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
Trailing Documents
Remind and support Applicant in securely uploading required supporting documents post Application.
Payment capture
Safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Provider credentialing with Plan
Support for provider credentialing information submission and status updates
Member ID card and driver's license digital collection
Safe and secure collection of member ID card(s), driver's license images
Cost transparency and cost relief
Education on cost tranparency and cost relief options
Member warm welcome benefits education and literacy
Member welcome notifications that educate on plan benefits, deliver digital ID cards
Proactive Rx status notifications
Proactive Rx status notifications (fill status, issues like prior auth)
Hospital discharge support
Support for inpatient to facility or home transitions to ensure safety and decrease readmissions
Appointment setting for preventive care screenings and visits
Proactive provider appointment reminders with the ability to reschedule rather than no show (any provider type)
Medication adherence
Medication Adherence (overcome barriers - cost, transportation, adverse effects)
Vaccination reminders, education, appointment scheduling, and paperwork
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.
Chronic Condition care gap closure
Education, navigation support and appointment setting for any chronic condition care gap (diabetes, CKD...)
Notification of lab and test results
Sharing of lab tests and results
Pediatric Preventative Wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Policy Reinstatement
Guide the Policy Holder through re-instating a lapsed policy.
Retail-to-mail conversion
Support for education and retail-to-mail conversion
Click-to-call or chat to speak with Care Manager
Click-to-call or chat to speak to Care Manager / Navigator when needed
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Digital consent
Ability for members to opt in to digital communications
Extraction (Hospital Indemnity)
Extract Hospital Indemnity 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.
Cardiac Disease care management and navigation
Year-round support for members with Cardiac Disease - including education, wellness, care gap closure, appointment setting
Revenue cycle support - payment collection / auto-pay
Bill delivery with safe and secure collection of payment information (credit, debit, ACH) to pass to payment processing
Profile Updates
Update Borrower information and contact preferences.
Profile Updates
Update Member information and contact preferences.
Policy Cancellation
Guide the Policy Holder through cancelling their policy.
Health Risk Assessment HRA surveys
Full Health Risk / Needs Survey completion with feeds to core systems for follow-up
Cost transparency (Good Faith Estimate)
Providing out of pocket cost transparency via Good Faith Estimates
Debt Management Plan
Proactively reach out to delinquent Borrowers to educate them on eligible Debt Management Plan options available and support their decision.
Follow-up appointment scheduling
Patient appointment setting support with reminders and ability to reschedule
Timely notifications to meet regulatory requirements
Ability to send notifications to members more timely to meet regulatory timing requirements
Payment Status
Provide Member with the current status of a payment on a Claim.
Sales appointment setting and reminders
Member appointment setting with service or sales agents in support of their buying process
Hardship Inquiry
Reach out to delinquent Borrowers with empathy to identify circumstances such as job loss, illness, divorce, deployment that may be eligible for relief measures.
Provider roster directory updates
Ability for any provider to update their roster information for provider directory accuracy
Chronic Kidney Disease CKD care management and navigation
Year-round support for members with Chronic Kidney Disease - including education, wellness, care gap closure, appointment setting
First Notice of Loss
Guide the Claimant through the process of reporting the death of a Policy Holder and filing a Claim.
Care education (chronic condition management)
Notifications to educate on the importance of chronic condition management, related appointment setting
Endorsements and Riders
Guide the Policy Holder through amending, adding, and removing lines of coverage to their existing policy.
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Behavioral Health care management and navigation
Year-round support for members with Behavioral Health conditions - including education, wellness, care gap closure, appointment setting
Digital Consent
Ability for Members to opt in to digital communications.
Prior Authorization transparency support
Ability for members to receive push notices for, or make inquiries about, prior authorization status
90-day fill conversion
Support for education and 90-day fill conversion
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
Pediatric preventative wellness
Ongoing pediatric preventative wellness education, appointment setting and other actions
Payment Status
Provide Policy Holder with the current status of a payment on a Claim.
Schedule Appointment
Schedule follow up call with Sales Representative with reminders and rescheduling.
Adult Preventative Wellness
Ongong adult preventative wellness education, appointment setting and other actions
Payment Status
Provide Borrower with the current status of a payment made to their account.
Policyholder After hours Support
Accurate, secure and compliant AI Agent Policy Holder inquiry and task completion support 24x7
Enrollment in mail order program and Rx transfers
Education on benefits of mail order delivery and Rx transfer support
Extraction (Critical Illness)
Extract Critical Illness related keys required for underwriting from structured Census files, semi-structured Prior Year Plans, and unstructured email body.
Pre visit preparation instructions
Sharing of pre visit preparation instructions with ability to automate answers to inquiries
Policy Renewal
Guide the Policy Holder through renewing their policy.
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.
Find a Provider
Patient support in finding in network doctors (of any type) that best fit their needs
Claim Status
Provide Member with the current status of a Claim.
Vaccination reminders, education, appointment scheduling, and paperwork
Overview of pharmacy supports and services
Overview of pharmacy support and services and population health and quality programs
Member information updates (i.e. add dependant)
Collection of member information updates such as adding dependants, changing address, etc
Disaster Preparedness
Proactively reach out to Policy Holders prior to a disaster, such as storm, wildfire, or flood and educate them on preparedness.
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.
