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.
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
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
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
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
Profile Updates
Update Borrower information and contact preferences.
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
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
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Claim Status
Provide Policy Holder with the current status of a Claim.
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
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.
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
Policy Renewal
Guide the Policy Holder through renewing their policy.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Chronic condition care navigation
Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Profile Updates
Update Member information and contact preferences.
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Extraction (Vision)
Extract Vision 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
Notification of lab and test results
Sharing of lab tests and results
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
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
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Payment Status
Provide Borrower with the current status of a payment made to their account.
Shipping status updates
Shipment status updates
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Plan Design
Triage inbound RFP emails to identify key attributes regarding Broker, Employer, Quote, and requested Products and automate case setup in Quoting and Underwriting systems.
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
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.
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Payment Status
Provide Member with the current status of a payment on a Claim.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Digital consent
Ability for members to opt in to digital communications
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Profile Updates
Update Policy Holder information and contact preferences.
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)
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Digital consent
Ability for members to opt in to digital communications
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Digital Consent
Ability for Borrowers to opt in to digital communications.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
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
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
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.
