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
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Chronic condition care navigation
Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
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.
90-day fill conversion
Support for education and 90-day fill conversion
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Payment Status
Provide Borrower with the current status of a payment made to their account.
Digital ID card delivery
Delivery of member ID cards digitally
New patient welcome and information gathering
Patient education on provider and information and documentation completion
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
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
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Profile Updates
Update Policy Holder information and contact preferences.
Payment Status
Provide Member with the current status of a payment on a Claim.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Member information updates
Member information updates – including cross-channel contact details and change of insurance
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Escrow Review
Guide Borrower through shortfalls or excesses in their escrow account, the tax or insurance payments that led to the shortfall, and to securely accept payments for any shortfall.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
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
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
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.
Profile Updates
Update Member information and contact preferences.
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
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
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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.
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Claim Status
Provide Member with the current status of a Claim.
Renewal education and reminders
Support for member retention with renewal education and reminders
Diabetes care management and navigation
Year-round support for diabetic members including education, wellness, care gap closure, appointment setting
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
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
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
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Policy Renewal
Guide the Policy Holder through renewing their policy.
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Shipping status updates
Shipment status updates
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Payment Status
Provide Member with the current status of a payment on a Claim.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
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
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
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
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.
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
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.
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
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.
