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.
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
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.
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
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Extraction (Critical Illness)
Extract Critical Illness 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)
Digital consent
Ability for members to opt in to digital communications
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
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
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Digital ID card delivery
Delivery of member ID cards digitally
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Shipping status updates
Shipment status updates
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Notification of lab and test results
Sharing of lab tests and results
Renewal education and reminders
Support for member retention with renewal education and reminders
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Profile Updates
Update Borrower information and contact preferences.
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Shipping status updates
Shipment status updates
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
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
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
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
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
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
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Medication adherence
Understand root causes of medication non-adherence and overcome them
Digital consent
Ability for members to opt in to digital communications
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
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
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
Policy Renewal
Guide the Policy Holder through renewing their policy.
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
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
Member information updates
Member information updates – including cross-channel contact details and change of insurance
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)
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Shipping status updates
Shipment status updates
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Premium Payment
Securely accept full or partial payment of outstanding premium amount.
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Diabetes care management and navigation
Year-round support for diabetic members including education, wellness, care gap closure, appointment setting
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
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.
