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
Prior authorization communications and intake
Ability for providers and pharmacies to perform prior authorization inquiries, submit forms and information, and receive status updates
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
Explanation of Benefits (EOB) notices and education
Education and notices on Explanation of Benefits (EOB)
Policy Review (KYC)
Remind and support Member in securely uploading required supporting KYC documents during Policy Review.
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
Product Comparison
Support for Applicants to find Lending options that best fits their needs.
Live Member Service chats and warm call transfers
Ability for service 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
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Certificate of Insurance (COI)
Respond to Policy Holder requests for copies of Certificate of Insurance (COI) with secure delivery of documents.
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Provider after hours support
Accurate, secure and compliant AI Agent provider inquiry and task completion support 24x7
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Product Comparison
Support for Applicants to find Insurance Plan options that best fit their needs.
Site of care guidance (wayfinding)
Support for appropriate site of care with appointment setting
Preventative wellness
Education and appointment setting for preventative wellness medications, immunizations and tests
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
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
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
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Surgery Confirmation
Collect detailed surgical information, including operative reports, discharge summaries, and post-operative recovery plans from the Claimant.
Overview of PBM supports and services
Overview of PBM support and services and population health and quality programs
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
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)
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Annual Wellness Visit (AWV) outreach and scheduling
Education and appointment setting support for Annual Wellness Visits (AWV) with appointment reminders and reschedules
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
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)
Refill reminders and ordering facilitation
Refill reminders and ordering facilitation (including payment capture)
Eligibility and Out of Pocket Cost (OOP) verification
Ability for members to inquire about eligibility and verify out of pocket costs
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
Cost transparency and cost relief
Education on cost tranparency and cost relief options
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
Extraction (Dental)
Extract Dental related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Payment Status
Provide Borrower with the current status of a payment made to their account.
ER avoidance
Education on when to use sites of care that are alternatives to the ER (telehealth, urgent care)
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
First Notice of Loss (FNOL)
Guide the Policy Holder through reporting a loss and filing a Claim.
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
90-day fill conversion
Support for education and 90-day fill conversion
Issues and Complaints
Proactively detect issues and escalate them as tickets to reduce complaints and improve satisfaction.
Profile Updates
Update Member information and contact preferences.
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
Vaccination outreach and scheduling
Education and appointment setting support for Vaccination with appointment reminders and reschedules
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
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.
Profile Updates
Update Borrower information and contact preferences.
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Grievance filing and updates
Ability for members to understand and file Grievances, and receive status updates
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
Digital consent
Ability for members to opt in to digital communications
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Digital Consent
Ability for Members to opt in to digital communications.
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.
