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
Post Disaster Outreach
Proactively reach out to Policy Holders after a Disaster, such as storm, wildfire, or flood to connect them to required services and relief, and to file any Claims if required.
HIPAA Release
Securely upload a signed HIPAA release form from the Claimant.
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
Digital ID Card
Securely deliver a digital copy of Policy Holder's Insurance ID Card upon request.
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
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
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”
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
New patient welcome and information gathering
Patient education on provider and information and documentation completion
Brand-to-generic conversion
Support for education and brand to generic fill conversion
Patient after hours support
Accurate, secure and compliant AI Agent patient inquiry and task completion support 24x7
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
Social Determinant of Health SDOH surveys
Social Determinant of Health SDOH survey completion with feeds to core systems for follow-up
Patient questionnaire automation
Capture of patient information updates and support for review and e-signature for new patient paperwork
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Co-payment collection
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Supporting Documents
Remind and support Member in securely uploading required supporting documents for a Claim.
Persistency of Benefits
Collect Member's bank details and payment information to ensure that Group Insurance coverage transitions to Individual coverage after employment ends.
Ongoing website, portal, & app adoption and utilization
Support for member ongoing utilization of website, traditional apps and portals
Medication reconciliation
Education and scheduling of Medication Reconciliation appointments
Care Management connectivity
Notifications to educate on the importance of Care Management and set appointments
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Cost transparency and cost relief
Education on cost tranparency and cost relief options
90-day fill conversion
Support for education and 90-day fill conversion
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.
Click-to-call or chat to speak to pharmacy staff member
Click-to-call or chat to speak to pharmacy staff member when needed
Address Verification
Remind and support Borrower in securely verifying address and contact information during KYC Reviews.
Member after hours support
Accurate, secure and compliant AI Agent member inquiry and task completion support 24x7
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
90-day fill conversion
Support for education and 90-day fill conversion
Extraction (Voluntary Life)
Extract Voluntary Life related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Claim Status
Provide Member with the current status of a Claim.
Shipping status updates
Shipment status updates
Profile Updates
Update Member information and contact preferences.
Appointment scheduling, reminders and rescheduling (any provider type)
Patient appointment setting support with reminders and ability to reschedule
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.
Member contact information collection / updates
Collection of cross-channel member contact information to support better communications
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 members to opt in to digital communications
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
Shopper plan compare support
Member support in finding a health insurance plan that best fits their needs
Clinical guideline requests and inquiries
Ability for providers to request clinical guidelines
Bill pay - payment capture
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Benefits Education
Answer policy holder questions on Plan benefits, coverage, and eligibility.
Paperless Statements
Ability for Borrowers to opt in to digital delivery of Statements.
Adult preventative wellness
Ongong adult preventative wellness education, appointment setting and other actions
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
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Payment Status
Provide Member with the current status of a payment on a Claim.
Records transfer paperwork
Completion of forms and e-signing records transfer paperwork
Shipping status updates
Shipment status updates
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Cancer Screening outreach and scheduling
Education and appointment setting support for Cancer Screening with appointment reminders and reschedules
Renewal education and reminders
Support for member retention with renewal education and reminders
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
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
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.
Respiratory Care care management and navigation (COPD, Asthma)
Year-round support for members with Respiratory Disease - including education, wellness, care gap closure, appointment setting
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.
