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
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)
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
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.
Notification of shipment with tracking number and delivery instructions
Notification of shipment with tracking number and delivery instructions (i.e. someone needs to be home at delivery)
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
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.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
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
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
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
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Claim Status
Provide Member with the current status of a Claim.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Policy Renewal
Guide the Policy Holder through renewing their policy.
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
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
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
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.
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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
Vaccination reminders, education, appointment scheduling, and paperwork
Retail-to-mail conversion
Support for education and retail-to-mail conversion
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Payment Status
Provide Member with the current status of a payment on a Claim.
Digital consent
Ability for members to opt in to digital communications
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Eligibility & benefits verification
Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Renewal education and reminders
Support for member retention with renewal education and reminders
Medication adherence
Understand root causes of medication non-adherence and overcome them
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Member's benefits are paid to intended individuals.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
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
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Digital Consent
Ability for Borrowers to opt in to digital communications.
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Extraction (Long Term Disability)
Extract Long Term Disability related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Diabetes care management and navigation
Year-round support for diabetic members including education, wellness, care gap closure, appointment setting
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
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 warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
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.
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
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”
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
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
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Digital Consent
Ability for Members to opt in to digital communications.
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
New patient welcome and information gathering
Patient education on provider and information and documentation completion
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
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Census Transformation
Identify Census files in an inbound RFP and Transform the file to the standard format required by the Carrier and identify any issues.
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.
