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

0%
increase in CSAT score
0%
Outbound calls eliminated
0%
Automated Resolution rate
X
ROI on AI investment

Trust-Native Architecture

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

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

badge-check
Observability

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

badge-check
Auditability

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

badge-check
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
arrow-rotate-left
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

Email Triage

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

Schedule Appointment

Schedule follow up call with Sales Representative with reminders and rescheduling.

Site of care guidance (wayfinding)

Support for appropriate site of care with appointment setting

Support for shipping / delivery issues, returns and reshipment

Support for shipping / delivery issues, returns and reshipment

Digital ID Card

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

Policy Renewal

Guide the Policy Holder through renewing their policy.

Vaccination reminders, education, appointment scheduling, and paperwork

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)

Hospital discharge support

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

Digital consent

Ability for members to opt in to digital communications

Chronic Condition care gap closure

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

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

Payment Status

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

Extraction (Hospital Indemnity)

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

Preventative Wellness Care Gap Closure

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

Follow-up appointment scheduling

Patient appointment setting support with reminders and ability to reschedule

Proactive member out of pocket notifications

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

Ongoing website, portal, & app adoption and utilization

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

Medication refills and reminders

Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence

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

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

Medication adherence

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

Member after hours support

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

Overview of PBM supports and services

Overview of PBM support and services and population health and quality programs

Transition of care support

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

Member after hours support

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

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.

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

Member information updates

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

Appointment reminder and rescheduling

Member appointment reminders for care management, provider appointments (any type), home health visits and more

Post-discharge information / education

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

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

Member warm welcome benefits education and literacy

Member welcome notifications that educate on plan benefits, deliver digital ID cards

Digital Consent

Ability for Borrowers to opt in to digital communications.

Notification of lab and test results

Sharing of lab tests and results

Make Payment

Securely accept full or partial payment of outstanding installment amount.

Preventative wellness actions and care gap closure

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

Refill reminders and ordering facilitation

Refill reminders and ordering facilitation (including payment capture)

Prior Authorization transparency support

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

Member ID card and driver's license digital collection

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

Cancer Screening outreach and scheduling

Education and appointment setting support for Cancer Screening with appointment reminders and reschedules

Payment Status

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

Care education (chronic condition management)

Notifications to educate on the importance of chronic condition management, related appointment setting

Prior authorization communications and intake

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

Enrollment in mail order program and Rx transfers

Education on benefits of mail order delivery and Rx transfer support

Medication adherence

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

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 (Voluntary Life)

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

Eligibility & benefits verification

Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level

Paperless Statements

Ability for Borrowers to opt in to digital delivery of Statements.

Brand-to-generic conversion

Support for education and brand to generic fill conversion

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

Retail-to-mail conversion

Support for education and retail-to-mail conversion

Medication (Rx) reconciliation

Education and scheduling of Medication Reconciliation

Appointment scheduling, reminders and rescheduling (any provider type)

Patient appointment setting support with reminders and ability to reschedule

Employer Onboarding

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

Member contact information collection / updates

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

Experience and Net Promoter Score (NPS) surveys

Surveying capability for experiences and NPS scoring

Profile Updates

Update Borrower information and contact preferences.

SDOH resources (transportation, food)

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

Retail-to-mail conversion

Support for education and retail-to-mail conversion

Benefit awareness and literacy

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

Update Beneficiaries

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

Policy Cancellation

Guide the Policy Holder through cancelling their policy.

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

Behavioral Health care management and navigation

Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting

Care appointment reminders

Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)

Annual Wellness Visit (AWV) outreach and scheduling

Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules

Patient questionnaire automation

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

Prior Authorization transparency support

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

Overview of pharmacy supports and services

Overview of pharmacy support and services and population health and quality programs

Extraction (Dental)

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

Incontinence education and support

Education and connectivity to support resources for incontenence

Digital Consent

Ability for Policy Holders to opt in to digital communications.

Support for shipping / delivery issues, returns and reshipment

Support for shipping / delivery issues, returns and reshipment

Sales appointment setting and reminders

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

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

Provider appointment setting and reminders

Patient appointment setting support with reminders and ability to reschedule

Community meeting invitations

Proactive invitations and RSVPs for community events and meetings (virtual and in person)

Provider roster directory updates

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

Chronic Condition care gap closure

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

Care education (preventative care)

Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting

Brand-to-generic conversion

Support for education and brand to generic fill conversion

SDOH Resources (transportation, food)

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

Follow-up appointment scheduling

Patient appointment setting support with reminders and ability to reschedule

Payoff Request

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

Chronic Condition care gap closure

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

Provider credentialing with Plan

Support for provider credentialing information submission and status updates

Supporting Documents

Remind and support Member in securely uploading required supporting documents for a Claim.

Care plan adherence

Notifications to educate on the importance of care plan adherence, related appointment setting

Patient after hours support

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

Fall prevention education and action

Education and connectivity to support resources for fall prevention (movement, home safety...)

ER avoidance

Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)

Digital consent

Ability for members to opt in to digital communications

Medication adherence

Understand root causes of medication non-adherence and overcome them

SCRA Protection

Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.

Policy Review (KYC)

Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.

arrow-down

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

G2 reviewstars
capterra logostars