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
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Shipping status updates
Shipment status updates
Medication adherence
Understand root causes of medication non-adherence and overcome them
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Make Payment
Securely accept full or partial payment of outstanding installment amount.
Digital Consent
Ability for Members to opt in to digital communications.
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
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)
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
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
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
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.
Profile Updates
Update Borrower information and contact preferences.
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Chronic condition care navigation
Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)
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 pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
Payment Status
Provide Member with the current status of a payment on a Claim.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Shipping status updates
Shipment status updates
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.
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
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
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
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
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Digital consent
Ability for members to opt in to digital communications
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
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.
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Vaccination reminders, education, appointment scheduling, and paperwork
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 (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
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
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Digital ID card delivery
Delivery of member ID cards digitally
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
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)
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
Claim Status
Provide Policy Holder with the current status of a Claim.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Digital consent
Ability for members to opt in to digital communications
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Payment Status
Provide Member with the current status of a payment on a Claim.
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Stay at Work
Guide the Member through potential insurance benefits and available workplace accommodations, reduced hours, and reassignments to help them decide between different disability options.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
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.
