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
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
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
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Claim Status
Provide Policy Holder with the current status of a Claim.
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Profile Updates
Update Borrower information and contact preferences.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
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
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
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
Community meeting invitations
Proactive invitations and RSVPs for community events and meetings (virtual and in person)
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Digital ID card delivery
Delivery of member ID cards digitally
Vaccination reminders, education, appointment scheduling, and paperwork
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Chronic condition care navigation
Education, care management, navigation support and appointment setting for any chronic condition (diabetes, CKD...)
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Digital consent
Ability for members to opt in to digital communications
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Digital Consent
Ability for Borrowers to opt in to digital communications.
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Confirmation of medication, immunization, DME orders / refills
Confirmation of medication, immunization, DME orders / refills
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Renewal education and reminders
Support for member retention with renewal education and reminders
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.
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
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
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
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
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
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
Redetermination journey support (Medicaid)
Support for member retention with ongoing redetermination process education, support and services - until redetermination is complete
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Persistency of Benefits
Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
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.
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
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.
