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.
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 the modern enterprise. Secure, compliant, and designed to resolve customer needs from start to finish.
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
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
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
Incontinence education and support
Education and connectivity to support resources for incontenence
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Digital ID card delivery
Delivery of member ID cards digitally
Appointment setting for preventive care screenings and visits
Proactive 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.
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Digital Consent
Ability for Borrowers to opt in to digital communications.
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
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.
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Cost transparency and cost relief
Education on cost tranparency and cost relief options
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
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
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
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
90-day fill conversion
Support for education and 90-day fill conversion
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Claim Status
Provide Policy Holder with the current status of a Claim.
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
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.
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
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
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Payment Status
Provide Borrower with the current status of a payment made to their account.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
90-day fill conversion
Support for education and 90-day fill conversion
Notification of lab and test results
Sharing of lab tests and results
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
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
Shipping status updates
Shipment status updates
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
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.
Claim Status
Provide Member with the current status of a Claim.
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Vaccination reminders, education, appointment scheduling, and paperwork
Premium Payment
Securely accept full or partial payment of outstanding premium amount.
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
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
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Shipping status updates
Shipment status updates
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Traditional app and portal registration support
Support for member app download and app and portal initial registration
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Profile Updates
Update Policy Holder information and contact preferences.
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
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Vaccination reminders, education, appointment scheduling, and paperwork
Transition of Care Support Readmission Avoidance
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Digital Consent
Ability for Members to opt in to digital communications.
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.
