Redetermine every member accurately, on time
Ushur AI Agents close the gap ex parte cannot. When a renewal cannot be completed from available data, agents reach beneficiaries proactively, interpret and validate what they submit in real time, and complete the renewal in a single interaction. Agencies improve accuracy and timeliness without adding caseworker capacity or waiting on a multi-year system upgrade.
The 2027 problem: twice-yearly renewals, the same runway
Beginning in 2027, Medicaid expansion adults must move to six-month eligibility redeterminations. How does a program double its volume of verifications, outbound mail and return notices, document reviews, and caseworker follow-up — with the same staff and the same eligibility system?
The eligibility system itself is rarely the fastest and typically the most expensive and slowest approach to absorb that change. Core Medicaid eligibility platforms are vendor-built, deeply customized, and on multi-year change-request cycles — the opposite of what a January 2027 deadline needs.
The other cost states are already managing: returned mail
State Medicaid agencies estimate that roughly 15% of outbound letters are returned, at a cost of about $25 per returned piece — volume that has to be manually scanned, indexed, and chased down by staff who could be focused on higher-value work.
Ushur reduces that burden by shifting critical communications from physical mail to AI-powered digital engagement — validating and updating contact information in every interaction, reaching members first by SMS, email, voice, and digital channels, and automatically following up when a message goes unread.
A communication layer, not a system replacement
Ushur integrates with your existing eligibility system, connecting through its existing interfaces to verify data, generate notices, guide members through renewals, answer questions, automatically update their record, and upload required documentation — verifying data in real time to ensure accuracy at each step.
AI Agents make those interactions conversational and easier to complete across voice and digital channels. Members can speak naturally with an AI Agent while using a synchronized mobile screen for precise tasks such as confirming information, making selections, completing forms, and uploading documents — without switching channels or losing context.
~15%
of Medicaid letters are returned
~$25
per returned piece
No rip-and-replace
Your eligibility system keeps running exactly as it does today.
Weeks, not years
Deployed independent of any system upgrade cycle or IT roadmap.
Complete tasks accurately
Data verification and security run throughout, so every step is captured correctly the first time.
A voice-guided conversation, not a phone tree.
Most renewal workflows today are still built the way IVRs were built a decade ago: menu-driven, single-channel, and rebuilt from scratch every time a new channel is added. Ushur's approach is designed once and delivered consistently across voice, SMS, web, and email — with a natural, guided experience that keeps members on track from start to finish.
What it covers
Pre-built, proven-effective workflows and AI Agent support to guide Medicaid beneficiaries through the full redetermination process.
Verify & auto-renew
Real-time data matching against SSA, IRS/wage, and SAVE sources, with ex parte logic that closes eligible cases before a caseworker ever opens them.
Reach every member
Plain-language, multi-channel renewal notices and reminders — mail, email, SMS, IVR, and portal — with contact information validated and addresses corrected automatically so fewer notices come back undelivered.
Lighten the caseload
Document capture with OCR, deadline-based routing, and call-center tools so staff spend their time on the cases that actually need a person.
Stay audit-ready
Procedural-vs.-eligibility tracking, deadline monitoring, Marketplace/CHIP transfer, appeals tracking, and the reporting metrics CMS now expects as standard practice.
Access for all
Support members in 74 languages, with automatic language detection and ADA-accessible experiences.
Enterprise-grade governance
Configurable guardrails, human oversight, complete interaction records, and secure handling of PII and beneficiary data.
