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
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Shipping status updates
Shipment status updates
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.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Stay at Work
Guide the Member through potential insurance benefits and available workplace accommodations, reduced hours, and reassignments to help them decide between different disability options.
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
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
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.
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
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Payment Status
Provide Member with the current status of a payment on a Claim.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Extraction (Basic Life)
Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Schedule and prep instructions for PT / OT / other visits
Patient appointment setting support with visit prep instructions, reminders and ability to reschedule
Shipping status updates
Shipment status updates
SDOH resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Post-discharge information / education
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Renewal education and reminders
Support for member retention with renewal education and reminders
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Payoff Request
Guide Borrower through requesting an official Payoff Letter for their loan.
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
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
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.
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Eligibility & benefits verification
Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Incontinence education and support
Education and connectivity to support resources for incontenence
Claim Status
Provide Policy Holder with the current status of a Claim.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
Loan Modification
Proactively reach out to delinquent Borrowers to educate them on eligible Loan Modification options available and support their decision.
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Appeal filing and updates
Ability for members to understand and file Appeals, and receive status updates
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Review and e-sign new patient paperwork
Support for review and e-signature for new patient paperwork
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Profile Updates
Update Policy Holder information and contact preferences.
Email Triage
Automatically triage incoming servicing emails to identify intent and respond to service requests.
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Extraction (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
Delivery Confirmation
Collect detailed delivery information, hospital discharge summaries from the Claimant to trigger benefits.
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Digital Consent
Ability for Policy Holders to opt in to digital communications.
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
Prior authorization education and updates for transparency
Ability for patients 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
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
Retail, mail order, 90-day medication refills
Support medication adherence with retail, mail order and 90-day refill request support
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Supporting Documents
Remind and support Claimant in securely uploading required supporting documents for a Claim.
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
Medication adherence:
Understand root causes of medication non-adherence and overcome them
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Digital Consent
Ability for Borrowers to opt in to digital communications.
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
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
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
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
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.
