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
Make Payment
Securely accept full or partial payment of outstanding installment amount.
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
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Digital consent
Ability for members to opt in to digital communications
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Extraction (Accidental Death & Dismemberment)
Extract Accidental Death and Dismemberment related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
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
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Extraction (Basic Life)
Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Eligibility & benefits verification
Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level
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.
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Digital consent
Ability for members to opt in to digital communications
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
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.
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Employer Onboarding
Guide the Broker / Employer through the information required from them to onboard them into the Carrier's core systems.
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Shipping status updates
Shipment status updates
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
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Digital ID card delivery
Delivery of member ID cards digitally
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
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
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
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Medication (Rx) reconciliation
Education and scheduling of Medication Reconciliation
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
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.
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Incontinence education and support
Education and connectivity to support resources for incontenence
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)
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
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)
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Care education (preventative care)
Notifications to educate on the importance of adult and pediatric preventative care, related appointment setting
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Chronic Condition Care Gap Closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
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.
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Provider after hours support
Accurate, secure and compliant AI Agent provider 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.
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Renewal education and reminders
Support for member retention with renewal education and reminders
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Care plan adherence
Notifications to educate on the importance of care plan adherence, related appointment setting
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
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
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.
