing SDOH resources such as nutrition, transportation

New patient welcome and information gathering

Patient education on provider and information and documentation completion

Live Member Service chats and warm call transfers

Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them

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.

Post-visit check-in and follow-up details / instructions

Sharing of pre visit instructions with ability to automate answers to inquiries

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.

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 communications and intake

Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates

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

Weight loss support

Support for eating well, exercising as well as weight loss medications like GLP1

Transition of care support

Support for inpatient to facility or home transitions to ensure safety and decrease readmissions

Digital ID card delivery

Delivery of member ID cards digitally

Medication adherence:

Understand root causes of medication non-adherence and overcome them

Disaster Preparedness

Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.

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

Policy Cancellation

Guide the Policy Holder through cancelling their policy.

Benefits Education

Answer policy holder questions on Plan benefits, coverage, and eligibility.

Employer Onboarding

Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.

Chronic Condition Care Gap Closure

Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)

Support for shipping / delivery issues, returns and reshipment

Support for shipping / delivery issues, returns and reshipment

Member after hours support

Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7

Policyholder After hours Support

Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7

Co-payment collection

Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing

Make Payment

Securely accept full or partial payment of outstanding installment amount.

Extraction (Basic Life)

Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.

Email Triage

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Benefits Education

Answer Member questions on Plan benefits, coverage, and eligibility.

Patient questionnaire automation

Capture of patient information updates and support for review and e-signature for new patient paperwork

Cost transparency and cost relief

Education on cost tranparency and cost relief options

Shopper plan compare support

Member support in finding a health insurance plan that best fits their needs

New member welcome

New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)

Experience and Net Promoter Score (NPS) surveys

Surveying capability for experiences and NPS scoring

Redetermination journey support (Medicaid)

Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete

Balance Inquiry

Provide Borrower with details of the current balance on their account.

Follow-up appointment scheduling

Patient appointment setting support with reminders and ability to reschedule

Member ID card and driver's license digital collection

Safe and secure collection of member ID card(s), driver's license images

Vaccination reminders, education, appointment scheduling, and paperwork

Profile Updates

Update Policy Holder information and contact preferences.

Email Triage

Automatically triage incoming servicing emails to identify intent and respond to service requests.

Proactive member out of pocket notifications

Proactive member out of pocket notifications – with support for “price shocks”

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)

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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.

Agentic AI that Analysts rave about

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