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
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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
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.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
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
Make Payment
Securely accept full or partial payment of outstanding installment amount.
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Incontinence education and support
Education and connectivity to support resources for incontenence
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Medication adherence
Understand root causes of medication non-adherence and overcome them
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
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
90-day fill conversion
Support for education and 90-day fill conversion
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
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)
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.
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Policy Renewal
Guide the Policy Holder through renewing their policy.
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
Balance Inquiry
Provide Borrower with details of the current balance on their account.
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
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Notification of lab and test results
Sharing of lab tests and results
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Shipping status updates
Shipment status updates
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
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
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Waitlisting
Proactive notifications of appointment availability for patients on wait lists
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
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
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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.
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
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
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
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
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
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)
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Digital consent
Ability for members to opt in to digital communications
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Transition of Care Support Readmission Avoidance
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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.
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
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Premium Payment
Securely accept full or partial payment of outstanding premium amount.
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Profile Updates
Update Borrower information and contact preferences.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
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.
