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
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Digital consent
Ability for members to opt in to digital communications
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Member information updates
Member information updates – including cross-channel contact details and change of insurance
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
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Policy Renewal
Guide the Policy Holder through renewing their policy.
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
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.
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.
Prior authorization education and updates for transparency
Ability for patients to receive push notices for, or make inquiries about, prior authorization status
Borrower After hours Support
Accurate, secure and compliant AI Agent Borrower inquiry and task completion support 24x7
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
Benefits Education
Answer Member questions on Plan benefits, coverage, and eligibility.
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
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Profile Updates
Update Member information and contact preferences.
Preventative Wellness Care Gap Closure
Education, navigation support and appointment setting for any preventative wellness care gap (immunizations, cancer screenings)
90-day fill conversion
Support for education and 90-day fill conversion
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Benefit awareness and literacy
Support for member education on benefits and how to utilize them throughout the plan year
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.
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
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 (Vision)
Extract Vision related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Transition of care support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
Eligibility & benefits verification
Ability for providers and pharmacies to perform eligibilty and benefits verification at the member level
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
Digital Consent
Ability for Borrowers to opt in to digital communications.
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Fall prevention education and action
Education and connectivity to support resources for fall prevention (movement, home safety...)
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
First Notice of Injury
Guide the Claimant through reporting an injury and filing a Claim.
Musculoskeletal (MSK) care management and navigation
Year-round support for members with Musculoskeletal conditions - including education, wellness, care gap closure, appointment setting
SCRA Protection
Securely collect proof of Active Duty Servicemembers in order to trigger financial protections.
Maternal health navigation
Support for full maternity journeys with education, appointment setting, wellness and more
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
Balance Inquiry
Provide Borrower with details of the current balance on their account.
Digital Consent
Ability for Policy Holders to opt in to digital communications.
Product Comparison
Support Applicants in finding Insurance Plan options that best fit their needs.
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Proactive member out of pocket notifications
Proactive member out of pocket notifications – with support for “price shocks”
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Financial Health Education
Support Borrowers with advice, reminders, and empathy to guide them towards financially healthy payment behavior.
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Provider appointment setting and reminders
Patient appointment setting support with reminders and ability to reschedule
Payment Status
Provide Borrower with the current status of a payment made to their account.
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
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.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
SDOH Resources (transportation, food)
Support for understanding and accessing SDOH resources such as nutrition, transportation
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)
Support for shipping / delivery issues, returns and reshipment
Support for shipping / delivery issues, returns and reshipment
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)
Policy Review (KYC)
Remind and support Policy Holder in securely uploading required supporting KYC documents during Policy Review.
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Medication reconciliation appointment setting
Education and scheduling of Medication Reconciliation
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Traditional app and portal registration support
Support for member app download and app and portal initial registration
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
Medication refills and reminders
Sharing of medication refills and reminders with ability to capture and overcome reasons for non adherence
Diabetes care management and navigation
Year-round support for diabetic members including education, wellness, care gap closure, appointment setting
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Profile Updates
Update Policy Holder information and contact preferences.
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Workplace Accommodations
Educate the Member on available workplace acommodations, reduced hours, and reassignment programs available through their employer.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
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
Extraction (Hospital Indemnity)
Extract Hospital Indemnity related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Eligibility of Insurability (EOI)
Guide the new Member through a dynamic set of questions to determine their eligibiity for Insurance.
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
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.




















