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
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Post-visit check-in and follow-up details / instructions
Sharing of pre visit instructions with ability to automate answers to inquiries
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
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
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Member After hours Support
Accurate, secure and compliant AI Member inquiry and task completion support 24x7
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.
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.
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
Care appointment reminders
Proactive care and provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Experience and Net Promoter Score (NPS) surveys
Surveying capability for experiences and NPS scoring
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Update Beneficiaries
Update Beneficiaries and respond to major life events to ensure Policy Holder's benefits are paid to intended individuals.
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
KYC Supporting Documents
Remind and support borrower in securely uploading required supporting KYC documents during Onboarding.
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Shipping status updates
Shipment status updates
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
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
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Profile Updates
Update Policy Holder information and contact preferences.
Claims status
Ability for members to receive push notices for, or make inquiries about, claims status
Extraction (Basic Life)
Extract Basic Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Return to Work
Confirm Claimant's Return to Work date as well as any supporting documentation from the doctor.
Extraction (Hospital Indemnity)
Extract Hospital Indemnity 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
Digital consent
Ability for members to opt in to digital communications
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Claim status, adjudication and payment updates
Ability for providers to inquire about claim status, adjudication and payments
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
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.
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Weight loss support
Support for eating well, exercising as well as weight loss medications like GLP1
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
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
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Prior Authorization transparency support
Ability for members 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
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
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
Premium Payment
Securely accept full or partial payment of outstanding premium amount.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Care plan adherence
Notifications to educate on the importance of care plan adherence, related 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
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
Live Member Service chats and warm call transfers
Ability for service representatives to chat within Ushur journeys, and to warm call transfer to them
Digital ID Card
Securely deliver a digital copy of Member's Insurance ID Card upon request.
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Appointment scheduling, reminders and rescheduling
Support for finding an in network provider and setting appointment via click-to-call or scheduling system integration
Appointment reminder and rescheduling
Member appointment reminders for care management, provider appointments (any type), home health visits and more
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
New member welcome
New member welcome, overview of PBM supports and services, info gathering / sharing (including insurance ID card capture)
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
90-day fill conversion
Support for education and 90-day fill conversion
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Notification of lab and test results
Sharing of lab tests and results
Traditional app and portal registration support
Support for member app download and app and portal initial registration
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Vaccination reminders, education, appointment scheduling, and paperwork
Payment Status
Provide Member with the current status of a payment on a Claim.
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
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Co-payment collection
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
Preventative wellness actions and care gap closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
Medication adherence
Understand root causes of medication non-adherence and overcome them
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
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.
Make Payment
Securely accept full or partial payment of outstanding installment amount.
Renewal education and reminders
Support for member retention with renewal education and reminders
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
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.
